F. Dursun, Erdal Akyar, G. Uygun, Z. Başlar, B. Çobanoğlu
Introduction: Isolated and combined factor deficiencies are known to occur in systemic primary amyloidosis. The most common factor deficiency known in these cases is isolated factor X deficiency. Other factor deficiencies are relatively less frequent. Isolated factor VII deficiency occurs very rarely in cases of systemic primary amyloidosis.Case report: A 58-year-old male patient previously presenting to another health center with complaints of generalized edema, fatigue, and itching had proteinuria and then he was diagnosed with systemic primary amyloidosis after the renal biopsy for proteinuria etiology. The patient’s laboratory tests showed prolongation of prothrombin time and factor VII deficiency. The patient responded well to the treatment for primary amyloidosis and factor VII deficiency.Discussion: In cases of systemic primary amyloidosis, if the etiology of prolonged prothrombin time involves no liver disease, warfarin use, or malabsorption, physicians should always keep in mind rare factor deficiencies such as factor VII deficiency, along with common factor deficiencies.
{"title":"Factor VII Deficiency in Systemic Primary Amyloidosis: A Rare Case","authors":"F. Dursun, Erdal Akyar, G. Uygun, Z. Başlar, B. Çobanoğlu","doi":"10.5430/CRIM.V5N4P28","DOIUrl":"https://doi.org/10.5430/CRIM.V5N4P28","url":null,"abstract":"Introduction: Isolated and combined factor deficiencies are known to occur in systemic primary amyloidosis. The most common factor deficiency known in these cases is isolated factor X deficiency. Other factor deficiencies are relatively less frequent. Isolated factor VII deficiency occurs very rarely in cases of systemic primary amyloidosis.Case report: A 58-year-old male patient previously presenting to another health center with complaints of generalized edema, fatigue, and itching had proteinuria and then he was diagnosed with systemic primary amyloidosis after the renal biopsy for proteinuria etiology. The patient’s laboratory tests showed prolongation of prothrombin time and factor VII deficiency. The patient responded well to the treatment for primary amyloidosis and factor VII deficiency.Discussion: In cases of systemic primary amyloidosis, if the etiology of prolonged prothrombin time involves no liver disease, warfarin use, or malabsorption, physicians should always keep in mind rare factor deficiencies such as factor VII deficiency, along with common factor deficiencies.","PeriodicalId":72533,"journal":{"name":"Case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5430/CRIM.V5N4P28","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48141604","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}
Galactorrhea is most commonly associated with elevated levels of prolactin; however, it does happen in individuals whose prolactin level is within normal range. Galactorrhea has been reported after neurosurgical procedures, cranial trauma or cerebral hemorrhage affecting the hypothalamus, pituitary or pituitary stalk, but these were associated with elevated levels of prolactin. In our knowledge, there has not been a case reported wherein a patient developed normoprolactinemic galactorrhea after an aneurysmal subarachnoid hemorrhage. The etiology and pathophysiology of normoprolactinemic galactorrhea have not been distinctly defined making this entity a diagnostic and therapeutic challenge for physicians.
{"title":"A case of normoprolactinemic galactorrhea following aneurysmal subarachnoid hemorrhage","authors":"E. Uy, K. Asadipooya","doi":"10.5430/CRIM.V6N1P8","DOIUrl":"https://doi.org/10.5430/CRIM.V6N1P8","url":null,"abstract":"Galactorrhea is most commonly associated with elevated levels of prolactin; however, it does happen in individuals whose prolactin level is within normal range. Galactorrhea has been reported after neurosurgical procedures, cranial trauma or cerebral hemorrhage affecting the hypothalamus, pituitary or pituitary stalk, but these were associated with elevated levels of prolactin. In our knowledge, there has not been a case reported wherein a patient developed normoprolactinemic galactorrhea after an aneurysmal subarachnoid hemorrhage. The etiology and pathophysiology of normoprolactinemic galactorrhea have not been distinctly defined making this entity a diagnostic and therapeutic challenge for physicians.","PeriodicalId":72533,"journal":{"name":"Case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5430/CRIM.V6N1P8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42078750","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}
C. Anjo, H. Campos, Sofia Narciso, G. Silva, F. Duarte
ANCA - associated Vasculitis (AAV) positive biopsy is supportive of vasculitis diagnosis, the aim of this manuscript is that renal biopsy is not always compulsory in the diagnosis and management of AAV. 79 years old, Caucasian women, admitted with AAV suspicion, MPO positive. A Microscopic polyangiitis with a pulmonary – renal syndrome was diagnosed after other AAV were excluded. Remission induction and maintenance therapy was made. In 6 months the patient presented a considerable improvement with lower MPO value, ESR and a stabilization of kidney function. Renal biopsy has to be performed in the majority of patients with the suspicion or renal AAV, although in this case it was not performed considering that the patient was on chronic anticoagulation and renal biopsy was not essential for the diagnosis. We suggest that renal biopsy is a valuable method in establishes the aetiology of kidney disease and that it could be dismissed in AAV with suggestive clinical presentation and low suspicion for secondary vasculitis.
