Acute liver failure secondary to chronic lymphocytic leukemia

Chronic lymphocytic leukemia is an indolent malignancy of lymphocytes commonly seen in elderly. Dissemination of malignancy is a rare cause of acute liver failure and has rarely been reported. Here we describe the case of a sixty five year old male presenting with acute liver failure. He is a diabetic with no known history of seropositive hepatitis, drug intake or any addictions. Bone marrow and liver biopsy suggestive of chronic lymphocytic leukemia. He eventually succumbed to his illness.

Deep vein thrombosis in patient with pulmonary tuberculosis: a rare and interesting causative link?

Pulmonary tuberculosis is a devastating disease affecting millions of people in developing countries such as India. Many complications of this disease are known, however only few of its hematological complications have been reported. Discovery of its unknown thrombogenic potential is one such disturbing new entity. Tuberculosis can induce a hypercoagulable state and can lead to thromboembolic complications and deep vein thrombosis. Here we report an interesting and rare case of 20-year-old male, newly diagnosed case of Pulmonary Tuberculosis presenting with complaints of acute onset right lower limb swelling and pain. He was diagnosed with thrombosis of external iliac vein. All possible causes for a provoked deep vein thrombosis were evaluated for and ruled out. The patient was started with first line anti tubercular treatment-rifampicin, isoniazid, pyrizinamide, ethambutol along with anti-thrombotics injection enoxaparin and warfarin and followed up for 6 months. He made complete recovery of both his pulmonary and limb disease.

Acute Pancreatitis Associated With Dengue Fever: An Interesting And Rare Complication Of Dengue Virus

In humans, infections with dengue viruses range from mild fever with thrombocytopenia to life-threatening forms like vasodilatory shock with hemorrhagic manifestations. Of the many complications known of dengue fever, pancreatitis is a rarely discussed event. We would like to present a rare and unusual complication of this common disease. A 17 year old female with past history of tuberculosis was admitted with complains of pain abdomen and fever along with thrombocytopenia. Besides features of dengue fever, the presence of typical abdominal pain, high serum amylase, ultrasound, and computerized tomography scan features suggested the diagnosis of an acute pancreatitis. This complication developed in the initial phase of the illness. The patient had mild-to-moderate pancreatitis that recovered uneventfully with conservative treatment. The awareness of this complication in dengue fever is necessary for timely management of patients which will aid in reducing mortality.

Brucellosis - A Major Differential For Juvenile Idiopathic Arthritis

Brucellosis is a Gram-negative, aerobic zoonotic infection acquired by Brucella species and transmitted from animals to humans through the ingestion of infected food products, direct contact with an infected animal, or inhalation of aerosols. Usually, the disease remains undiagnosed due to lack of awareness and inadequate reporting and is a challenging health problem in tropical countries. We report a case of 16-year-old male presenting to us with chronic inflammatory symmetric polyarthritis misdiagnosed as juvenile idiopathic arthritis but later found to be suffering from brucellosis on reevaluation. Through this case report, we would like to highlight the possibility and advantage of the high degree of suspicion for an infectious etiology responsible for arthritis in the background of autoimmunity and would also like to emphasize on the possibility of Brucella inducing a false-positive response for young patients presenting with arthritis.