ABSTRACT
Neurological side-effects of linezolid manifesting as a posterior reversible leuco-encephalopathy syndrome (PRES) is rare. Early identification of this offending drug might reverse this catastrophic event. We report a 45-year-old female, who was diagnosed as a case of disseminated tuberculosis and was treated with antitubercular drugs (ATT), but later developed ATT-induced hepatitis. She was then put on modified ATT (moxifloxacin, terizidone, and linezolid). In the next two days she developed an altered sensorium. Brain imaging was suggestive of PRES. Linezolid was withdrawn, following which she showed an excellent clinical and radiological recovery.
Subject(s)
Posterior Leukoencephalopathy Syndrome , Tuberculosis , Brain/diagnostic imaging , Female , Humans , Linezolid/adverse effects , Magnetic Resonance Imaging , Middle Aged , Posterior Leukoencephalopathy Syndrome/chemically induced , Posterior Leukoencephalopathy Syndrome/diagnosis , Posterior Leukoencephalopathy Syndrome/drug therapyABSTRACT
A 50-year-old male, presented with a two-months history of ascending paresthesias, with continuous twitchings over the body, associated with insomnia. His electromyography (EMG) revealed neuromyotonia and was diagnosed as a case of peripheral nerve hyperexcitability (PNH) syndrome due to Leucin-rich glioma-inactivated 1 (LGI1) antibody. He showed significant improvement with intravenous immunoglobulin and carbamazepine.
Subject(s)
Glioma , Isaacs Syndrome , Autoantibodies , Fasciculation , Humans , Immunoglobulins, Intravenous , Intracellular Signaling Peptides and Proteins , Isaacs Syndrome/drug therapy , Male , Middle Aged , MusclesABSTRACT
BACKGROUND: Mutations in PRKN (PARK2) are commonly encountered in early-onset Parkinson disease (PD). OBJECTIVES: To screen for PRKN mutations in a clinically well-characterized cohort of early-onset PD patients with a family history (FEOPD; ≤50â¯yearsâ¯at onset) or sporadic (SEOPD; ≤50â¯yearsâ¯at onset) and late-onset familial patients (FLOPD; >50â¯yearsâ¯at onset). METHODS: A total of 97 patients including 52 SEOPD and 45 familial PD (FEOPD: 23; FLOPD: 22) were screened for variants in PRKN by PCR- Sanger sequencing. PRKN dosage and variants in known PD genes were screened by qPCR and whole-exome sequencing in a subset of samples. RESULTS: A total of 25 (25.77%) patients (SEOPD: 12, FEOPD: 6, and FLOPD: 7) were positive for PRKN variants. Of these, two patients manifested homozygous variants; while one patient was carrying three PRKN variants and two patients were carrying two PRKN variants. But, we could not examine their parents or relatives and their genotypes remain unknown. The remaining 20 (80%) patients were carrying heterozygous variants only. 32% of these variants were in exon 2, including a novel truncating homozygous variant (c.97Câ¯>â¯T:p.Arg33Ter) in a SEOPD patient. CONCLUSION: In our cohort, a novel homozygous variant (c.97Câ¯>â¯T:p.Arg33Ter) in a patient with hyperhidrosis expands the spectrum of PRKN associated mutations. Furthermore, ~80% of the PRKN variants being heterozygous in this study cohort, implies the utility of the cohort for identification of additional novel/known causative PD gene(s).
Subject(s)
Parkinson Disease/genetics , Ubiquitin-Protein Ligases/genetics , Adolescent , Adult , Age of Onset , Aged , Cohort Studies , Humans , Hyperhidrosis/genetics , India , Middle Aged , Mutation , Young AdultABSTRACT
INTRODUCTION: Sarcoidosis is a multisystemic inflammatory disease with myriad clinical manifestations. Neurologic involvement in sarcoidosis is uncommon. Peripheral neuropathic presentations include mononeuropathy, mononeuritis multiplex, and generalized sensory, motor, autonomic, and sensorimotor polyneuropathies. CASE PRESENTATION: We report a case of carpal tunnel syndrome caused by sarcoidosis in a 30-year-old woman. Other causes of carpal tunnel syndrome were ruled out. The patient responded well to the standard line of corticosteroid treatment and wrist splinting. DISCUSSION: Carpal tunnel syndrome caused by sarcoidosis is a rare presentation. The mechanism of neurologic involvement in sarcoidosis is not clear.