{"title":"Biopsy utility in the workup of ANCA-associated vasculitis","authors":"C. Anjo, H. Campos, Sofia Narciso, G. Silva, F. Duarte","doi":"10.5430/CRIM.V6N1P5","DOIUrl":"https://doi.org/10.5430/CRIM.V6N1P5","url":null,"abstract":"ANCA - associated Vasculitis (AAV) positive biopsy is supportive of vasculitis diagnosis, the aim of this manuscript is that renal biopsy is not always compulsory in the diagnosis and management of AAV. 79 years old, Caucasian women, admitted with AAV suspicion, MPO positive. A Microscopic polyangiitis with a pulmonary – renal syndrome was diagnosed after other AAV were excluded. Remission induction and maintenance therapy was made. In 6 months the patient presented a considerable improvement with lower MPO value, ESR and a stabilization of kidney function. Renal biopsy has to be performed in the majority of patients with the suspicion or renal AAV, although in this case it was not performed considering that the patient was on chronic anticoagulation and renal biopsy was not essential for the diagnosis. We suggest that renal biopsy is a valuable method in establishes the aetiology of kidney disease and that it could be dismissed in AAV with suggestive clinical presentation and low suspicion for secondary vasculitis.","PeriodicalId":72533,"journal":{"name":"Case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5430/CRIM.V6N1P5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48206406","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}
E. Trejo, C. Le, G. Weinstein, Patrick Barr, M. Feldman
Swyer-James-MacLeod Syndrome (SJMS) is a rare, unilateral lung disease represented by radiographic translucency of the lung parenchyma secondary to the diminution of the pulmonary vasculature and to the overdistention of the alveoli. It is an uncommon sequela of post-infectious bronchiolitis obliterans (BO) in childhood. Patients with SJMS are often diagnosed in childhood and typically present with recurrent respiratory tract infections. Symptoms during childhood can be mild or absent, leading to a delayed diagnosis in adulthood. SJMS is characterized by the destruction of the small bronchioles and agenesis or hypoplasia of the pulmonary arteries leading to hypoperfusion of the pulmonary parenchyma, resulting in characteristic chest imaging findings of unilateral hyperlucency or translucence.Swyer and James first described this syndrome in 1953. It is a rare disease that can be can be caused by an infection with adenoviruses (types 3, 7, or 21) or Bordetella pertussis, a foreign body in the airway and hydrocarbon inhalation. We present a case of SJMS in whom the adult patient had been misdiagnosed with chronic obstructive pulmonary disease (COPD). She was eventually diagnosed with SJMS based on chest x-ray and chest CT findings of unilateral lung hyperlucency, as well as with scintigraphic findings showing virtually absent perfusion to the left lower lobe of the lung.
