RESUMEN
INTRODUCTION: We present a case of a 58-year-old man with a history of laryngo-pharyngectomy including bilateral thyroidectomy due to hypopharyngeal cancer presenting with lethargy, acute kidney failure, and hypercalcemia. Milk alkali syndrome was diagnosed given the history of high-dose calcium / vitamin D supplementation after ruling out other causes of hypercalcemia. After initial treatment with normal saline, furosemide and denosumab, the patient developed severe symptomatic hypocalcemia as a rare adverse effect of denosumab.
Asunto(s)
Lesión Renal Aguda , Hipercalcemia , Letargia , Humanos , Hipercalcemia/etiología , Hipercalcemia/diagnóstico , Masculino , Persona de Mediana Edad , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/etiología , Letargia/etiología , Diagnóstico Diferencial , Hipocalcemia/diagnóstico , Hipocalcemia/etiología , Hipocalcemia/tratamiento farmacológico , Denosumab/efectos adversos , Denosumab/uso terapéuticoRESUMEN
Non-ketotic hyperglycinaemia (NKH) is an inborn error of glycine metabolism with autosomal recessive inheritance. A female infant presented to our emergency department with intractable seizures, lethargy and hypotonia, 2 weeks after her routine vaccination. Detailed infective and metabolic workup revealed normal blood sugar, ketone, lactate ammonia, and a high level of glycine in serum and cerebrospinal fluid suggesting NKH. Diagnosis of NKH was further confirmed on genetic analysis for AMT gene mutation. The child showed clinical improvement with oral sodium benzoate. Here, we report the inheritance, pathophysiology, diagnostic approach, genetic confirmation, management and prognosis of a child with NKH.
Asunto(s)
Hiperglicinemia no Cetósica , Humanos , Hiperglicinemia no Cetósica/diagnóstico , Femenino , Lactante , Diagnóstico Diferencial , Hipotonía Muscular/etiología , Benzoato de Sodio/uso terapéutico , Vacunación/efectos adversos , Convulsiones/etiología , Letargia/etiologíaAsunto(s)
Neoplasias Óseas , Enfermedades de los Perros , Osteosarcoma , Femenino , Perros , Animales , Citología , Letargia/etiología , Letargia/veterinaria , Osteosarcoma/veterinaria , Neoplasias Óseas/veterinaria , Pérdida de Peso , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/cirugía , Enfermedades de los Perros/patologíaAsunto(s)
Enfermedades de los Perros , Leishmania infantum , Leishmaniasis Visceral , Síndrome de Dificultad Respiratoria , Masculino , Perros , Animales , Letargia/etiología , Letargia/veterinaria , Anorexia/etiología , Anorexia/veterinaria , Leishmaniasis Visceral/veterinaria , Reacción en Cadena de la Polimerasa/veterinaria , Síndrome de Dificultad Respiratoria/veterinaria , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/cirugíaAsunto(s)
Enfermedades de los Perros , Dilatación Gástrica , Vólvulo Gástrico , Femenino , Perros , Animales , Letargia/etiología , Letargia/veterinaria , Apetito , Abdomen , Dilatación Gástrica/veterinaria , Vólvulo Gástrico/veterinaria , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/cirugíaAsunto(s)
Letargia , Convulsiones , Recién Nacido , Humanos , Letargia/diagnóstico , Letargia/etiología , Convulsiones/diagnóstico , Convulsiones/etiologíaAsunto(s)
Anorexia , Letargia , Femenino , Animales , Letargia/etiología , Letargia/veterinaria , Anorexia/etiología , Anorexia/veterinaria , Pollos , Fiebre/veterinariaAsunto(s)
Letargia , Conducta Materna , Femenino , Fiebre/etiología , Humanos , Lactante , Letargia/etiología , MadresAsunto(s)
Discinesias , Encefalitis por Herpes Simple , Herpes Simple , Aciclovir/uso terapéutico , Encefalitis por Herpes Simple/complicaciones , Encefalitis por Herpes Simple/diagnóstico , Encefalitis por Herpes Simple/tratamiento farmacológico , Herpes Simple/complicaciones , Herpes Simple/diagnóstico , Herpes Simple/tratamiento farmacológico , Humanos , Lactante , Letargia/etiologíaRESUMEN
BACKGROUND: Feline pancreatitis (FP) is an important health problem of cats. Its diagnostics is based on the combination of quantification of serum pancreatic lipase immunoreactivity (fPLI) and abdominal ultrasonography (AUS). These modalities allow for establishing highly specific diagnosis, however they are relatively expensive and time-consuming. On the other hand, a screening test of high sensitivity which would allow to rule out FP on the first visit without a considerable increase of costs would be clinically useful. To evaluate accuracy of nonspecific inflammatory biomarkers based on complete blood count (CBC) in diagnosing FP 73 client-owned cats with signs of lethargy and reduced appetite lasting for at least 2 days before presentation were