Thyrotoxic Neuropathy - A Case Report

Thyrotoxic neuropathy is a rare entity in literature. The association between thyrotoxicosis and neuropathy is under-recognized. We here present a rare case report in which patient was presented with ascending sensory-motor paralysis coupled with respiratory muscle weakness which closely resembles Guillain–Barré syndrome (GBS). But relevant history suggested thyrotoxic features, thus a timely focused investigation revealed the diagnosis. It was confirmed in nerve conduction studies (NCS) and other necessary investigations ruled out other differential diagnosis. Patient was treated with anti-thyroid drugs. On follow up patient’s power improved and NCS after 6 months came out to be normal which established the diagnosis. Thyrotoxic neuropathy is a close differential diagnosis of LGBS and other commonly encountered neuroparalytic illnesses. So high degree of suspicion is needed to diagnose this potentially treatable neuropathy

Rheumatoid Arthritis 1st Time Presenting With Bilateral Pleural Effusion- A Rare Presentation

Rheumatoid arthritis is the most common chronic autoimmune disorder involving joints and extra-axial system. Varied presentations have been described in the literature. Pulmonary involvement is also common. Inflammatory pleural effusions are an uncommon complication and are rarely seen in about 2% to 5% of patients with rheumatoid arthritis. Here, we present an interesting case where the patient presented with bilateral pleural effusion early in the disease. On further evaluation of the patient and the pleural fluid, it was found to be consistent with pleural effusion secondary to rheumatoid arthritis. The patient responded to oral non-steroidal anti-inflammatory drugs along with disease-modifying agents

Pulmonary Embolism As Presenting Feature Of Membranous Nephropathy Induced Nephrotic Syndrome

Severe pulmonary embolism as first-time presentation of Nephrotic syndrome is rare but Nephrotic syndrome secondary to membranous nephropathy (MN) may impose a greater thrombotic risk for unclear reasons. Here, we report the case of a 36-year-old female patient presented with complaints of sudden onset of shortness of breath since 4-5 days and features of right-sided heart failure. There was no preceding history of any chronic disease or renal disease. She was diagnosed as having a bilateral severe pulmonary embolism. Extensive workup and renal biopsy were done which was suggestive of primary membranous nephropathy.