{"title":"Swyer-James-MacLeod Syndrome: A case report in an adult and review of the literature","authors":"E. Trejo, C. Le, G. Weinstein, Patrick Barr, M. Feldman","doi":"10.5430/CRIM.V5N4P23","DOIUrl":"https://doi.org/10.5430/CRIM.V5N4P23","url":null,"abstract":"Swyer-James-MacLeod Syndrome (SJMS) is a rare, unilateral lung disease represented by radiographic translucency of the lung parenchyma secondary to the diminution of the pulmonary vasculature and to the overdistention of the alveoli. It is an uncommon sequela of post-infectious bronchiolitis obliterans (BO) in childhood. Patients with SJMS are often diagnosed in childhood and typically present with recurrent respiratory tract infections. Symptoms during childhood can be mild or absent, leading to a delayed diagnosis in adulthood. SJMS is characterized by the destruction of the small bronchioles and agenesis or hypoplasia of the pulmonary arteries leading to hypoperfusion of the pulmonary parenchyma, resulting in characteristic chest imaging findings of unilateral hyperlucency or translucence.Swyer and James first described this syndrome in 1953. It is a rare disease that can be can be caused by an infection with adenoviruses (types 3, 7, or 21) or Bordetella pertussis, a foreign body in the airway and hydrocarbon inhalation. We present a case of SJMS in whom the adult patient had been misdiagnosed with chronic obstructive pulmonary disease (COPD). She was eventually diagnosed with SJMS based on chest x-ray and chest CT findings of unilateral lung hyperlucency, as well as with scintigraphic findings showing virtually absent perfusion to the left lower lobe of the lung.","PeriodicalId":72533,"journal":{"name":"Case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5430/CRIM.V5N4P23","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46929789","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}
Shekhawat Ravindra Singh, Lim Winston Eng Hoe, Yong Kok Pin, D. Silva, Sonu Kumar Sumit
Pulsatile tinnitus is an uncommon presenting symptom and is perceived to be repetitively synchronous with the patient’s heartbeat. Prompt recognition of this rare symptom and subsequent early identification of the underlying etiology is essential for timely management to prevent potentially major complications. Here we highlight a case of a middle-aged female who presented with symptom of ‘heartbeat in the head’ and was later found to have left dural arteriovenous fistula.
{"title":"“Heartbeat in the head”–An atypical presentation of Dural Arteriovenous Malformation","authors":"Shekhawat Ravindra Singh, Lim Winston Eng Hoe, Yong Kok Pin, D. Silva, Sonu Kumar Sumit","doi":"10.5430/CRIM.V5N4P19","DOIUrl":"https://doi.org/10.5430/CRIM.V5N4P19","url":null,"abstract":"Pulsatile tinnitus is an uncommon presenting symptom and is perceived to be repetitively synchronous with the patient’s heartbeat. Prompt recognition of this rare symptom and subsequent early identification of the underlying etiology is essential for timely management to prevent potentially major complications. Here we highlight a case of a middle-aged female who presented with symptom of ‘heartbeat in the head’ and was later found to have left dural arteriovenous fistula.","PeriodicalId":72533,"journal":{"name":"Case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5430/CRIM.V5N4P19","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45540651","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}
Glutamic acid decarboxylase (GAD) is becoming increasingly recognised as an antigenic target in autoimmune disorders of the central nervous system. There are currently no reports of weight loss being a manifestation in such disorders. We describe two cases of anti-GAD associated neurological disorders with profound and otherwise unexplained weight loss. Both patients had incomplete response to immunotherapy, as is becoming typical of these disorders. The variable disease associations of anti-GAD antibodies is incompletely understood, and leads us to question whether weight loss in these patients could possibly be immune-mediated.
{"title":"Case reports of unexplained weight loss in autoimmune central neurological syndromes with anti-GAD antibodies","authors":"J. Broadley, M. Monif","doi":"10.5430/CRIM.V6N2P5","DOIUrl":"https://doi.org/10.5430/CRIM.V6N2P5","url":null,"abstract":"Glutamic acid decarboxylase (GAD) is becoming increasingly recognised as an antigenic target in autoimmune disorders of the central nervous system. There are currently no reports of weight loss being a manifestation in such disorders. We describe two cases of anti-GAD associated neurological disorders with profound and otherwise unexplained weight loss. Both patients had incomplete response to immunotherapy, as is becoming typical of these disorders. The variable disease associations of anti-GAD antibodies is incompletely understood, and leads us to question whether weight loss in these patients could possibly be immune-mediated.","PeriodicalId":72533,"journal":{"name":"Case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5430/CRIM.V6N2P5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47423853","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}
Renal oncocytomas are benign tumors representing 3% to 7% of primary renal neoplasms. Oncocytomas are often asymptomatic, discovered incidentally on routine radiological imaging. We report a giant renal oncocytoma in a 68-year-old male with chronic kidney disease. Patient had right upper quadrant pain and hematoma. The mass was palpable on physical exam. CT scan showed a 16 cm × 14 cm right renal mass, consistent with renal cell carcinoma, no major adenopathy, no renal vein invasion. Right radical nephrectomy was performed and histological examination was consisted with oncocytoma.
