Pub Date : 2024-02-03DOI: 10.32677/ijcr.v10i1.4352
Muhammad Arif Ozir, Syaratul Emma Hashim
Exposure keratopathy is a corneal damage that occurs from prolonged exposure of the ocular surface to the outside environment. Exposure keratopathy can lead to keratitis, ulceration, and cornea scarring. Lagophthalmos is the inability to close the eyelid completely and this leads to a portion of the eye remaining open and subject to cornea damage. Here, we describe the 72-year-old man with a case of exposure keratopathy secondary to facial nerve palsy with complications of cornea ulceration and scarring that cause permanent vision loss. We discuss difficult challenges during management from medical to surgical management.
{"title":"Exposure keratopathy secondary to lagophthalmos with facial nerve palsy – Challenges in management","authors":"Muhammad Arif Ozir, Syaratul Emma Hashim","doi":"10.32677/ijcr.v10i1.4352","DOIUrl":"https://doi.org/10.32677/ijcr.v10i1.4352","url":null,"abstract":"Exposure keratopathy is a corneal damage that occurs from prolonged exposure of the ocular surface to the outside environment. Exposure keratopathy can lead to keratitis, ulceration, and cornea scarring. Lagophthalmos is the inability to close the eyelid completely and this leads to a portion of the eye remaining open and subject to cornea damage. Here, we describe the 72-year-old man with a case of exposure keratopathy secondary to facial nerve palsy with complications of cornea ulceration and scarring that cause permanent vision loss. We discuss difficult challenges during management from medical to surgical management.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"398 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139807772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-03DOI: 10.32677/ijcr.v10i1.4341
S. Jangla
Onychomycosis is a common condition constituting fungal infection of nails. It is generally caused by dermatophytes but non-dermatophytic mold and yeast as its causative agent are on the rise. Acremonium, a non-dermatophytic mold, is commonly found in decaying vegetation, soil, and air. Identification of the causative agent is important as non-dermatophytic molds are resistant to commonly used antifungals. This is a case of an Indian woman who presented with onychomycosis of the toenail and the causative agent was documented and reported as Acremonium species.
{"title":"Onychomycosis caused by Acremonium species: A case report","authors":"S. Jangla","doi":"10.32677/ijcr.v10i1.4341","DOIUrl":"https://doi.org/10.32677/ijcr.v10i1.4341","url":null,"abstract":"Onychomycosis is a common condition constituting fungal infection of nails. It is generally caused by dermatophytes but non-dermatophytic mold and yeast as its causative agent are on the rise. Acremonium, a non-dermatophytic mold, is commonly found in decaying vegetation, soil, and air. Identification of the causative agent is important as non-dermatophytic molds are resistant to commonly used antifungals. This is a case of an Indian woman who presented with onychomycosis of the toenail and the causative agent was documented and reported as Acremonium species.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"43 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139867790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-03DOI: 10.32677/ijcr.v10i1.4354
Umer Hamid Wani, Saiyad Shah Alam
The thyroglossal duct cyst is one of the most common lesions in the midline of the neck and is found in around 7% of the population. They often present as painless neck swellings that move in response to tongue protrusion and during deglutition. We describe a case of thyroglossal duct cyst that was atypical in that the cyst was distant from the midline, it did not move in response to tongue protrusion, and the swelling was significant that resembled a colloid goiter. A 36-year-old male presented to the surgical outpatient department with a complaint of painless swelling in the neck for the past year. A 6.5×4.5 cm2 swelling was observed in the anterolateral aspect of the right side of the neck extending to the thyroid notch. Neck ultrasound and fine needle aspiration cytology showed features suggestive of a thyroglossal duct cyst. The patient was prepared for the Sistrunk procedure for thyroglossal duct cyst excision. The patient was on regular follow-up postoperatively for 6 months, and no evidence of any recurrence was seen.
