ABSTRACT
INTRODUCTION: and importance: Limited data are available about various effects of COVID-19 on pregnancy. On the other hand, the COVID-19 pandemic could exacerbate anxiety or schizophrenia symptoms. CASE PRESENTATION: The patient is a 5-day-old newborn, whom his mother suffers from schizophrenia, depression and anxiety disorders. The young pregnant mother gets delusions of being infected with Covid-19, thus attempts suicide with Sertraline, Clonazepam, Quetiapine and Rispeirdone, although she was in the last week of pregnancy. The newborn baby referred to our neonatal ward with seizure and apnea. Phenytoin and caffeine were administered leading to some degree of symptom relief, but due to the dermatologic reactions of phenytoin, they were replaced with levetiracetam. CLINICAL DISCUSSION: The Covid-19 may increase levels of anxiety and depression or exacerbation of schizophrenia symptoms, especially in pregnant women suffering from mental disorders. In addition, there are evidence supporting the occurrence of neonatal malformations as a result of exposure to antipsychotic drugs during the first trimester of pregnancy. CONCLUSION: Investigating the role of antidepressant and antipsychotic drugs in the perinatal period, especially near delivery has received less attention so far; thus further studies are required to determine the safety of these drugs.
ABSTRACT
INTRODUCTION AND IMPORTANCE: Diabetes mellitus and hypertension are two conditions that can coexist in obese individuals. Roux-en-Y gastric bypass (RYGB) surgery, are used to control obesity. Complications such as steatorrhea, hyperoxaluria, and decreased bone mineral density, may occur after RYGB. CASE PRESENTATION: A 58-year-old woman referred to the emergency department complaining of pain on the right side of her lower abdomen. Her past medical history was RYGB surgery, COVID-19 with 40% pulmonary involvement, and Chronic Kidney Disease (CKD). Rapid progressive glomerulonephritis (RPGN) was predicted based on extensive laboratory test results. A kidney biopsy demonstrated oxalate nephropathy. Along with the findings from the kidney biopsy, acute tubulointerstitial nephritis with tubular injury secondary oxalosis was diagnosed. CLINICAL DISCUSSION: RYGB surgery and chronic kidney disease, can increase the risk of secondary oxalosis. Recent studies introduce enteric hyperoxaluria as an important marker for diagnosing end-stage kidney disease. Renal biopsy is often prescribed for absolute recognition of oxalosis. On the other hand, our patient has a recent history of COVID-19 infection. The use of anti-Covid-19 drugs in patients with renal insufficiency should be considered with caution. CONCLUSION: It is important to monitor kidney function following RYGB surgery, particularly in patients with underlying diseases such as diabetes or hypertension.