The American journal of the medical sciences
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Review Case Reports
A rare case of spontaneous hemoperitoneum in a bone marrow transplant recipient on VV-ECMO.
A 53-year-old man with acute myeloid leukemia received an allogeneic hematopoietic cell transplant (HCT) from a matched unrelated donor. One month after his transplantation, he developed ARDS requiring initiation of VV-ECMO. He suffered from pancytopenia, managed with frequent transfusions, granulocyte-colony stimulating factor (G-CSF) and weekly thrombopoietin receptor agonist. ⋯ His family chose to discontinue ECMO and he passed away peacefully. Spontaneous splenic rupture after GM-CSF has never been reported in patients on VV-ECMO. This manuscript reviews the literature regarding the pathophysiology and clinical manifestation of this rare occurrence.
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Review Case Reports
Severe Hyponatremia Secondary to Syndrome of Inappropriate Antidiuretic Hormone (SIADH): A Rare Cause of Takotsubo (Stress) Cardiomyopathy.
Takotsubo cardiomyopathy is a reversible, stress-induced systolic abnormality of the left ventricular apex.1,2 It can carry significant morbidity and mortality for patients, largely due to associated complications that can occur in the acute setting. While it is most commonly linked with acute emotional or physical stressors, it is now recognized that many acute medical illnesses can precipitate the syndrome. Severe acute hyponatremia (<120 mmol/L) should be considered as a possible causative condition for Takotsubo cardiomyopathy, however reports of its occurrence in the literature are exceedingly rare.3-14 We present a case of a 73-year-old woman who was admitted for severe hyponatremia secondary to syndrome of inappropriate anti-diuretic hormone (SIADH) with a sodium level of 105 mmol/L and a concomitant diagnosis of Takotsubo cardiomyopathy, as well as a review of the epidemiology, pathophysiology, clinical features, diagnosis, treatment and clinical outcomes of Takotsubo cardiomyopathy.
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Review Case Reports
A Case of Winkia neuii (Actinomyces neuii) Vertebral Osteomyelitis and Review of the Literature.
This case report presents an unusual occurrence of Winkia (Actinomyces) neuii vertebral osteomyelitis in a 55-year-old male patient with diabetes mellitus. W. neuii is a distinct species formerly placed within the Actinomyces genus, exhibiting unique morphological and clinical characteristics. ⋯ The patient was successfully managed with a combination of intravenous ceftriaxone during hospitalization and an oral antibiotic regimen for an extended period. This case report contributes to the limited body of knowledge surrounding W. neuii, as well as actinomycotic vertebral osteomyelitis.
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Given the previously reported harmful effects of abdominal fat burden on kidney function, we aim to investigate the relationship between major adverse kidney events within 30 days (MAKE30) and abdominal obesity in acute necrotizing pancreatitis (ANP) patients and explore the underlying risk factors. ⋯ Early assessment of the VAT area may help identify ANP patients at high risk of MAKE30, suggesting that it could be a potential indicator for adverse kidney events.
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Primary biliary cirrhosis-idiopathic inflammatory myopathy (PBC-IIM) overlap syndrome (OS) is a rare condition in which cardiac involvement is observed. We aimed to characterize the clinical features and associated factors of PBC-IIM OS patients with cardiac involvement. ⋯ PBC-IIM OS has unique features. Typical clinical manifestations and early worsening cardiac indicators can be used to identify cardiac involvement and predict prognosis. Anti-Ro52 may have prognostic value for PBC-IIM OS.