肾嗜瘤细胞瘤为良性肿瘤，占原发性肾肿瘤的3% ~ 7%。嗜瘤细胞瘤通常无症状，是在常规影像学检查中偶然发现的。我们报告一例68岁男性慢性肾脏疾病的巨大肾嗜瘤细胞瘤。患者有右上腹疼痛和血肿。体格检查时可摸到肿块。CT示右肾16 cm × 14 cm肿块，符合肾细胞癌，无重大腺病，无肾静脉浸润。行右侧根治性肾切除术，组织学检查为癌细胞瘤。
{"title":"Giant renal oncocytoma presenting with right flank pain and hematoma","authors":"Robert Zakhia El Doueihi, M. Bulbul","doi":"10.5430/CRIM.V5N4P13","DOIUrl":"https://doi.org/10.5430/CRIM.V5N4P13","url":null,"abstract":"Renal oncocytomas are benign tumors representing 3% to 7% of primary renal neoplasms. Oncocytomas are often asymptomatic, discovered incidentally on routine radiological imaging. We report a giant renal oncocytoma in a 68-year-old male with chronic kidney disease. Patient had right upper quadrant pain and hematoma. The mass was palpable on physical exam. CT scan showed a 16 cm × 14 cm right renal mass, consistent with renal cell carcinoma, no major adenopathy, no renal vein invasion. Right radical nephrectomy was performed and histological examination was consisted with oncocytoma.","PeriodicalId":72533,"journal":{"name":"Case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5430/CRIM.V5N4P13","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48119064","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}
Jack Xu, S. Verga, J. Stoll, Lauren Pioppo, E. Shanahan, W. Khan
Introduction: Statins have been shown to effectively prevent both cardiovascular morbidity and mortality by inhibiting the hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase enzyme. Pulmonary complications are very rare, and can include pneumonitis, pleural effusion, and nonspecific interstitial pneumonia (NSIP). There have been very few previously documented cases of statin-induced fibrotic NSIP.Case report: We present a female with a history of hyperlipidemia on atorvastatin who presented with shortness of breath. Computed tomography scan of the chest revealed interstitial infiltrates with bilateral ground-glass opacities. She underwent a surgical lung biopsy which showed uniform fibrous alveolar septal thickening, scattered collections of alveolar macrophages and inflammation, along with areas of fibrosis. The findings were most suggestive of fibrotic NSIP. Atorvastatin was stopped and she was started on mycophenolic acid with improvement of her symptoms.Discussion: Although rare, the clinician should be aware of possible pulmonary complications of statin therapy. The exact mechanism of injury is unclear, however immunological or toxicological mechanisms are implicated. One case series of statin induced interstitial lung disease showed some improvement of dyspnea with systemic glucocorticoids and termination of statin therapy. Statins, specifically pravastatin, lovastatin, and simvastatin have been associated with drug induced pneumonitis and interstitial lung disease.
