Risperidone induced angioedema with concurrent EPS symptoms: a case report and review of literature.

Angioedema has recently been reported as a side effect associated with the antipsychotic risperidone. We report a case of dystonia with concurrent angioedema due to risperidone. A 40-year-old male with a history of schizophrenia was started on 3 mg of risperidone BID and developed perioral and periorbital edema along with increased muscle rigidity and hand tremor within 24 h of initial administration. His symptoms abated after cessation of risperidone and intravenous administration of corticosteroids and antihistamine. This case study adds to the current literature, which has already established angioedema as a dose-dependent side effect of risperidone. Moreover, this case study aims to increase awareness about the potential for the simultaneous occurrence of angioedema and extrapyramidal symptoms, and promotes vigilance among prescribers so that the life-threatening consequences of such effects can be avoided.

Outcomes of kidney transplantation in Alport syndrome compared with other forms of renal disease.

INTRODUCTION: Alport syndrome is an inherited renal disease characterized by hematuria, renal failure, hearing loss and a lamellated glomerular basement membrane. Patients with Alport syndrome who undergo renal transplantation have been shown to have patient and graft survival rates similar to or better than those of patients with other renal diseases. METHODS: In this national case series, based in Beaumont Hospital Dublin, we studied the cohort of patients who underwent renal transplantation over the past 33 years, recorded prospectively in the Irish Renal Transplant Registry, and categorized them according to the presence or absence of Alport syndrome. The main outcomes assessed were patient and renal allograft survival. RESULTS: Fifty-one patients diagnosed with Alport syndrome in Beaumont Hospital received 62 transplants between 1982 and 2014. The comparison group of non-Alport patients comprised 3430 patients for 3865 transplants. Twenty-year Alport patient survival rate was 70.2%, compared to 44.8% for patients with other renal diseases (p = .01). Factors associated with patient survival included younger age at transplantation as well as differences in recipient sex, donor age, cold ischemia time, and episodes of acute rejection. Twenty-year graft survival was 46.8% for patients with Alport syndrome compared to 30.2% for those with non-Alport disease (p = .11). CONCLUSIONS: Adjusting for baseline differences between the groups, patients with end-stage kidney disease (ESKD) due to Alport syndrome have similar patient and graft survival to those with other causes of ESKD. This indicates that early diagnosis and management can lead to favorable outcomes for this patient cohort.

Fibrosingmediastinitis and consequent superior vena cava syndrome - A case report.

Fibrosing mediastinitis is a rare, chronic inflammatory disease that has several implicated etiologies. We describe a case of a 41-year old woman who presented with the classic signs and symptoms of superior vena cava syndrome. Imaging revealed a diffuse infiltrative mediastinal process, which on biopsy was consistent with fibrosing mediastintis.

Calcium bioavailability from a fortified cereal-legume snack (laddoo).

OBJECTIVE: Calcium intakes in underprivileged Indian children are often low. Improving calcium intake fortification of indigenous foods may be a viable strategy. The aim of this study was to evaluate calcium absorption, as judged by an acute increase in serum ionized calcium concentration, after ingestion of a calcium-fortified cereal-legume snack (laddoo). METHODS: Three groups of eight children (8-12 y old) with low habitual dietary calcium intake were recruited for the study. After an overnight fast, a calcium-fortified (500 mg of calcium carbonate) cereal-legume snack (laddoo) was given to group A, a similar but non-fortified snack was given to group B, and group C received calcium carbonate (500 mg) alone. Serum concentrations of ionized calcium and intact parathyroid hormone were measured at 0, 1, 2, 3, 4, and 5 h. RESULTS: In group A, a peak of 6% above baseline was observed at 1 h in serum ionized calcium, whereas group C showed a peak of 5.5% at 4 h and group B showed a small increase of 1.8% at 1 h. The change in area under curve of groups A and C were of similar order (4.6 and 5.5, respectively), whereas that of group B was significantly lower (0.82). Serum parathyroid hormone was lowest at 2 h in groups A and B and at 3 h in group C. CONCLUSION: The fortified cereal-legume laddoo may act as a novel vehicle for increasing calcium intake in children.