ABSTRACT
A 13-year-old hypertensive girl with a history of severe headaches following exercise developed circulatory collapse after "squat jumps." Pulmonary edema was present without evidence of a cerebral mass. The patient died with increased intracranial pressure despite decompressive craniectomy. Neuropathological evaluation revealed diffuse cerebral edema and a pheochromocytoma in the right adrenal gland. Examination of urine revealed elevation of vanillylmandelic acid levels.
Subject(s)
Headache/etiology , Pheochromocytoma/complications , Physical Exertion , Pulmonary Edema/etiology , Adolescent , Brain Edema/etiology , Female , Humans , Pheochromocytoma/pathologyABSTRACT
The relative independence of serum T-3 from changes in thyroid binding protein levels makes it a more effective screening test for hyper- and hypothyroidism than the T-4 assay alone. In fact, its efficiency is comparable to that of the free T-4 index.
Subject(s)
Hyperthyroidism/diagnosis , Hypothyroidism/diagnosis , Triiodothyronine , Humans , Thyroid Function TestsABSTRACT
The metastatic transfer of cells from a primary bronchogenic carcinoma to other portions of the lung as a result of mucus embolization and inoculation has been demonstrated. Histologic observations indicate tumor implantation and survival in peripheral bronchioles. In these regions mucosal dysplasia and carcinoma-in-situ changes which characteristically accompany a primary lesion are notably absent. Morphologic changes associated with acute bronchitis and focally denuded bronchial mucosa may be implicated.
Subject(s)
Carcinoma, Bronchogenic/metabolism , Carcinoma, Squamous Cell/metabolism , Lung Neoplasms/metabolism , Mucus/metabolism , Carcinoma, Bronchogenic/pathology , Carcinoma, Squamous Cell/pathology , Humans , Lung/pathology , Lung Neoplasms/pathology , Male , Middle Aged , Mucous Membrane/pathology , Neoplasm MetastasisABSTRACT
This report records the first reported case of a fatal anaphylactic reaction to an intravenous infusion of iron dextran. An elderly woman was given an infusion of iron dextran in 5% dextrose. Shortly after the infusion started, she developed laryngeal stridor, shock, respiratory arrest, and died despite attempts at resuscitation. Necropsy findings are described and are consistent with death due to anaphylaxis. With the increased parenteral use of dextran and iron dextran complexes it is important for the clinician to be aware of the hazards of anaphylactic reactions. Since the reactions generally occur shortly after the administration has begun, a physician should be in attendance during the infusion of the first 25 cm3 (5 to 10 min). He should be able to promptly recognize and treat the asphyxia and hypotension should it occur. It is also important for the pathologist to be aware of the occurrence of anaphylaxis after the use of these drugs. However, the cause of death should not be based solely on the presence of classic clinical features of fatal anaphylaxis. Specific features of anaphylaxis should be searched for at autopsy and other causes of sudden death must be ruled out.