Subject(s)
Carpal Tunnel Syndrome/etiology , Sarcoidosis/complications , Adult , Female , HumansABSTRACT
Ankylosing spondylitis (AS) is a chronic systemic inflammatory disorder. It primarily affects the axial skeleton through involvement of the peripheral joint scan occurs. Temporomandibular joint (TMJ) involvement in AS varies from 4% to 35%. Here, we present a case of a 35-year-old male, follow-up of AS from last 8 years on nonsteroidal anti-inflammatory drugs, presented with fresh complaints of painfully restricted movements of jaw during swallowing. Computer tomography of patient demonstrates articular cartilage changes with disc and joint abnormalities.
Subject(s)
Antidepressive Agents/adverse effects , Depression/drug therapy , Inappropriate ADH Syndrome/chemically induced , Mianserin/analogs & derivatives , Aged , Antidepressive Agents/administration & dosage , Citalopram/administration & dosage , Dose-Response Relationship, Drug , Humans , Inappropriate ADH Syndrome/diagnosis , Male , Mianserin/administration & dosage , Mianserin/adverse effects , MirtazapineABSTRACT
Malaria has emerged as a major public health problem worldwide. Complications are commonly seen in Plasmodium falciparum (P. falciparum) and Plasmodium vivax (P. vivax) infection, but due to Plasmodium ovale (P. ovale) infection is rarely described in literature. Here we report a case of severe disease due to P. ovale infection complicated with jaundice, thrombocytopenia, hypotension and acute renal failure.
Subject(s)
Malaria/diagnosis , Plasmodium ovale , Acute Kidney Injury/etiology , Aged , Diagnosis, Differential , Humans , Hypotension/etiology , Jaundice/etiology , Malaria/complications , Malaria/microbiology , Male , Thrombocytopenia/etiologyABSTRACT
Both dengue and typhoid fever have emerged as major public health problems in India. Coinfection with both these diseases is rarely reported. Here we report two confirmed cases of concurrent illness of dengue with typhoid fever; both patients were managed as outpatients and recovered completely.
Subject(s)
Dengue/diagnosis , Typhoid Fever/diagnosis , Adult , Coinfection , Dengue/complications , Diagnosis, Differential , Female , Humans , Male , Typhoid Fever/complicationsABSTRACT
The association of acute hepatitis E viral (HEV) infection with glucose-6-phosphate dehydrogenase (G6PD) deficiency leading to extensive intravascular haemolysis is a very rare clinical entity. Here we discuss such a patient, who presented with acute HEV illness, developed severe intravascular haemolysis and unusually high levels of bilirubin, complicated by acute renal failure (ARF), and was later on found to have a deficiency of G6PD. The patient recovered completely with haemodialysis and supportive management.
Subject(s)
Acute Kidney Injury/etiology , Anemia, Hemolytic/etiology , Glucosephosphate Dehydrogenase Deficiency/complications , Hepatitis E/diagnosis , Acute Disease , Adolescent , Disease Management , Glucosephosphate Dehydrogenase , Hepatitis E/complications , Hepatitis E/therapy , Hepatitis E virus/isolation & purification , Humans , MaleABSTRACT
Epidemic dropsy (ED) is caused due to intoxication with Argemone mexicana. Here we report a case series of three families, all of whom were residents of Uttar Pradesh, India, who presented in August 2013 with all the classical features of ED. We aim to highlight the importance of this malady even though the sale of unbottled mustard oil is illegal in India.
Subject(s)
Argemone/toxicity , Edema/diagnosis , Mustard Plant/toxicity , Plant Oils/toxicity , Adult , Edema/chemically induced , Edema/epidemiology , Epidemics , Female , Humans , India/epidemiology , Male , Middle AgedABSTRACT
Association of dengue fever with transverse myelitis in the form of extensive spinal cord involvement is a rare entity described in the literature. We describe a middle-aged man who presented with dengue fever and in whom weakness of the bilateral lower limbs and urinary incontinence developed on the third day of fever. Magnetic resonance imaging confirmed the diagnosis of longitudinally extensive transverse myelitis. Over a four-week course of corticosteroids with supportive management, the patient recovered without any residual neurologic deficit.
