RESUMO
We report the case of a 40-year-old African-American female who presented to the Emergency Department with unstable angina. The patient, who had multiple risk factors for coronary artery disease, was admitted to the coronary care unit for cardiac work-up and management. Shortly after the intravenous administration of unfractionated heparin, she suffered the acute onset of upper abdominal pain and shock. A CT scan of the abdomen revealed splenic rupture with hemoperitoneum. The patient, who was managed surgically, had complete recovery before discharge. A review of systems and medical records revealed no obvious risk factors or other potential etiology for this rupture. We herein provide the characteristics of this rarely documented causal relationship between heparin and spontaneous splenic rupture and retrospectively review similar cases in the literature.
Assuntos
Doença das Coronárias/tratamento farmacológico , Heparina/efeitos adversos , Esplenopatias/etiologia , Adulto , Anticoagulantes/efeitos adversos , População Negra , Feminino , Humanos , Philadelphia , Ruptura Espontânea/etiologia , Esplenopatias/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
We report the case of an 87-year-old woman with coma who was found to be in thyrotoxic crisis. The patient had a recent history of decreased mentation and apathy, and laboratory findings were found to be consistent with hyperthyroidism. After a stormy course, the clinical condition recovered to baseline, with return of laboratory values to normal following antithyroid therapy. We provide the details of this rarely documented presentation of apathetic hyperthyroidism with thyroid storm and coma and review the characteristics of similar cases in the literature.
Assuntos
Sintomas Afetivos/etiologia , Coma/etiologia , Crise Tireóidea/complicações , Crise Tireóidea/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Humanos , Tireotoxicose/diagnósticoRESUMO
We report the case of a 27-year-old woman who presented with palpitations, hyperemesis, and weight loss. The patient was found to have laboratory values consistent with hyperthyroidism. A serum pregnancy test was positive for an estimated 8-week gestation. After an ultrasound diagnosis of a molar pregnancy, the patient underwent a uterine evacuation with subsequent resolution of her hyperthyroid status. We provide herein the details of this rarely documented presentation of hyperthyroidism in the setting of gestational trophoblastic disease.