{"title":"An immobile thyroglossal duct cyst with tongue protrusion: A case report","authors":"Umer Hamid Wani, Saiyad Shah Alam","doi":"10.32677/ijcr.v10i1.4354","DOIUrl":"https://doi.org/10.32677/ijcr.v10i1.4354","url":null,"abstract":"The thyroglossal duct cyst is one of the most common lesions in the midline of the neck and is found in around 7% of the population. They often present as painless neck swellings that move in response to tongue protrusion and during deglutition. We describe a case of thyroglossal duct cyst that was atypical in that the cyst was distant from the midline, it did not move in response to tongue protrusion, and the swelling was significant that resembled a colloid goiter. A 36-year-old male presented to the surgical outpatient department with a complaint of painless swelling in the neck for the past year. A 6.5×4.5 cm2 swelling was observed in the anterolateral aspect of the right side of the neck extending to the thyroid notch. Neck ultrasound and fine needle aspiration cytology showed features suggestive of a thyroglossal duct cyst. The patient was prepared for the Sistrunk procedure for thyroglossal duct cyst excision. The patient was on regular follow-up postoperatively for 6 months, and no evidence of any recurrence was seen.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139867793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gastrointestinal stromal tumors (GISTs) are rare tumors that constitute 1% of all GI tract tumors. Jejunal GISTs are the rarest subtype. We present a middle-aged gentleman, who presented with pain in the right lower abdomen. On abdominal examination, a lump was palpable in the right iliac fossa (RIF). Contrast-enhanced computed tomography of the abdomen revealed an extraluminal soft-tissue mass in the ileum. Computed Tomography-guided core needle biopsy from the lump was consistent with GIST, which was confirmed on immunohistochemistry. Mutation analysis revealed exon 11 mutations. Due to the proximity of GIST to the rectum and urinary bladder, the patient was started on imatinib therapy. After 3 months of treatment, imatinib therapy had to be stopped due to skin reactions. Restaging was done with a positron-emission tomography scan, which demonstrated a soft-tissue mass likely arising from the ileocecal region in the RIF abutting the ascending colon without any significant decrease in size. On exploration, a well-circumscribed mobile extraluminal lobulated mass was seen arising from the antimesenteric border of the jejunum. Histopathologic examination showed GIST, which was confirmed on immunohistochemistry. We report this case to emphasize keeping small bowel GIST as an unusual differential diagnosis of a RIF lump. Furthermore, not all patients can tolerate imatinib treatment, hence exon mutation study is important, and surgery should be considered if it is deemed resectable.
{"title":"A rare presentation of jejunal GIST: A case report","authors":"Pranjit Kalita, Arnab Gupta, Piyas Sengupta, Samir Bhattacharyya","doi":"10.32677/ijcr.v10i1.4347","DOIUrl":"https://doi.org/10.32677/ijcr.v10i1.4347","url":null,"abstract":"Gastrointestinal stromal tumors (GISTs) are rare tumors that constitute 1% of all GI tract tumors. Jejunal GISTs are the rarest subtype. We present a middle-aged gentleman, who presented with pain in the right lower abdomen. On abdominal examination, a lump was palpable in the right iliac fossa (RIF). Contrast-enhanced computed tomography of the abdomen revealed an extraluminal soft-tissue mass in the ileum. Computed Tomography-guided core needle biopsy from the lump was consistent with GIST, which was confirmed on immunohistochemistry. Mutation analysis revealed exon 11 mutations. Due to the proximity of GIST to the rectum and urinary bladder, the patient was started on imatinib therapy. After 3 months of treatment, imatinib therapy had to be stopped due to skin reactions. Restaging was done with a positron-emission tomography scan, which demonstrated a soft-tissue mass likely arising from the ileocecal region in the RIF abutting the ascending colon without any significant decrease in size. On exploration, a well-circumscribed mobile extraluminal lobulated mass was seen arising from the antimesenteric border of the jejunum. Histopathologic examination showed GIST, which was confirmed on immunohistochemistry. We report this case to emphasize keeping small bowel GIST as an unusual differential diagnosis of a RIF lump. Furthermore, not all patients can tolerate imatinib treatment, hence exon mutation study is important, and surgery should be considered if it is deemed resectable.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"429 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139807692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-03DOI: 10.32677/ijcr.v10i1.4345
Binod Kumar Behera, Payel Roy, Susmita Dora
With the advancement in family planning practices and shifting norms from “hum do hamare do” to “one child,” there still exist mothers who are delivering their 10th children. Such an example is a woman residing in an urban slum in the Khordha district of Odisha, India. She has never used any modern methods of contraception. Neither the health workers in that area could fulfill her unmet need for family planning. The helpless mother missed all the antenatal checkups as she did not have anyone to accompany her to the hospital. Three of her children were delivered at home and none of them were immunized to date. She has become a victim of domestic violence by her husband, who is addicted to alcohol. She has done two medical terminations of pregnancy due to non-usage of any contraception. Neither she is able to provide herself nor her children sufficient food every day, as she is not able to go to work in her post-partum period. Her alcoholic husband is not able to earn regularly and there is no other family member to support her. There is no Accredited Social Health Activist appointed for that area whom she can rely on. We need to look at what is the cause of such a scenario – Is it poverty, lack of awareness, lack of education, or our health system has failed to achieve universal health coverage.