enrolled in the cross-sectional study. They were examined with fPLI assay and AUS and classified as cats with very low risk of FP when fPLI ≤3.5 µg/L and AUS negative for FP, or as cats with increased risk of FP in the case of any other combination of results. Then, 7 various CBC measurements were measured in each cat and linked to the risk of FP using the multivariable logistic regression. RESULTS: Five CBC measurements turned out to be significantly associated with the risk of FP - total leukocyte count (WBC; crude odds ratio(ORcrude) = 12.2; CI 95%: 1.52, 98.5), total neutrophil count (ORcrude = 5.84; CI 95%: 1.22, 27.9), band neutrophil count (BNC; ORcrude = 6.67; CI 95%: 1.98, 22.4), neutrophil-to-lymphocyte ratio (ORcrude = 3.68; CI 95%: 1.25, 10.9), and eosinophil count (EC; ORcrude = 0.34; CI 95%: 0.12, 0.96). The model based on WBC, BNC, and EC proved to have at least fair diagnostic potential (area under ROC curve 82.7%; CI 95%: 72.8%, 92.5%). When WBC < 18 G/L, BNC < 0.27 G/L, and EC > 0.3 G/L was considered as a negative result, and any other combination as the positive result, the CBC model had high sensitivity (91.8%; CI 95%: 80.8%, 96.8%) at a relatively low specificity (58.3%; CI 95%: 38.8%, 75.5%). CONCLUSION: The combination of three CBC measurements is an immediately available and fairly accurate screening method for identification of lethargic and anorectic cats with increased risk of FP.
Asunto(s)
Enfermedades de los Gatos , Trastornos de Alimentación y de la Ingestión de Alimentos , Letargia , Pancreatitis , Animales , Recuento de Células Sanguíneas/veterinaria , Enfermedades de los Gatos/sangre , Enfermedades de los Gatos/diagnóstico , Gatos , Estudios Transversales , Trastornos de Alimentación y de la Ingestión de Alimentos/etiología , Trastornos de Alimentación y de la Ingestión de Alimentos/veterinaria , Letargia/sangre , Letargia/etiología , Letargia/veterinaria , Pancreatitis/sangre , Pancreatitis/complicaciones , Pancreatitis/diagnóstico , Pancreatitis/veterinaria , Sensibilidad y EspecificidadRESUMEN
Fatigue and sleepiness are widely observed but ill-understood responses to tissue injury. A new study in Caenorhabditis elegans illuminates how the innate immune system mediates injury-induced sleep, which may help in surviving the injury.
Asunto(s)
Proteínas de Caenorhabditis elegans , Animales , Caenorhabditis elegans , Humanos , Letargia/etiología , Sueño , VigiliaAsunto(s)
Encéfalo/patología , Infarto Cerebral/diagnóstico por imagen , Líquido Cefalorraquídeo/microbiología , Pulmón/patología , Mycobacterium tuberculosis/aislamiento & purificación , Tuberculosis Meníngea/diagnóstico , Adenocarcinoma/complicaciones , Anciano , Encéfalo/diagnóstico por imagen , Infarto Cerebral/etiología , Diagnóstico Diferencial , Disnea/etiología , Femenino , Cefalea/etiología , Humanos , Letargia/etiología , Pulmón/diagnóstico por imagen , Imagen por Resonancia Magnética , Trastornos Mentales/etiología , Radiografía Torácica , Neoplasias Gástricas/complicaciones , Tomografía Computarizada por Rayos X , Tuberculosis Meníngea/complicacionesAsunto(s)
Anomalías del Sistema Digestivo , Letargia , Diagnóstico Diferencial , Humanos , Recién Nacido , Letargia/etiologíaRESUMEN
Background/aim: Hantavirus is a rodent borne zoonosis caused by the members of the virus family Bunyaviridae, genus Hantavirus. In this study, we aimed to determine the role of peripheral blood leukocyte ratio in differential diagnosis of Hantavirus disease. Materials and methods: The medical records of patients at the Düzce University Medical Faculty were examined retrospectively. A total of 20 patients diagnosed with hantavirus infection confirmed by serologic tests were included in the study (Group 1). The other group consisted of 30 patients suspected of hantavirus infection but found negative (Group 2). Demographic, clinical and laboratory characteristics, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lymphocyte/monocyte (LMR) ratios of both groups were compared. Results: As a result of the istatistics analysis, no difference was found between the groups' age, sex, and clinical complaints except lethargy-weakness (P = 0.004) and diarrhea (P < 0.001). Hemogram analysis showed a significant difference between the groups in terms of leukocyte, hemoglobin, hematocrit, platelet, mean platelet volume (P < 0.05) and PLR (P = 0.001) and LMR (P = 0.003) values from peripheral blood leukocyte ratios. Conclusion: In conclusion, NLR, PLR, and LMR ratios may be useful for clinicians in differential diagnosis of Hantavirus in patients presenting with similar symptoms of Hantavirus disease.
