Asunto(s)
Acidosis Tubular Renal , Calcio/uso terapéutico , Parálisis Periódica Hipopotasémica , Debilidad Muscular , Potasio/uso terapéutico , Síndrome de Sjögren , Bicarbonato de Sodio/uso terapéutico , Acidosis Tubular Renal/sangre , Acidosis Tubular Renal/complicaciones , Acidosis Tubular Renal/diagnóstico , Adulto , Autoanticuerpos/sangre , Hormonas y Agentes Reguladores de Calcio/uso terapéutico , Diagnóstico Diferencial , Electromiografía/métodos , Femenino , Humanos , Parálisis Periódica Hipopotasémica/complicaciones , Parálisis Periódica Hipopotasémica/inmunología , Parálisis Periódica Hipopotasémica/fisiopatología , Masculino , Debilidad Muscular/diagnóstico , Debilidad Muscular/tratamiento farmacológico , Debilidad Muscular/etiología , Síndrome de Sjögren/complicaciones , Síndrome de Sjögren/inmunología , Síndrome de Sjögren/fisiopatología , Resultado del TratamientoRESUMEN
Posterior reversible encephalopathy syndrome (PRES) is a clinic-radiological syndrome that is generally reversible and may lead to permanent neurological damage if left untreated. PRES has been commonly linked with hypertension along with associated vasogenic oedema. Children are more susceptible to these perturbations due to the narrow range of cerebral autoregulation. PRES must be considered in differentials of any neurological dysfunction which is associated with hypertension in the immediate post-operative period. Inadequate pain control in the post-operative period may cause hypertension that may lead to subsequent PRES. We report a case of postoperative PRES in a 12-year-old previously normotensive child posted for splenectomy with an acute rise in blood pressure in the post-operative period.
RESUMEN
Patients suffering from acute intractable vomiting are usually treated in the Gastroenterology department. The causes of acute intractable vomiting range from acute pancreatitis and acute intestinal obstruction to cardiac causes like acute myocardial infarction and neurological causes like posterior circulation stroke. However, most of the underlying causes of acute intractable vomiting also produce other telltale signs/symptoms. Rarely, isolated acute intractable vomiting may be the initial symptom of a recurrent neurological syndrome of neuromyelitis optica spectrum disorder (NMOSD). Not only can it be promptly treated if diagnosed correctly, but also a timely diagnosis may help in prevention of recurrent neurological deficits, which can sometimes be life threatening. We present three cases of NMOSD that presented with intractable vomiting and were treated in a Gastroenterology facility prior to their diagnosis.