ABSTRACT
Primary aldosteronism is a clinical syndrome of muscle weakness, hypertension and hypokalemia due to excess secretion of mineralocorticoid by the adrenal gland. In primary adlosteronism, muscle weakness is often caused by excess secretion of aldosterone, however, to our knowledge there have been no case reports rhabdomyolysis due to severe hypokalemia in domestic cases. A fifty-eight year old female who presented with myalgia was admitted into the hospital. Initial laboratory values demonstrate marked hypokalemia with elevated creatinine kinase and LDH. Also, her urine myoglobin was positive and plasma renin activity level was decreased and serum aldosterone level was increased. Owing to a high clinical suspicion of primary aldosteronism, an abdominal CT scan was performed revealing 1.6 cm sized mass in the right adrenal gland. After surgery, her blood pressure was normalized and serum potassium level was maintained to normal range without potassium replacement therapy. She is now in outpatient care under close follow-up. We report a case of a patient with paralysis of both lower extremities and myalgia, who later found to have primary aldosteronism with rhabdomyolysis due to severe hypokalemia.
Subject(s)
Female , Humans , Adrenal Glands , Aldosterone , Ambulatory Care , Blood Pressure , Creatinine , Follow-Up Studies , Hyperaldosteronism , Hypertension , Hypokalemia , Lower Extremity , Muscle Weakness , Myalgia , Myoglobin , Paralysis , Phosphotransferases , Plasma , Potassium , Reference Values , Renin , Rhabdomyolysis , Tomography, X-Ray ComputedABSTRACT
Trichosporon beigelii is a causative agent of white piedra, an superficial hair shaft infection in immunocompetent individuals, and rarely of disseminated trichosporonosis in immunocompromised patients especially in neutropenic patients with leukemia. Trichosporon infections in immunocompromised patients are frequently fatal despite therapy with amphotericin B. We describe an acute myelogenous leukemia patient with T. beigelii fungemia after remission induction chemotherapy who was successfully treated with amphotericin B and fluconazole.
Subject(s)
Humans , Amphotericin B , Drug Therapy , Fluconazole , Fungemia , Hair , Immunocompromised Host , Leukemia , Leukemia, Myeloid, Acute , Neutropenia , Piedra , Remission Induction , Trichosporon , TrichosporonosisABSTRACT
BACKGROUND: The criteria set by the International Society on Thrombosis and Hemostasis (ISTH) with the criteria of the Korean Society on Thrombosis and Hemostasis (KSTH) for the diagnosis of DIC was compared to evaluate the agreement between two criteria and the characteristics of each criteria. METHODS: Two hundred ninety-six adult patients with sepsis (57 pneumonia, 75 hepatobiliary and gastrointestinal infection, 25 urinary tract infection, 51 infection associated with malignant diseases and 84 other causes) were studied. The rate of agreement in the diagnosis of DIC by the two diagnostic systems was analyzed. Characteristics of each criteria was also analyzed by the comparison of laboratory criteria. RESULTS: The kappa coefficient and concordance rate, agreement parameters in the diagnosis of DIC by the two diagnostic systems was 0.78 and 89.5%, respectively. The median platelet count was lower and FDP level was higher in the patients diagnosed by ISTH criteria than in patients diagnosed by KSTH criteria. CONCLUSION: The agreement between ISTH and KSTH criteria was significantly high.
Subject(s)
Adult , Humans , Dacarbazine , Diagnosis , Disseminated Intravascular Coagulation , Hemostasis , Platelet Count , Pneumonia , Sepsis , Thrombosis , Urinary Tract InfectionsABSTRACT
Thrombosis is one of the important complications in nephrotic syndrome and related to the hypercoagulable state of the nephrotic syndrome, although the exact mechanism is under the debate. While venous trombosis is frequently encountered, arterial thrombosis is rare. Renal vein thrombosis occurs frequently in the patients with nephrotic syndrome due to membranous glomerulonephritis (MGN), membranoproliferative glomerulonephritis (MPGN). It, however, rarely happens in IgA nephropathy. Intracardiac thrombus in the nephrotic syndrome have been described few in the earlier literatures. We reported a case of IgA nephropathy with LV thrombus and cerebral infarction that has been treated successfully with thrombolytic theraphy. So far, the patient on the outpatient clinics have reported no specific complaints.