随着计划生育实践的进步，以及从 "hum do hamare do "到 "one child "的规范转变，仍有一些母亲生下了自己的第 10 个孩子。居住在印度奥迪沙霍尔达区城市贫民窟的一位妇女就是这样一个例子。她从未使用过任何现代避孕方法。该地区的卫生工作者也无法满足她未得到满足的计划生育需求。由于没有人陪她去医院，这位无助的母亲错过了所有的产前检查。她的三个孩子都是在家分娩的，至今没有一个孩子接种过疫苗。她已成为酗酒丈夫家庭暴力的受害者。由于没有采取任何避孕措施，她已经做过两次医疗终止妊娠。由于产后无法工作，她无法每天为自己和孩子提供足够的食物。她酗酒的丈夫也无法正常赚钱，而且也没有其他家庭成员支持她。该地区没有指定她可以依赖的认可社会健康活动家。我们需要看看造成这种情况的原因是什么--是贫穷、缺乏认识、缺乏教育，还是我们的卫生系统未能实现全民医保。
{"title":"A grand multipara woman in the modern era: A case of public health dilemma from an urban slum","authors":"Binod Kumar Behera, Payel Roy, Susmita Dora","doi":"10.32677/ijcr.v10i1.4345","DOIUrl":"https://doi.org/10.32677/ijcr.v10i1.4345","url":null,"abstract":"With the advancement in family planning practices and shifting norms from “hum do hamare do” to “one child,” there still exist mothers who are delivering their 10th children. Such an example is a woman residing in an urban slum in the Khordha district of Odisha, India. She has never used any modern methods of contraception. Neither the health workers in that area could fulfill her unmet need for family planning. The helpless mother missed all the antenatal checkups as she did not have anyone to accompany her to the hospital. Three of her children were delivered at home and none of them were immunized to date. She has become a victim of domestic violence by her husband, who is addicted to alcohol. She has done two medical terminations of pregnancy due to non-usage of any contraception. Neither she is able to provide herself nor her children sufficient food every day, as she is not able to go to work in her post-partum period. Her alcoholic husband is not able to earn regularly and there is no other family member to support her. There is no Accredited Social Health Activist appointed for that area whom she can rely on. We need to look at what is the cause of such a scenario – Is it poverty, lack of awareness, lack of education, or our health system has failed to achieve universal health coverage.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139868318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diverticulosis is a common condition in the western world. It is often asymptomatic. However, its inflammation and the occurrence of its complications precipitate symptoms. Uncomplicated diverticulitis can be managed conservatively, most of the times. Complicated diverticulitis may need an endoscopic, interventional radiological, or surgical intervention. Herein, we report the case of a 53-year-old patient with complicated sigmoid diverticulitis, i.e., stricture caused by repetitive attacks of acute diverticulitis, who underwent a laparoscopic sigmoid colectomy followed by primary anastomosis.
