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3.
Critical Care Conference: 42nd International Symposium on Intensive Care and Emergency Medicine Brussels Belgium ; 27(Supplement 1), 2023.
Article in English | EMBASE | ID: covidwho-2314369
4.
Journal of the American College of Cardiology ; 81(8 Supplement):3829, 2023.
Article in English | EMBASE | ID: covidwho-2264170
5.
Kidney International Reports ; 8(3 Supplement):S434, 2023.
Article in English | EMBASE | ID: covidwho-2253921
7.
Journal of the American College of Cardiology ; 81(8 Supplement):3766, 2023.
Article in English | EMBASE | ID: covidwho-2283260
8.
Journal of the American College of Cardiology ; 81(8 Supplement):3421, 2023.
Article in English | EMBASE | ID: covidwho-2281635
9.
Gazzetta Medica Italiana Archivio per le Scienze Mediche ; 181(11):904-906, 2022.
Article in English | EMBASE | ID: covidwho-2276255
10.
American Journal of the Medical Sciences ; 365(Supplement 1):S221, 2023.
Article in English | EMBASE | ID: covidwho-2236298

ABSTRACT

Case Report:We describe a case of a non-verbal 5-yearold patient with autism and global developmental delay who presented with headache, nausea, vomiting, and decreased oral intake and found to have acute cerebellar syndrome/cerebellitis secondary to COVID-19 infection. Method(s): Chart Review. Summary of Results: A 5-year-old male with autism spectrum disorder and global developmental delay presented with one week history of headache, nausea, and non-bilious, non-bloody emesis. Despite intravenous fluid resuscitation and anti-emetic treatment, the patient continued to have persistent emesis with decreased oral intake and urine output. Physical exam findings were notable for aniscoria with right pupil larger than left, fixed upward gaze deviation, horizontal nystagmus, and nuchal rigidity. Patient was able to move all extremities spontaneously with normal tone and without rigidity or hyperreflexia. A complete blood cell count was consistent with the following: WBC 17.29 K/uL, hemoglobin level 12.8 g/dL, hematocrit 38.9%, and platelet count 482 K/ uL. C-reactive protein <4.0 mg/L and procalcitonin 0.12 ng/mL. CT Head on hospital day one showed no acute intracranial abnormality. Due to the patient's acute neurological changes, MRI brain was obtained and revealed patchy areas of hyperintensity in both the cerebellar hemispheres with moderate swelling of the cerebellum causing narrowing of the posterior fossa extra-axial cerebrospinal fluid (CSF) spaces. In addition, there was obstruction of the cerebral aqueduct due to extrinsic mass effect by the swollen cerebellum. CSF studies were notable for the following: 148 total nucleated cells with 75% lymphocytes and 17% monocytes and 2 red blood cells, protein was elevated at 113 mg/dL, and glucose was normal at 52 mg/dL. Meningitis and encephalitis panel was without any acute findings. Other laboratory testing was negative for tuberculosis, syphilis, chlamydia, HIV, and EBV. The patient tested positive for COVID-19 virus about one month prior to the onset of symptoms. Imaging and laboratory results in the setting of obstructive hydrocephalus with associated symptoms of nausea, emesis, headache, and upward gaze deviation are consistent with acute cerebellar syndrome, or cerebellitis. Due to obstructive hydrocephalus and inflammation of the cerebellum, patient was started on high-dose steroids, and neurosurgery placed external ventricular drain (EVD). The patient worked closely with physical medicine and rehabilitation as well as speech therapy, physical therapy, and occupational therapy to make a full recovery following this illness. Conclusion(s): Headache, nausea, and vomiting are often seen as benign findings;however, it is important to obtain specific details regarding the timing of symptoms, especially in the setting of a non-verbal patient. Because inflammation of the cerebellum can lead to hydrocephalus and potential herniation, prompt diagnosis is crucial to prevent long term effects of cerebellitis. Copyright © 2023 Southern Society for Clinical Investigation.

