ABSTRACT
Clarithromycin is a commonly used advanced generation macrolide. This case study reviews a case of an 81 year old woman who developed sensorineural deafness in the right ear after the start of low dose oral clarithromycin for an infective exacerbation of chronic obstructive pulmonary disease. Despite cessation of this drug after only three days, the sensorineural deafness was found to be irreversible. Reversible sensorineural deafness secondary to macrolides has previously been described and evidence in the literature shows that a dose related phenomenon occurs. Research has indicated that transient dysfunction of the outer hair cells could be the possible mechanism. In this case, however, the patient experienced an irreversible sensorineural deafness associated with the start of low dose oral clarithromycin. This is a side effect profile that has not previously been reported.
Subject(s)
Anti-Bacterial Agents/adverse effects , Clarithromycin/adverse effects , Hearing Loss, Sensorineural/chemically induced , Aged , Aged, 80 and over , Female , Follow-Up Studies , HumansABSTRACT
The occurrence of primary hepatocellular carcinoma (HCC) in patients with genetic haemochromatosis (GH) with cirrhosis is well known. In the past it has been suggested that patients with GH without cirrhosis have the same risk of HCC and life expectancy as the general population. However, recently there have been cases of HCC arising in non-cirrhotic livers, and we report another such case. A review of the literature has been included.
Subject(s)
Carcinoma, Hepatocellular/pathology , Hemochromatosis/complications , Hemochromatosis/genetics , Liver Neoplasms/pathology , Aged , Autopsy , Carcinoma, Hepatocellular/etiology , Disease Progression , Fatal Outcome , Humans , Liver Cirrhosis/complications , Liver Cirrhosis/pathology , Liver Neoplasms/etiology , MaleABSTRACT
The patient was a 22-year-old woman who had presented in early childhood with gastroesophageal reflux and who subsequently underwent surgery. It was commented upon by the surgeons at that time that the esophagus was abnormally thickened. The patient subsequently presented during her first pregnancy with a vulval tumor, which proved histologically to be a leiomyoma. She was also found to have a grossly dilated esophagus and was thought to have achalasia. However, endoscopic ultrasound imaging showed gross hypertrophy of the mid- and distal esophageal wall, with only mild symptoms of dysphagia, which had been long-standing. The appearance of the esophagus was consistent with diffuse esophageal leiomyomatosis. In view of the associated vulval leiomyoma, the patient demonstrated esophagovulvar syndrome.
Subject(s)
Esophageal Neoplasms/diagnosis , Leiomyomatosis/diagnosis , Neoplasms, Multiple Primary , Vulvar Neoplasms , Adult , Deglutition Disorders/etiology , Endosonography , Esophageal Neoplasms/complications , Esophagus/diagnostic imaging , Esophagus/pathology , Female , Humans , Hypertrophy , Leiomyomatosis/complications , Neoplasms, Multiple Primary/complications , Neoplasms, Multiple Primary/diagnosis , SyndromeABSTRACT
This report describes a complication that occurred as a result of deploying an Ultraflex stent too low in relation to a stenosing carcinoma of the gastro-oesophageal junction. Intermittent kinking of the redundant lower end of the stent caused frequent episodes of total dysphagia. A percutaneous endoscopic gastrostomy was deployed to anchor the redundant portion of the stent within the stomach, allowing it to be shortened with endoscopic stitch cutters. This procedure relieved the episodic dysphagia, and was well tolerated.
