Cases reported "Acute Disease"

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1/135. Acute anaphylaxis following midline catheterisation in a patient with cystic fibrosis.

    A 16 year old male with cystic fibrosis experienced an acute life threatening anaphylactic reaction following the insertion of an Ohmeda Hydrocath(TM) midline peripheral venous catheter. The catheter was immediately withdrawn and treatment with intravenous adrenaline, hydrocortisone, chlorpheniramine, and colloid over a 24 hour period resulted in a gradual resolution of symptoms.
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ranking = 1
keywords = adrenal
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2/135. Hemorrhagic adrenal cyst: an unusual reason of acute hypovolemia.

    Adrenal cysts are often asymptomatic and included in the larger "incidentaloma" group. They may reach significant size without onset of compressive symptoms and are often left undiagnosed until an ultrasound or CT scan are performed for a vague lumbar or flank discomfort. Intracystic hemorrhage is a rare but life-threatening complication since a sudden and significant blood loss may occur without any evident clinical source, hypovolemic shock resulting as the first symptom. The authors report their personal experience in two patients along with a review of the literature on this insidious emergency, its diagnosis and therapeutic approach.
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ranking = 4
keywords = adrenal
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3/135. Eosinophilic pneumonia and respiratory failure associated with venlafaxine treatment.

    Drugs are well known causes of eosinophilic lung disease. In many patients, symptoms increase slowly, pulmonary infiltrates and eosinophilia progress over weeks, and resolve upon withdrawal of the offending agent. Rarely, the disease presents like acute eosinophilic pneumonia with acute onset of symptoms and rapidly progressing infiltrates which may be associated with respiratory failure. This report describe a case of venlafaxine-induced acute eosinophilic pneumonia causing respiratory insufficiency that rapidly resolved upon institution of corticosteroid treatment. This 5-hydroxytryptamine and noradrenaline reuptake inhibitor was previously not known to cause lung or peripheral blood eosinophilia. Considering the increasing use of this class of medication physicians have to be aware of this life-threatening and fully reversible complication.
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ranking = 1
keywords = adrenal
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4/135. Cortical reorganization after acute unilateral hearing loss traced by fMRI.

    Unilateral acoustic stimulation produces a functional MRI (fMRI)-blood-oxygenation-level-dependent (BOLD) response mainly in the contralateral auditory cortex. In unilateral deaf patients, the BOLD response is bilateral. We studied a subject with sudden hearing loss after cochlear nerve resection before and repeatedly after surgery. During normal bilateral hearing, contralateral cortical BOLD responses were found. Progressing compensatory reorganization with bilateral representation of unilateral stimulation was detected over a period of approximately 1 year.
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ranking = 0.05821252892562
keywords = cortex
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5/135. 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.
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ranking = 2
keywords = adrenal
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6/135. Unilateral acute renal cortical necrosis: correlative imaging.

    Bilateral acute cortical necrosis is a rare form of acute renal failure characterized by necrosis of the renal cortex and sparing of the medulla. Little information on the imaging presentation of bilateral acute renal cortical necrosis is available. The enhanced CT appearance is pathognomonic and diagnostic. The unilateral presentation of acute cortical necrosis is extremely rare, and no imaging methods have been described. The authors chose to apply scintigraphic evaluation to this unique condition complementary to CT to confirm the diagnosis. Mercaptoacetylglycine (T3) was selected to assess tubular damage, in contrast to the pure glomerular agent DTPA. Evidence of some tubular function and clear delineation of the shrunken kidney was found. Conversely, in the DTPA study the kidney was not visualized. A DMSA scan was performed for assessment of viability of the renal cortex and showed a photopenic halo around the small area of the viable cortex of the upper pole. The halo sign represents a cortical loss. The visualization of the upper pole as evidence of cortical viability as a consequence of collateral blood flow from capsular vessels was seen on angiography. Radiographic and scintigraphic correlation of this rare condition may be an effective means to confirm the diagnosis and to establish the extent of involvement. However, contrast CT remains the preferred method in the diagnosis of acute cortical necrosis.
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ranking = 0.17463758677686
keywords = cortex
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7/135. Acute adrenal insufficiency after cardiac surgery.

    adrenal insufficiency after cardiac surgery can easily be confused during the course of an immediate unstable postoperative period. If unrecognized, this condition may cause serious morbidity and can be fatal. We report on a 43-yr-old female patient with chronic known adrenal insufficiency, who, despite her adequate preoperative replacement therapy, presented with one episode of acute hypoadrenal crisis after elective open heart surgery, which could serve as a model to illustrate the salient clinical features and possible problems in this setting for diagnosing this problem to patients in whom chronic adrenal insufficiency remains unknown.
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ranking = 7
keywords = adrenal
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8/135. Acute rhombencephalitis: neuroimaging evidence.

    Following a high fever, a healthy woman became comatose within a few days. Severe cerebellar symptoms appeared when she regained consciousness. The brain MRIs revealed abnormal signal intensity of the cerebellar cortex and brainstem gray matter, however, no abnormalities were revealed in the cerebral hemispheres. Acute inflammation due to direct viral or autoimmune involvement of the cerebellar and brainstem gray matter was a likely explanation and thus acute cerebellitis may in fact be a rhombencephalitis. Among the previous reports of acute cerebellar ataxia, this is perhaps one of the most profoundly affected cases and appears important for the understanding of the target of this particular form of encephalitis.
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ranking = 0.05821252892562
keywords = cortex
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9/135. Wernicke's encephalopathy induced by total parenteral nutrition in patient with acute leukaemia: unusual involvement of caudate nuclei and cerebral cortex on MRI.

    We report a 13-year-old girl with leukaemia and Wernicke's encephalopathy induced by total parenteral nutrition. MRI showed unusual bilateral lesions of the caudate nuclei and cerebral cortex, as well as typical lesions surrounding the third ventricle and aqueduct. After intravenous thiamine, the patient improved, and the abnormalities on MRI disappeared.
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ranking = 0.2910626446281
keywords = cortex
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10/135. Central retinal artery occlusion after a local anesthetic with adrenaline on nasal mucosa.

    The purpose of this article is to describe a 75-year-old patient with an acute central retinal artery occlusion after a local anesthetic with adrenaline on nasal mucosa. The local anesthetic was used in removing Jackson tubes from the left lacrimal canal. Occlusion of the central retinal artery related to nasal operations is a rare complication. In previous reports, retinal artery occlusions have been noted in connection with nasal submucosal injections of anesthetic and epinephrine. In our case, the use of anesthetic and adrenaline was superficial.
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ranking = 6
keywords = adrenal
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