A Case of Suspected Lisdexamfetamine (Vyvanse) Drug-Induced Liver Injury

Amphetamines are a well-established cause of liver injury though the typical presentation is that of illicit drug abuse rather than liver injury occurring in a prescribed setting.1 Lisdexamfetamine (Vyvanse) is one of the most commonly prescribed stimulant medications used for the treatment of Attention Deficit Hyperactive Disorder (ADHD). The authors were only able to find a single case of lisdexamfetamine-related drug-induced liver injury (DILI) occurring in the pediatric population in their review of the literature. Here we present a case of suspected lisdexamfetamine DILI in an adult patient

Acute Systemic Infection-Associated Russell Body Gastroesophagitis: A Case Report and Literature Review

Russell body esophagitis/gastritis (RBG) is a rare gastrointestinal inflammatory condition characterized by accumulation of plasma cells containing dense eosinophilic cytoplasmic inclusions, i.e., Russell bodies. Herein, we report a case of RBG in a patient with a systemic inflammation background. A 61-year-old female presented with oral infection. Upper gastrointestinal endoscopy revealed patchy salmon-colored esophageal mucosa proximally to the gastroesophageal junction, suggestive of “Barrett’s esophagus”. Histologic examination of the biopsy tissue from the lower esophagus showed diffuse lymphoplasmacytic infiltration with abundant admixed enlarged plasma cells (Mott cells) containing bright eosinophilic, round, dense, homogenous inclusions (Russell bodies) in cytoplasm. Immunohistochemical study demonstrated membranous staining of CD138 in the Mott cells, while immunoglobulin light chain in situ hybridization revealed positivity of only kappa light chain, indicating kappa light chain restriction and clonality. A proton-pump inhibitor therapy was initiated, but the patient passed away due to generalized infection. Our case suggests that Russell body esophagitis/gastritis (RBG) can be a gastrointestinal presentation associated with acute systemic infection