1/6. Acute watery diarrhea as the initial presenting feature of a pheochromocytoma in an 84-year-old female patient.We report the case of an 84-year-old woman who was initially admitted to the emergency room of our institution for frank dehydration caused by acute and severe secretory diarrheas along with acidosis and hypokalemia. After extensive gastrointestinal investigations, the etiology of the diarrhea remained unclear. Because clinical symptoms and ionogram parameters worsened, despite intravenous fluids and electrolyte replacement, an abdominal CT scan was performed and unexpectedly revealed a 4.5-cm mass in the right adrenal gland. Several separate 24-hour urine catecholamines were shown to be highly elevated. The diagnosis of pheochromocytoma was confirmed by MIBG scintigraphy and MRI. Before the admission, the patient never experienced symptoms suggestive of pheochromocytoma, except dry mouth and fear of impending death on several occasions. After 2 weeks, the diarrhea stopped abruptly and spontaneously without specific medication but after adequate rehydration. The patient subsequently underwent surgical removal of the adrenal medullary mass. Postoperatively, urinary catecholamines returned to normal values. Immunohistochemical study of the tumor confirmed the diagnosis of pheochromocytoma and revealed the presence of VIP-positive cells organized as islets in scattered areas of the tissue. This case illustrates the protean mode of presentation of pheochromocytoma, as well as the ability of medullary neural crest-derived cells to produce various neuropeptides potentially responsible for a large variety of symptoms.- - - - - - - - - - ranking = 1keywords = europe (Clic here for more details about this article) |
2/6. Acute pleuropericarditis after coronary stenting: a case report.A case of acute pleuropericarditis, which occurred after apparently successful percutaneous coronary intervention (PCI) for chronic total occlusion of the right coronary artery, is reported. The patient underwent coronary stenting without any immediate signs of complications. However, he had an acute onset of chest pain with fever which happened 4 h after PCI. He was diagnosed with acute pleuropericarditis by blood tests, electrocardiogram, chest X-ray, and echocardiogram. He rapidly recovered by intravenous hydrocortisone followed by oral prednisone administrations and percutaneous catheter pericardial drainage. Acute pleuropericarditis relevant to post-cardiac injury syndrome with an atypically early onset might have occurred in this case as a rare complication of PCI.- - - - - - - - - - ranking = 7keywords = europe (Clic here for more details about this article) |
3/6. Tropical myositis with pleuropericardial effusion and anterior uveitis.An unusual patient of tropical pyomyositis, who developed pleuropericardial effusion and anterior uveitis, is described. Such complications of this disease have not been reported in the literature reviewed.- - - - - - - - - - ranking = 5keywords = europe (Clic here for more details about this article) |
4/6. pericardial effusion as an early complication of acute myocardial infarction.Two days after an acute myocardial infarction, a patient developed pleuropericarditis. A negative lung scan and echocardiographic evidence of pericardial effusion were instrumental in making the diagnosis. Steroid therapy led to a dramatic resolution of the signs and symptoms. pericardial effusion is usually a late complication of myocardial infarction (Dressler's syndrome), but the increasing use of echocardiography may demonstrate that it occurs early in the course.- - - - - - - - - - ranking = 1keywords = europe (Clic here for more details about this article) |
5/6. Pleuropericardial reaction to treatment with dantrolene.Chronic pleural effusion occurred in three patients, one of whom also developed acute pericarditis. A fourth patient developed both pleural and pericardial effusions. All patients had been receiving dantrolene sodium for at least two months. The pleural fluid was a sterile exudate with pleural and peripheral blood eosinophilia in all patients. No pulmonary parenchymal involvement was apparent. Pleural biopsy specimens showed nonspecific inflammation. Resolution of the pleural process was prolonged after dantrolene therapy was discontinued. Although a causal relationship between dantrolene and serosal inflammation remains unproved, this association in four patients warrants careful observation of others receiving long-term dantrolene therapy.- - - - - - - - - - ranking = 4keywords = europe (Clic here for more details about this article) |
6/6. Chronic monoarticular arthritis and acute pericardial tamponade in a child with Crohn's disease.We describe a 7-year-old child who developed right knee arthritis unresponsive to nonsteroidal anti-inflammatory drug therapy. Additional rheumatologic disorders including pleuropericardial effusion with tamponade supervened before the recognition of Crohn's disease involving the colon. Suppression of all sites of inflammation resulted from corticosteroid therapy. Aspects of diagnosis and treatment of these extraintestinal components of inflammatory bowel disease are discussed.- - - - - - - - - - ranking = 1keywords = europe (Clic here for more details about this article) |