{"title":"Laparoscopic sigmoid colectomy for diverticulitis – stricture: A case report with review of literature","authors":"Ravikumar Kalyanbhai Balar, Abhijit Sharadchandra Joshi","doi":"10.32677/ijcr.v10i1.4340","DOIUrl":"https://doi.org/10.32677/ijcr.v10i1.4340","url":null,"abstract":"Diverticulosis is a common condition in the western world. It is often asymptomatic. However, its inflammation and the occurrence of its complications precipitate symptoms. Uncomplicated diverticulitis can be managed conservatively, most of the times. Complicated diverticulitis may need an endoscopic, interventional radiological, or surgical intervention. Herein, we report the case of a 53-year-old patient with complicated sigmoid diverticulitis, i.e., stricture caused by repetitive attacks of acute diverticulitis, who underwent a laparoscopic sigmoid colectomy followed by primary anastomosis.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"386 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139807706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oral myiasis is a condition in which the soft tissues of different parts of the oral cavity are invaded by the parasitic larvae of flies known as maggots. Parasites causing myiasis belong to the order Diptera. Oral myiasis is often seen secondary to oral wounds, suppurative lesions, and extraction wounds, especially in individuals with neurological deficits. In such cases, neglected oral hygiene and halitosis attract the flies to lay eggs in oral wounds, resulting in oral myiasis. Hereby, we present the case of oral myiasis in a 45‑year‑old male patient who is immunocompetent and has a history of dental extraction.
{"title":"Rare case report of oral myiasis in immunocompetent patient","authors":"Shubham Aryan, Chavi Sharma, Naveen Kumar, Ravinder Garg, Himanshu Khutan, Jasmeen Chahal","doi":"10.32677/ijcr.v10i1.4343","DOIUrl":"https://doi.org/10.32677/ijcr.v10i1.4343","url":null,"abstract":"Oral myiasis is a condition in which the soft tissues of different parts of the oral cavity are invaded by the parasitic larvae of flies known as maggots. Parasites causing myiasis belong to the order Diptera. Oral myiasis is often seen secondary to oral wounds, suppurative lesions, and extraction wounds, especially in individuals with neurological deficits. In such cases, neglected oral hygiene and halitosis attract the flies to lay eggs in oral wounds, resulting in oral myiasis. Hereby, we present the case of oral myiasis in a 45‑year‑old male patient who is immunocompetent and has a history of dental extraction.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139808475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-03DOI: 10.32677/ijcr.v10i1.4342
Ratnesh Singh Kanwar, Kanika Kakkar
Celiac disease (CD) can be defined as an autoimmune chronic disorder in gluten-intolerant individuals producing malabsorption of nutrients and vitamins. The presence of CD in individuals causes an alteration in the absorption and pharmacokinetics of certain drugs. This poses a great challenge in maintaining serum thyrotropin levels in hypothyroidism patients on replacement therapy with levothyroxine (LT4). In this report, we present the case of a 39-year-old woman with hypothyroidism, pericardial effusion, and (previously unrecognized) CD. Our patient was a known case of hypothyroidism with a history of previous hospitalization for an episode of acute gastroenteritis. In our clinic, after an initial workup, the patient was continued on LT4 supplement, oral iron, and multivitamins. During her follow-up visit, when an anti-tissue transglutaminase IgA-positive report was available, a gluten-free diet was advised. Following this, the clinical condition of the patient improved drastically, accompanied by a fall in elevated thyroid-stimulating hormone (TSH) levels. This case highlights the necessity of understanding the etiology of rising serum TSH levels, hence ruling out malabsorption. Pericardial effusion, being a rare complication of hypothyroidism and CD, may lead to adverse cardiac events, hence resulting in hospitalization and patient disability.
