Subject(s)
Alcohol Withdrawal Delirium , Dietary Supplements , Magnesium Deficiency , Magnesium Sulfate/pharmacology , Adult , Alcohol Withdrawal Delirium/blood , Alcohol Withdrawal Delirium/drug therapy , Alcohol Withdrawal Delirium/physiopathology , Humans , Magnesium Deficiency/blood , Magnesium Deficiency/drug therapy , Magnesium Deficiency/physiopathology , Magnesium Sulfate/administration & dosage , MaleABSTRACT
Gitelman' syndrome, although a relatively frequent cause of chronic hypokalemia in adults, is rarely diagnosed correctly. It is frequently confused with overt diuretic abuse or Bartter's syndrome. We describe a 60 year man with 2 year history of recurrent paralytic ileus attributed to recurrent hypokalemia. Investigations in this patient revealed hypokalemia, metabolic alkalosis, hypocalciurea, and hypomagnesemia a tetrad diagnostic of Gitelman's syndrome. The peculiar clinical features of this condition and its management are discussed.
Subject(s)
Gitelman Syndrome/diagnosis , Hypokalemia/etiology , Intestinal Pseudo-Obstruction/etiology , Alkalosis/etiology , Alkalosis/metabolism , Bartter Syndrome/complications , Bartter Syndrome/diagnosis , Bartter Syndrome/metabolism , Calcium/metabolism , Chronic Disease , Diagnosis, Differential , Diuretics/administration & dosage , Gitelman Syndrome/complications , Gitelman Syndrome/metabolism , Humans , Hypokalemia/metabolism , Kidney Tubules/metabolism , Male , Middle Aged , Potassium Chloride/administration & dosage , Recurrence , Spironolactone/administration & dosage , Syndrome , Treatment OutcomeABSTRACT
Neurocysticercosis is endemic in India, cerebral and ocular manifestations being common. A 32 yr old man on treatment with Albendazole for cerebral neurocysticercosis for 10 days presented with 3 days of painful uniocular blindness. He had only light perception in the left eye, left pupil was non-reactive to light and left disc was edematous. B-scan of eye revealed retinal detachment due to sub retinal cyst and CT brain showed multiple parenchymal cysticerci. The natural history of ocular neurocysticercosis or enhanced sub-retinal inflammation due to Albendazole therapy could have resulted in the retinal detachment in this case.
Subject(s)
Albendazole/adverse effects , Anticestodal Agents/adverse effects , Blindness/etiology , Brain Diseases/drug therapy , Neurocysticercosis/drug therapy , Adult , Anticonvulsants/therapeutic use , Blindness/diagnostic imaging , Blindness/surgery , Brain Diseases/diagnostic imaging , Brain Diseases/parasitology , Dexamethasone/administration & dosage , Humans , India , Male , Neurocysticercosis/diagnostic imaging , Neurocysticercosis/parasitology , Retinal Detachment/complications , Retinal Detachment/diagnostic imaging , Retinal Detachment/etiology , Seizures/drug therapy , Seizures/etiology , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
The association of muscle tyrosine kinase (Musk) antibody with recurrent bulbar weakness in acetylcholine receptor antibody (Ach-R Ab) negative myasthenia gravis (MG) has been well documented. We describe 2 patients, a middle aged man and a 9-year-old girl, both seronegative for Ach R antibody who had recurrent bulbar weakness and MUSK antibody positivity. Patients made a full recovery from the acute episode with intravenous immunoglobulin (IV Ig) therapy. The peculiar clinical features of this condition and its management are discussed.