{"title":"Nonspecific interstitial pneumonia: A rare adverse reaction of atorvastatin","authors":"Jack Xu, S. Verga, J. Stoll, Lauren Pioppo, E. Shanahan, W. Khan","doi":"10.5430/CRIM.V5N4P16","DOIUrl":"https://doi.org/10.5430/CRIM.V5N4P16","url":null,"abstract":"Introduction: Statins have been shown to effectively prevent both cardiovascular morbidity and mortality by inhibiting the hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase enzyme. Pulmonary complications are very rare, and can include pneumonitis, pleural effusion, and nonspecific interstitial pneumonia (NSIP). There have been very few previously documented cases of statin-induced fibrotic NSIP.Case report: We present a female with a history of hyperlipidemia on atorvastatin who presented with shortness of breath. Computed tomography scan of the chest revealed interstitial infiltrates with bilateral ground-glass opacities. She underwent a surgical lung biopsy which showed uniform fibrous alveolar septal thickening, scattered collections of alveolar macrophages and inflammation, along with areas of fibrosis. The findings were most suggestive of fibrotic NSIP. Atorvastatin was stopped and she was started on mycophenolic acid with improvement of her symptoms.Discussion: Although rare, the clinician should be aware of possible pulmonary complications of statin therapy. The exact mechanism of injury is unclear, however immunological or toxicological mechanisms are implicated. One case series of statin induced interstitial lung disease showed some improvement of dyspnea with systemic glucocorticoids and termination of statin therapy. Statins, specifically pravastatin, lovastatin, and simvastatin have been associated with drug induced pneumonitis and interstitial lung disease.","PeriodicalId":72533,"journal":{"name":"Case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5430/CRIM.V5N4P16","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48558850","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}
Treatment of cancer patients with olaparib (PARP inhibitor) is associated with an increased risk of anemia, which is seen in a majority of treated patients. However, symptomatic anemia requiring transfusion is rare. Olaparib-induced anemia can be secondary to bone marrow suppression, hemolysis or folate deficiency. We report a case of new onset severe folic acid deficiency anemia in a patient with breast and relapsed fallopian tube cancer being treated with olaparib. Complete blood count on admission showed a hemoglobin of 4.2 g/dl and serum folate was undetectable (< 1.6 ng/ml; reference range 7-31.4 ng/ml). This is the second report of olaparib-induced folate deficiency anemia. She received three units packed red cell transfusion and parenteral folic acid supplementation and improved symptomatically. This case highlights the importance of recognizing folate deficiency as a reversible cause of anemia with PARP inhibitor therapy.
{"title":"Severe folate deficiency anemia associated with the use of a PARP inhibitor (olaparib) in a patient with fallopian tube cancer","authors":"B. Yohannan, K. McIntyre, M. Feldman","doi":"10.5430/CRIM.V6N1P1","DOIUrl":"https://doi.org/10.5430/CRIM.V6N1P1","url":null,"abstract":"Treatment of cancer patients with olaparib (PARP inhibitor) is associated with an increased risk of anemia, which is seen in a majority of treated patients. However, symptomatic anemia requiring transfusion is rare. Olaparib-induced anemia can be secondary to bone marrow suppression, hemolysis or folate deficiency. We report a case of new onset severe folic acid deficiency anemia in a patient with breast and relapsed fallopian tube cancer being treated with olaparib. Complete blood count on admission showed a hemoglobin of 4.2 g/dl and serum folate was undetectable (< 1.6 ng/ml; reference range 7-31.4 ng/ml). This is the second report of olaparib-induced folate deficiency anemia. She received three units packed red cell transfusion and parenteral folic acid supplementation and improved symptomatically. This case highlights the importance of recognizing folate deficiency as a reversible cause of anemia with PARP inhibitor therapy.","PeriodicalId":72533,"journal":{"name":"Case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5430/CRIM.V6N1P1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46454639","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}
Y. Hailemariam, Olufolahan Carrena, D. Eshun, Henry E. Okafor
Takotsubo cardiomyopathy is also known as stress induced cardiomyopathy and transient left ventricular apical ballooning syndrome. There have been few case reports where hyponatremia was implicated as a trigger for stress-induced cardiomyopathy. We report the unusual case of a 79-year-old African American woman without any discernible recent stressors who presented atypically with generalized fatigue and was found to have severe hyponatremia (from chronic alcohol use and thiazide diuretics) and significantly elevated Troponin. Her echocardiogram and cardiac catheterization revealed typical features of apical ballooning syndrome.
{"title":"Apical ballooning (Takotsubo) syndrome in the setting of chronic alcohol-induced hyponatremia","authors":"Y. Hailemariam, Olufolahan Carrena, D. Eshun, Henry E. Okafor","doi":"10.5430/CRIM.V5N4P10","DOIUrl":"https://doi.org/10.5430/CRIM.V5N4P10","url":null,"abstract":" Takotsubo cardiomyopathy is also known as stress induced cardiomyopathy and transient left ventricular apical ballooning syndrome. There have been few case reports where hyponatremia was implicated as a trigger for stress-induced cardiomyopathy. We report the unusual case of a 79-year-old African American woman without any discernible recent stressors who presented atypically with generalized fatigue and was found to have severe hyponatremia (from chronic alcohol use and thiazide diuretics) and significantly elevated Troponin. Her echocardiogram and cardiac catheterization revealed typical features of apical ballooning syndrome.","PeriodicalId":72533,"journal":{"name":"Case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5430/CRIM.V5N4P10","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44581288","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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