乳糜泻（Celiac disease，CD）可被定义为一种自身免疫性慢性疾病，在麸质不耐受的人群中会导致营养和维生素吸收不良。CD 会改变某些药物的吸收和药代动力学。这给正在接受左甲状腺素（LT4）替代疗法的甲状腺功能减退症患者维持血清促甲状腺素水平带来了巨大挑战。在本报告中，我们介绍了一名患有甲状腺功能减退症、心包积液和（之前未被发现的）CD 的 39 岁女性病例。患者已知患有甲状腺功能减退症，曾因急性肠胃炎住院治疗。在我们诊所，经过初步检查后，患者继续服用LT4补充剂、口服铁剂和多种维生素。在随访期间，当获得抗组织转谷氨酰胺酶 IgA 阳性的报告时，我们建议她采用无麸质饮食。此后，患者的临床状况大为改善，同时促甲状腺激素（TSH）水平也有所下降。本病例强调了了解血清促甲状腺激素水平升高的病因的必要性，从而排除了吸收不良的可能性。心包积液是甲状腺功能减退症和CD的罕见并发症，可能会导致不良心脏事件，从而导致患者住院和残疾。
{"title":"Pericardial effusion in a patient of celiac disease and hypothyroidism: A case report","authors":"Ratnesh Singh Kanwar, Kanika Kakkar","doi":"10.32677/ijcr.v10i1.4342","DOIUrl":"https://doi.org/10.32677/ijcr.v10i1.4342","url":null,"abstract":"Celiac disease (CD) can be defined as an autoimmune chronic disorder in gluten-intolerant individuals producing malabsorption of nutrients and vitamins. The presence of CD in individuals causes an alteration in the absorption and pharmacokinetics of certain drugs. This poses a great challenge in maintaining serum thyrotropin levels in hypothyroidism patients on replacement therapy with levothyroxine (LT4). In this report, we present the case of a 39-year-old woman with hypothyroidism, pericardial effusion, and (previously unrecognized) CD. Our patient was a known case of hypothyroidism with a history of previous hospitalization for an episode of acute gastroenteritis. In our clinic, after an initial workup, the patient was continued on LT4 supplement, oral iron, and multivitamins. During her follow-up visit, when an anti-tissue transglutaminase IgA-positive report was available, a gluten-free diet was advised. Following this, the clinical condition of the patient improved drastically, accompanied by a fall in elevated thyroid-stimulating hormone (TSH) levels. This case highlights the necessity of understanding the etiology of rising serum TSH levels, hence ruling out malabsorption. Pericardial effusion, being a rare complication of hypothyroidism and CD, may lead to adverse cardiac events, hence resulting in hospitalization and patient disability.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"46 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139808631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oral myiasis is a condition in which the soft tissues of different parts of the oral cavity are invaded by the parasitic larvae of flies known as maggots. Parasites causing myiasis belong to the order Diptera. Oral myiasis is often seen secondary to oral wounds, suppurative lesions, and extraction wounds, especially in individuals with neurological deficits. In such cases, neglected oral hygiene and halitosis attract the flies to lay eggs in oral wounds, resulting in oral myiasis. Hereby, we present the case of oral myiasis in a 45‑year‑old male patient who is immunocompetent and has a history of dental extraction.
