Liver transplantation for fulminant hepatic failure in yellow phosphorus poisoning

Yellow phosphorus (YP) containing rodenticides is a readily available poison that may be accidentally or deliberately ingested, leading to symptoms ranging from simple gastrointestinal symptoms to fulminant hepatic failure, depending on the amount ingested. As there is no specific antidote, the treatment requires early gastric lavage and institution of supportive measures such as acetyl cysteine infusion and Vitamin K. Progression to fulminant hepatic failure is characterized by rapid deterioration of liver function tests, worsening coagulopathy, and sensorium. The only definitive treatment at this stage is a liver transplant and therapeutic plasma exchange (TPE) can serve as a bridge therapy until a compatible liver donor is found. We present a case of YP-containing rodenticide poisoning, in which the patient progressed to fulminant hepatic failure despite aggressive supportive therapy and was successfully managed with TPE until liver transplantation.

Pituitary carcinoid coexisting with systemic lupus erythematosus: A rare combination.

Gastrointestinal carcinoids have occasionally been reported in patients with autoimmune diseases. We report a middle-aged woman who presented with episodic hypertension and a skin rash. Initial evaluation led to the diagnosis of systemic lupus erythematosus for which the patient was treated. Further investigations revealed the presence of a carcinoid tumour in the pituitary. Although gastrointestinal carcinoids associated with autoimmune diseases have been seen occasionally, to our knowledge, extragastric carcinoid coexisting with an autoimmune disorder has never been reported before. A better understanding of how inflammation induces cytological changes leading to development of a carcinoid from a cellular and molecular perspective could provide potential therapeutic strategies for preventing these lesions. Natl Med J India 2016;29:209–11

Coexistence of chancroid and donovanosis in HIV with low CD4 count: a rare case.

Genital ulceration as a syndrome has been associated with increased transmission of HIV. The purpose of the present study is to establish skin diseases as clinical indicators of underlying immune status and help in clinical monitoring by estimating and correlating with low CD4 count. This study concludes that, cutaneous manifestations can be considered as good clinical indicators to predict and assess the underlying immune status and reviews the need to be aware of this entity.