ABSTRACT
Although angioneurotic oedema (AE) is a rare entity, it sometimes leads to devastating consequences. We report the case of an oro-pharyngeal angioneurotic attack following the initiation of a fibrinolysis therapy by alteplase and relay by heparin in a patient with severe acute pulmonary embolism. In view of this original case, we propose to highlight the most recent elements concerning the physiopathology of this disease.
L'Ådème angioneurotique (OAN) est une entité rare, dont les conséquences peuvent pourtant être parfois désastreuses. Nous présentons le cas d'un patient atteint d'une embolie pulmonaire grave ayant présenté un Ådème angioneurotique oro-pharyngé dans le décours du traitement fibrinolytique et de son relais par héparinothérapie. A la lumière de cette présentation originale, nous proposons de discuter les éléments actuels concernant la physiopathologie de cette maladie et les facteurs favorisant le développement de cette maladie.
Subject(s)
Angioedema/chemically induced , Fibrinolytic Agents/adverse effects , Pulmonary Embolism/drug therapy , Tissue Plasminogen Activator/adverse effects , Aged , Humans , MaleABSTRACT
Sometimes, the emergency department is confronted with cases of repetitive vomiting and abdominal pain without organic causes. These patients come back again and again for this problem. All diagnostic tests are systematically negative. A well conducted history taking reveals a chronic cannabis addiction and the disappearance of symptomatology by taking hot showers. This presentation is pathognomonic of the cannabinoid hyperemesis syndrome.
La pratique aux urgences nous confronte, de temps à autre, à des cas de vomissements incoercibles et de douleurs abdominales sans substrat organique retrouvé. Ces patients se présentent généralement de manière répétée pour ces symptômes. Les examens complémentaires réalisés aux urgences n'apportent classiquement aucune information. Une anamnèse quelque peu poussée met finalement en évidence une consommation chronique de cannabis et le soulagement de la symptomatologie par la prise de douches chaudes. Cette présentation est pathognomonique du syndrome d'hyperémèse cannabinoïde.
Subject(s)
Marijuana Abuse/diagnosis , Vomiting/diagnosis , Baths/adverse effects , Cannabinoids/toxicity , Diagnosis, Differential , Female , Humans , Marijuana Abuse/complications , Syndrome , Vomiting/etiology , Young AdultABSTRACT
Chronic consumption of soda energizing caffeine has known a growing success. Its deleterious effects, however, are often ignored. We report a case of tetraparesis associated with chronic excessive consumption of cola. The development of muscle weakness is variable, resulting from a hyperpolarization of excitable membranes. The outcome is most often favorable after potassium supplementation and interruption of the offending beverage consumption. The mechanisms involved are multiple and involve both a leakage of fecal and urinary potassium and a potassium entry into the intracellular compartment. Other mechanisms related to caffeine are also involved. It therefore appears mandatory to assess the consumption of such beverages in the presence of hypokalemia and muscle weakness.