{"title":"Rare case report of oral myiasis in immunocompetent patient","authors":"Shubham Aryan, Chavi Sharma, Naveen Kumar, Ravinder Garg, Himanshu Khutan, Jasmeen Chahal","doi":"10.32677/ijcr.v10i1.4343","DOIUrl":"https://doi.org/10.32677/ijcr.v10i1.4343","url":null,"abstract":"Oral myiasis is a condition in which the soft tissues of different parts of the oral cavity are invaded by the parasitic larvae of flies known as maggots. Parasites causing myiasis belong to the order Diptera. Oral myiasis is often seen secondary to oral wounds, suppurative lesions, and extraction wounds, especially in individuals with neurological deficits. In such cases, neglected oral hygiene and halitosis attract the flies to lay eggs in oral wounds, resulting in oral myiasis. Hereby, we present the case of oral myiasis in a 45‑year‑old male patient who is immunocompetent and has a history of dental extraction.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"57 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139867970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-03DOI: 10.32677/ijcr.v10i1.4342
Ratnesh Singh Kanwar, Kanika Kakkar
Celiac disease (CD) can be defined as an autoimmune chronic disorder in gluten-intolerant individuals producing malabsorption of nutrients and vitamins. The presence of CD in individuals causes an alteration in the absorption and pharmacokinetics of certain drugs. This poses a great challenge in maintaining serum thyrotropin levels in hypothyroidism patients on replacement therapy with levothyroxine (LT4). In this report, we present the case of a 39-year-old woman with hypothyroidism, pericardial effusion, and (previously unrecognized) CD. Our patient was a known case of hypothyroidism with a history of previous hospitalization for an episode of acute gastroenteritis. In our clinic, after an initial workup, the patient was continued on LT4 supplement, oral iron, and multivitamins. During her follow-up visit, when an anti-tissue transglutaminase IgA-positive report was available, a gluten-free diet was advised. Following this, the clinical condition of the patient improved drastically, accompanied by a fall in elevated thyroid-stimulating hormone (TSH) levels. This case highlights the necessity of understanding the etiology of rising serum TSH levels, hence ruling out malabsorption. Pericardial effusion, being a rare complication of hypothyroidism and CD, may lead to adverse cardiac events, hence resulting in hospitalization and patient disability.
乳糜泻（Celiac disease，CD）可被定义为一种自身免疫性慢性疾病，在麸质不耐受的人群中会导致营养和维生素吸收不良。CD 会改变某些药物的吸收和药代动力学。这给正在接受左甲状腺素（LT4）替代疗法的甲状腺功能减退症患者维持血清促甲状腺素水平带来了巨大挑战。在本报告中，我们介绍了一名患有甲状腺功能减退症、心包积液和（之前未被发现的）CD 的 39 岁女性病例。患者已知患有甲状腺功能减退症，曾因急性肠胃炎住院治疗。在我们诊所，经过初步检查后，患者继续服用LT4补充剂、口服铁剂和多种维生素。在随访期间，当获得抗组织转谷氨酰胺酶 IgA 阳性的报告时，我们建议她采用无麸质饮食。此后，患者的临床状况大为改善，同时促甲状腺激素（TSH）水平也有所下降。本病例强调了了解血清促甲状腺激素水平升高的病因的必要性，从而排除了吸收不良的可能性。心包积液是甲状腺功能减退症和CD的罕见并发症，可能会导致不良心脏事件，从而导致患者住院和残疾。
{"title":"Pericardial effusion in a patient of celiac disease and hypothyroidism: A case report","authors":"Ratnesh Singh Kanwar, Kanika Kakkar","doi":"10.32677/ijcr.v10i1.4342","DOIUrl":"https://doi.org/10.32677/ijcr.v10i1.4342","url":null,"abstract":"Celiac disease (CD) can be defined as an autoimmune chronic disorder in gluten-intolerant individuals producing malabsorption of nutrients and vitamins. The presence of CD in individuals causes an alteration in the absorption and pharmacokinetics of certain drugs. This poses a great challenge in maintaining serum thyrotropin levels in hypothyroidism patients on replacement therapy with levothyroxine (LT4). In this report, we present the case of a 39-year-old woman with hypothyroidism, pericardial effusion, and (previously unrecognized) CD. Our patient was a known case of hypothyroidism with a history of previous hospitalization for an episode of acute gastroenteritis. In our clinic, after an initial workup, the patient was continued on LT4 supplement, oral iron, and multivitamins. During her follow-up visit, when an anti-tissue transglutaminase IgA-positive report was available, a gluten-free diet was advised. Following this, the clinical condition of the patient improved drastically, accompanied by a fall in elevated thyroid-stimulating hormone (TSH) levels. This case highlights the necessity of understanding the etiology of rising serum TSH levels, hence ruling out malabsorption. Pericardial effusion, being a rare complication of hypothyroidism and CD, may lead to adverse cardiac events, hence resulting in hospitalization and patient disability.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"72 3-4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139868371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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