Asunto(s)
Diarrea , Infecciones por Hantavirus , Letargia , Recuento de Leucocitos/métodos , Orthohantavirus/aislamiento & purificación , Recuento de Plaquetas/métodos , Adulto , Diagnóstico Diferencial , Diarrea/diagnóstico , Diarrea/etiología , Femenino , Infecciones por Hantavirus/sangre , Infecciones por Hantavirus/diagnóstico , Infecciones por Hantavirus/epidemiología , Infecciones por Hantavirus/fisiopatología , Humanos , Letargia/diagnóstico , Letargia/etiología , Masculino , Estudios Retrospectivos , Pruebas Serológicas/métodos , Turquía/epidemiologíaRESUMEN
A 57-year-old woman presented with severe lethargy, dizziness and nausea 1 week after transsphenoidal resection of a growth hormone secreting pituitary adenoma. She was found to have severe hyponatremia of 115 mmol/L. Importantly, she was neurologically intact and clinically euvolaemic. Her fluid intake was restricted and her sodium levels increased to 131 mmol/L over 4 days. She made a full recovery.She was diagnosed with isolated second-phase diabetes insipidus, a state of symptomatic hypoosmolar hyponatremia that usually occurs 7-10 days after transsphenoidal surgery. The sodium levels improve with fluid restriction.
Asunto(s)
Adenoma/cirugía , Agua Potable , Hiponatremia , Hipofisectomía , Neoplasias Hipofisarias/cirugía , Complicaciones Posoperatorias , Desequilibrio Hidroelectrolítico/terapia , Adenoma/metabolismo , Adenoma/patología , Dietoterapia/métodos , Mareo/diagnóstico , Mareo/etiología , Femenino , Humanos , Hiponatremia/sangre , Hiponatremia/etiología , Hiponatremia/fisiopatología , Hiponatremia/terapia , Hipofisectomía/efectos adversos , Hipofisectomía/métodos , Letargia/diagnóstico , Letargia/etiología , Persona de Mediana Edad , Neoplasias Hipofisarias/metabolismo , Neoplasias Hipofisarias/patología , Complicaciones Posoperatorias/sangre , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/terapia , Hueso Esfenoides/cirugía , Resultado del TratamientoRESUMEN
The aquatic environment and the associated fish assemblages are being exposed to an increasing amount of microplastics. Despite the high number of publications on the presence of microplastics in fish, little is known about their uptake, translocation and accumulation within fish organs. Experimental studies on the detection and effects of pristine microplastics in fish have shown controversial and ambiguous results, respectively. Here, we conducted two experiments to detect and assess the impacts of dietary exposure of Danio rerio to different types of pristine microplastics. Our results show that D. rerio recognizes plastic particles as inedible materials but ingests them when mixed with food or fish oil. Accidental ingestion occurs in fish exposed to relatively small (1-5 µm) microplastic particles without associated food or fish oil. Additionally, D. rerio effectively eliminated pristine microplastics 24 h after ingestion; however, retention time was associated with increasing particle size and the intake of additional meals. Clinical signs, such as anorexia and lethargy, are present in fish fed relatively large microplastics (120-220 µm). The ingestion of microplastics does not induce any histopathological changes. To the best of our knowledge, we are able, for the first time, to fully demonstrate the uptake and translocation of plastic microbeads using confocal microscopy. Our results question the findings of previous studies on the detection and effects of pristine microplastics in fish and state that inaccurate interpretations of the histological findings regarding microplastics in fish organs is a prevalent flaw in the current scientific literature.