ABSTRACT
Eosinophilic gastroenteritis (EG) is a rare disease of unknown etiology characterized by patchy or diffuse eosinophilic infiltration of the gastrointestinal tract wall with various gastrointestinal manifestations. As clinical presentation and radiological findings in EG are nonspecific, diagnosis requires a high index of suspicion and exclusion of other disorders that are associated with peripheral eosinophilia. This article reviews the history, current concepts of this complex disorder and the common symptoms. Because there is no gold standard for this disease, a wide variety of diagnostic criteria is presented.
Subject(s)
Eosinophilia/diagnosis , Gastroenteritis/diagnosis , Biopsy , Diagnosis, Differential , Diagnostic Imaging , Endoscopy, Gastrointestinal , HumansABSTRACT
Cardiac troponin I is released from myocytes in both reversible and irreversible myocardial injury. The changes in myocyte membrane permeability resulting from the injury could be enough for the release of cardiac troponins from the free cytosolic pool of myocytes without structural damage. We report a case of parvovirus B19 myocarditis in a 26-year-old male who developed regional wall motion abnormalities and severe left ventricular systolic dysfunction with elevated serum levels of cardiac troponin I (peak=11.7 ng/ml). Diagnosis of parvovirus myocarditis was confirmed by presence of high titers of parvovirus B19 IgG and identification of parvovirus B19 DNA by polymerase chain reaction. Within a few days of supportive treatment, the regional wall motion abnormalities resolved, the cardiac function recovered, and the elevation in serum cardiac troponin I subsided. This case further denotes the possibility of release of cardiac troponin I in non-ischemic, reversible myocardial injury.
Subject(s)
Myocarditis/metabolism , Myocarditis/virology , Parvoviridae Infections/metabolism , Parvovirus B19, Human , Troponin I/metabolism , Adult , Humans , Male , Myocarditis/complications , Parvoviridae Infections/complicationsABSTRACT
This report describes a unique case of prolonged hypoglycemia in a nondiabetic patient with end-stage renal disease and chronic liver disease. Following a less-than-24-hour period of being NPO (nothing per oral), the patient developed hypercapnic respiratory failure. Severe hypoglycemia in such a patient leading to respiratory failure provides major challenges in identification and management of his illness. To our knowledge, this is the first ever reported case of severe hypoglycemia leading to hypercapnic respiratory failure. We believe that the pathogenic basis for this patient's severe hypoglycemia is failure of contribution by the kidneys and liver to glucose production.
Subject(s)
Hypoglycemia/complications , Respiratory Insufficiency/etiology , Acute Disease , Blood Glucose/metabolism , Humans , Hypoglycemia/blood , Kidney Failure, Chronic/complications , Male , Middle Aged , Severity of Illness IndexABSTRACT
Renal medullary carcinoma is an epithelial malignant tumor arising from collecting duct epithelium. The tumor is almost exclusive to young black patients with the sickle cell hemoglobinopathies, mainly sickle cell trait (SCT). Most patients present with metastatic disease and have a worse prognosis. An African-American male with sickle cell disease (HbSCD) who was diagnosed to have renal medullary carcinoma is presented here. The clinical, histologic and radiologic features of this tumor are described. In the setting of advanced disease, treatment modalities have proved largely unsuccessful. Given the shared demographic, clinical and radiographic features of these patients, awareness and early diagnosis may prove essential in improving survival.