Serum Copeptin Levels in Adult Patients with a Migraine Attack: A Cross-Sectional Study

Aim:This study investigated the potential role of serum copeptin, a mediator of acute pain via sympathetic stress stimulation, as a biomarker of varying degrees of migraine-related disability. Specifically, we aimed to analyze whether the serum copeptin level can be used to differentiate migraine types (e.g., with and without aura).Methods:The study population included 80 consecutively consenting adult patients who had migraine attacks and attended the emergency department from June 2020 through November 2020, as well as 80 age- and sex-matched healthy controls. Using the Migraine Disability Assessment Scale (MIDAS), the same medical professional assessed each patient’s level of headache-related disability. Based on their MIDAS scores, the patients were separated into four groups: no disability (score 0-5; group MIDAS-I); mild disability (score 6-10; group MIDAS-II); moderate impairment (score 11-20; group MIDAS-III); and severe disability (score >20; group MIDAS-IV). There were also two categories of migraineurs: those with auras and those without auras. Upon admission, comparisons were made between the groups’ serum copeptin values.Results:In comparison to the control group, the patient group’s serum copeptin levels were noticeably higher (2113.30±206.20 vs. 1383.40±488.40; p<0.001). The study of the receiving operator’s characteristics showed that the cut-off copeptin level was 1898.5 pg/mL, with 90% sensitivity and 82.4% specificity for distinguishing patients from controls. There were no noticeable differences in the mean serum copeptin levels between the patient groups when compared by MIDAS score. Additionally, patients with and without aura did not differ notably in terms of mean serum copeptin levels. (2118.70±211.60 vs. 2071.10±160.40).Conclusion:Serum copeptin levels may be used as a diagnostic aid to help anticipate migraine-related headache attacks when combined with clinical signs and symptoms

Giant bladder (10,500 mL in volume) in the ED

A 66-year-old diabetic man presented to the emergency department with 3 days of abdominal distension and constipation. There was no history of neurologic and urologic disorders. A giant bladder was detected with abdominal ultrasound and computed tomography (CT). A total of 10,500 mL of urine was drained with urinary catheter. The diagnosis was neurogenic bladder due to diabetes mellitus with autonomic neuropathy. This is the largest volume of bladder in the literature