ABSTRACT
ST segment elevation of more than 1 mm from the baseline is an electrocardiographic presentation of acute myocardial injury. This phenomenon is not confined only to ischemic injury, and various other etiological factors have been described in relation to ST segment elevation. We report the case of a young man who presented in the emergency department complaining of loin pain. He was subsequently found to have transient ST segment elevation, but a thorough evaluation showed no evidence of coronary artery disease. ST segment elevation is one of the best tools for diagnosing acute myocardial infarction, of which reperfusion therapy is the treatment of choice thus making it important to make the diagnosis as quickly as possible. It is equally important, however, not to misdiagnose acute myocardial infarction, as there are other causes of ST segment elevation. Therefore, we report this unique case of renal pain due to stone causing ST segment elevation.
Subject(s)
Colic/diagnosis , Electrocardiography , Kidney Diseases/diagnosis , Adult , Colic/etiology , Colic/physiopathology , Diagnosis, Differential , Heart Conduction System/physiopathology , Humans , Kidney Calculi/complications , Kidney Diseases/etiology , Kidney Diseases/physiopathology , Male , Myocardial Infarction/diagnosis , Troponin I/bloodABSTRACT
Muco-cutaneous bleeding is a common presenting feature of acute leukemias. Mucosal bleeding usually manifests as gum bleeding and/or epistaxis but may occur in any mucosal surface of the body. Hematuria as an isolated or main presenting feature of acute leukemia is rare. We describe two cases of acute leukemia, a 19 year old male with acute lymphoblastic leukemia and a 52 year old male with acute myeloid leukemia, both presenting with gross hematuria. There was no demonstrable leukemic infiltration of the urinary tract on imaging studies. Hematuria in these patients was likely to be due to occult leukemic infiltration of the urinary system, aggravated by thrombocytopenia, as it subsided after starting chemotherapy. Our cases highlight that hematuria should be remembered as a rare presenting feature of acute leukemia.
Subject(s)
Hematuria/etiology , Leukemia, Myeloid, Acute/diagnosis , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Blood Cell Count , Bone Marrow Examination , Fatal Outcome , Humans , Leukemia, Myeloid, Acute/complications , Leukemia, Myeloid, Acute/drug therapy , Leukocyte Count , Male , Middle Aged , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Thrombocytopenia/etiology , Treatment Outcome , Young AdultABSTRACT
Hypernatremia is a relatively common entity and is more prevalent among the elderly and critically ill. A number of medical conditions are commonly associated with hypernatremia, and these differ substantially among children and adults. Severe hypernatremia is usually associated with central nervous system manifestations and carries a high mortality rate. We report a case of a female patient who presented to the emergency department of the King Khalid University Hospital, Riyadh, Saudi Arabia with severe hypernatremia and without any associated co-morbid conditions or neurological manifestations. We did not find any etiological background despite extensive evaluation other than under hydration due to decreased fluid intake, which was secondary to behavioural causes.