11.
American Journal of the Medical Sciences ; 365(Supplement 1):S204, 2023.
Article in English | EMBASE | ID: covidwho-2229639

ABSTRACT

Case Report: Protein losing enteropathy (PLE) occurs when proteins leak from the gastrointestinal (GI) system more rapidly than they are produced. Inflammation of the GI tract facilitates increased membrane permeability of gastric mucosa, leading to excess protein leakage. 1 PLE in children has been associated with CMV, rotavirus, COVID-19, HIV, C. difficile, and autoimmune diseases like Crohn's Disease. 2-6 Norovirus is a known cause of PLE in immunocompromised pediatric patients. 7-8 However, to our knowledge, there are no case reports about PLE precipitated by norovirus in immunocompetent pediatric patients. The purpose of this case report is to present a case of PLE precipitated by a norovirus infection in a 4- year-old previously healthy child. While the above gastrointestinal viruses have been proposed as precipitators for this disease, PLE precipitated by norovirus infection has not been well described. This case also highlights the importance of early diagnosis and management to avoid complications. Method(s): Our patient initially presented with two days of abdominal pain, diarrhea, emesis, reduced urine output, and swelling of the lower extremities. He was exposed to several sick family members-his sister had upper respiratory symptoms and his grandmother had gastrointestinal symptoms. Physical exam was notable for diminished breath sounds in the right lower lobe, abdominal distension with diffuse tenderness and dullness to percussion, significant scrotal and penile edema, and bilateral lower extremity pitting edema. Laboratory results revealed leukocytosis, hypoalbuminemia, hyponatremia, elevated aspartate aminotransferase (AST), and elevated serum alpha-1-antitrypsin, as well as low Immunoglobulins G and M. CD3 and CD4 levels were low reflecting cellular immune dysregulation seen in patients with PLE. IgA and Tissue Transglutaminase (TTF) were within normal limits. Ebstein Barr Virus and cytomegalovirus IgM antibodies were negative. COVID IgG was negative as well. His Polymerase chain reaction (PCR) gastrointestinal panel was positive for norovirus. A chest X-ray showed a large right pleural effusion. Abdominal CT revealed large ascites slightly more predominant in the upper abdomen, mesenteric lymphadenitis, and bilateral pleural effusions. Echocardiogram showed small anterior and apical pericardial effusions. Result(s): Based on the patient's elevated serum alpha-1 antitrypsin levels, hypoalbuminemia, low levels of immunoglobulins and lymphocytes, and clinical manifestations of ascites, bilateral pleural effusions, pericardial effusion, and dependent edema, along with a positive PCR for norovirus, the diagnosis of PLE secondary to Norovirus was made. Conclusion(s): This case demonstrates the importance of recognizing viruses like Norovirus as potential causes of PLE to avoid a delay in diagnosis and initiation of therapy, and to avoid unnecessary additional testing. Copyright © 2023 Southern Society for Clinical Investigation.

12.
Hormone Research in Paediatrics ; 95(Supplement 1):155-156, 2022.
Article in English | EMBASE | ID: covidwho-2223855
14.
Indian Journal of Nephrology ; 32(7 Supplement 1):S15-S16, 2022.
Article in English | EMBASE | ID: covidwho-2201608
15.
16.
Indian Journal of Nephrology ; 32(7 Supplement 1):S87, 2022.
Article in English | EMBASE | ID: covidwho-2201584
17.
Critical Care Medicine ; 51(1 Supplement):297, 2023.
Article in English | EMBASE | ID: covidwho-2190582
18.
Journal of the American Society of Nephrology ; 33:896, 2022.
Article in English | EMBASE | ID: covidwho-2126180
19.
Journal of the American Society of Nephrology ; 33:334-335, 2022.
Article in English | EMBASE | ID: covidwho-2126171
20.
Journal of the American Society of Nephrology ; 33:919, 2022.
Article in English | EMBASE | ID: covidwho-2126096
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