Refractory thrombocytopenia in a patient with systemic lupus erythematosus and prior immune thrombocytopenia, not responsive to an accessory splenectomy.

We report a patient with systemic lupus erythematosus (SLE) that was preceded by immune thrombocytopenia (ITP). She subsequently developed refractory thrombocytopenia. An accessory spleen was found and removed, however, she continued to have severe thrombocytopenia.

Repeated inhalation of nebulized albuterol did not induce arrhythmias in a patient with Wolff-Parkinson-White syndrome and asthma.

It has been assumed that in asthmatic patients with Wolff-Parkinson-White (WPW) syndrome, ablative therapy for the condition is necessary for the safe treatment of the asthma with beta 2-adrenergic drugs. The following case report illustrates that inhaled albuterol was safely administered to an asthmatic patient with electrocardiographic evidence of preexcitation, without the need of an ablative procedure. This case report is, to our knowledge, the first in the literature in which the cardiac rhythm of a patient with WPW syndrome was monitored during repeated inhalations of a beta 2-agonist.