7 research outputs found

    Anti-neutrophil cytoplasmic antibodies associated vasculitis with interstitial lung disease: a case report

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    Anti-neutrophil cytoplasmic antibodies (ANCA) associated vasculitis is a necrotizing vasculitis that primarily affect small blood vessels of the airway and kidneys. The major clinicopathologic feature include microscopic polyangiitis and granulomatosis with polyangiitis. There are several studies done that have shown the association of interstitial lung disease (ILD) and ANCA vasculitis. Majority of the studies showed that the prognosis was bad in patients with AAV and ILD, then those without it, and patients with pulmonary fibrosis and ANCA had as low a prognosis as patients with IPF without ANCA. We hereby report a case of a female patient in her 70s who was been treated as a case of infection at different hospital, only to be diagnosed later as ANCA associated vasculitis with interstitial lung disease. Methylenetetrahydrofolate reductase (MTHFR) enzyme is one of the key enzymes involved in the metabolism of folate

    The copper conundrum: a case of toxicity and altered mental status in a young male with opioid dependency

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    Copper is a trace element with higher concentrations in the brain, liver, and kidneys. Its toxicity is rare in humans because of its homeostatic mechanisms. This case highlights a 30-year-old male with a history of opioid abuse and occupational exposure to metallurgy. Despite treatment, a gradual neurological worsening prompted us for heavy metal screening and nerve conduction velocity study (NCV) which revealed copper toxicity and demyelinating polyneuropathy. Following the initiation of D-penicillamine therapy, he showed gradual improvement. The coexistence of opioid abuse and dependency posed challenges in the clinical presentation, necessitating a comprehensive approach to effectively manage both opioid withdrawal and evaluation for other toxic substances

    Primary adrenal insufficiency presenting with neuropsychiatric illness

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    Adrenal insufficiency is characterized by decreased production of glucocorticoids from adrenal cortex, either due to a primary adrenal or a secondary pituitary etiology. Neuropsychiatric symptoms and signs could be the first presenting symptoms or the only presentation of adrenal insufficiency and are relatively less explored in patients with adrenal insufficiency and less understood. Patients with chronic psychiatric symptoms, namely depression and anxiety should be evaluated for association with adrenal insufficiency

    Post COVID nocardiosis-an opportunistic enemy

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    Nocardia is an opportunistic infection seen mostly in immunocompromised individuals. It has become an important pathogen especially in these post covid times in which multiple individuals had to go through high dose corticosteroid therapy as part of their severe COVID-19 treatment. We present a 62 years old male with diabetes mellitus and hypertension who had previously been hospitalized for a month for COVID-19 and received high dose corticosteroids for the same. He presented again one month later with symptoms of fever and breathlessness and was worked up extensively for infections in which all his investigations came negative. For suspicion of opportunistic pathogen his HRCT thorax was done which showed consolidation and cavitation in lung along with other infective changes. In view of HRCT thorax findings bronchoscopy was done and bronchoalveolar lavage was sent for examination which grew Nocardia beijingensis on culture. Cotrimoxazole was started for the patient and 3 days after the initiation of therapy he became afebrile and was weaned off of oxygen support gradually over next one month

    COVID-19 associated meningoencephalitis or a neuropsychiatric manifestation of systemic lupus erythematosus-a diagnostic dilemma

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    The infection with SARS-CoV-2 is associated with fever and respiratory symptoms but is not limited to respiratory system only. Since its appearance, several neurological symptoms have been reported, most commonly headache and anosmia, as well as less frequent complications such as COVID-19-associated encephalitis and meningitis. In this case report, we report a 40-year-old female recently infected with SARS-CoV-2, who presented with history of high-grade fever, cough, breathlessness 12 days back followed by altered sensorium and restlessness. The patient was also found to have underlying systemic lupus erythematosus which surfaced post-COVID-19 infection. Cerebrospinal fluid (CSF) analysis was done and the patient received IVIG therapy and showed dramatic improvement. SARS-CoV-2 has been implicated in development of autoimmune diseases

    Iron pill associated duodenitis: a less recognised clinical entity

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    Iron supplementation is a widely prescribed treatment for anemia, but its association with gastrointestinal complications, specifically duodenitis, remains inadequately acknowledged in clinical practice. One of the common oral iron preparations to treat iron deficiency anemia is ferrous sulphate. Iron preparations have been known to cause gastric side effects, including gastritis and duodenitis. This case report explores the emerging concern of iron pill-associated duodenitis, shedding light on the potential adverse effects of oral iron supplementation on the duodenal mucosa. Existing literature and clinical cases are reviewed to highlight the connection between iron pill consumption and duodenal inflammation. From asymptomatic cases to severe symptoms like abdominal pain and gastrointestinal bleeding, the clinical spectrum is diverse. Histopathological analysis of endoscopic biopsies reveals characteristic features of duodenitis linked with iron deposits, raising concerns about long-term consequences. In conclusion, this case underscores the significance of recognizing iron pill-associated duodenitis as a distinct clinical entity, necessitating further investigation for optimized patient care and the safe administration of iron supplements in managing anemia.

    Hepatic brucelloma

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    The liver is commonly affected in human brucellosis, reflected the effect of Brucella on the RES (reticuloendothelial system) (Akritidis et al. 2007 [1], Sadia Pérez et al. 2001 [2]). The formation of liver abscess (brucelloma) is uncommon (Rovery et al. 2003 [3]). Here we report an interesting case of brucellosis with a liver abscess in a young immmunocompetent individual with no known comorbidities
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