A CURIOUS CASE OF FEVER AND INTERSTITIAL LUNG DISEASE

Antisynthetase syndrome is a rare chronic autoimmune inflammatory myopathy with fever, interstitial lung disease, Raynaud’s phenomenon and polyarthritis. The exact underlying cause of antisynthetase syndrome is not yet known. Diagnosis is made with presence of Jo-1 (Histydyl t RNA synthase) antigen in a patient with underlying interstitial lung disease, myositis, arthritis, Raynaud’s phenomenon and mechanic’s hand. Some of the other antisynthetase anti bodies are PL-7 (antigen – threonyl-tRNA synthase), PL-12 (antigen - Alanyl-tRNA synthetase), OJ (antigen – Isoleucyl-tRNA synthetase), EJ (antigen - Glycyl-tRNA synthetase), KS (Antigen – Asparaginyl-tRNA synthetase, WA (Antigen- Autoantibody to a 48 kDa transfer RNA related protein), YRS (antigen - Tyrosyl-tRNA synthetase) however the prevalence is found to be highest with anti Jo-1 antibody (25-30%). In a patient with nonspecific interstitial pneumonitis, Raynaud’s phenomenon and arthralgia antisynthetase syndrome can be best diagnosed with anti ZO ab, though prevalence of the disease is not yet known and in a patient with usual interstitial pneumonitis and fever diagnosis of anti synthetase syndrome can be made with anti KS antibodies. Symptomatic treatment is preferred, which may include immunosuppressive therapy and corticosteroids especially in a patient with muscle and lung involvement

SUCCESSFUL AND STENTING OF THORACO ABDOMINAL IN A CASE OF MEDIAN ARCUATE LIGAMENT SYNDROME

Median Arcuate Ligament Syndrome (MALS) or Celiac Artery Compression Syndrome (CACS) is a rare clinical entity, and presents as symptoms of acute intestinal obstruction. CT angiography is diagnostic in a hemodynamically stable patient. Treatment modalities of choice still remain controversial. In patients with acute presentations it is usually managed by surgical (exploratory laparotomy/ laparoscopic) repair or endovascular repair or combined interventions. We hereby present a case of 33 years old gentleman who was diagnosed to have acute intestinal obstruction secondary to MALS and underwent emergency exploratory laparotomy, adhesiolysis and release of median arcuate ligament followed by angioplasty and stenting of the Thoracic Aorta

RANITIDINE INDUCED HYPERSENSITIVITY – A RARE CASE REPORT

Ranitidine is a very commonly used drug in clinical practice for acid peptic disease and has an excellent safety record. Studies from Uppsala Monitoring Center database cited that the frequency of hypersensitivity reactions for proton pump inhibitor and H2- histamine receptor antagonist is between 0.2% and 0.7%. Only a few cases of hypersensitivity to ranitidine have been reported. We report a case of 3 years old boy who developed hypersensitivity reaction after administration of Inj. Ranitidine, which subsided on removal of offending drug