RESUMO
A 76-year-old Korean woman visited to emergency room because of respiratory arrest and admitted to intensive care unit of the hospital. Severe hypothyroidism was diagnosed after repeated failure of weaning mechanical ventilator. Respiratory arrest and weaning failures were considered to be associated with hypoventilation due to hypothyroidism. She was recovered and weaned from mechanical ventilation after replacement of thyroid hormone. Severe hypothyroidism may be a cause of respiratory failure or weaning failure.
Assuntos
Idoso , Feminino , Humanos , Serviço Hospitalar de Emergência , Hipotireoidismo , Hipoventilação , Unidades de Terapia Intensiva , Respiração Artificial , Insuficiência Respiratória , Glândula Tireoide , Ventiladores Mecânicos , DesmameRESUMO
Acute transverse myelitis (ATM) is a heterogeneous syndrome characterized by acute spinal cord dysfunction resulting in paresis and sensory and autonomic impairment below the level of the lesion. The etiology of ATM includes parainfectious, paraneoplastic, drug-induced, systemic autoimmune disorders, and acquired demyelinating diseases. ATM is very rare in patients with rheumatoid arthritis (RA). A 79-year-old woman with RA, a recurring peptic ulcer, and congestive heart failure presented with acute weakness of both upper and lower extremities. She was diagnosed with ATM based on the results of laboratory and radiological tests. ATM is usually treated with high-dose glucocorticoid. However, we treated her with intravenous immunoglobulin (IVIG) considering the adverse events of high-dose glucocorticoid, and she improved. We report a case of ATM in a patient with RA successfully treated with IVIG.
Assuntos
Idoso , Feminino , Humanos , Artrite Reumatoide , Doenças Desmielinizantes , Insuficiência Cardíaca , Imunoglobulinas , Imunoglobulinas Intravenosas , Extremidade Inferior , Mielite Transversa , Paresia , Úlcera Péptica , Medula EspinalRESUMO
Amiodarone is a widely used antiarrhythmic agent. Among its various adverse effects, amiodarone-induced pulmonary toxicity (APT) is the most life threatening complication, which has been described mostly in patients who have been in treatment with high accumulative doses for a long duration of time. However, amiodarone therapy in short-term duration induced APT was rarely reported. We describe a case of a 54-year-old man who is presented with symptoms of APT after a few days of therapy for post-myocardial infarction ventricular tachycardia. For early diagnosis and successful treatment, awareness and high suspicion of this rare type of early onset APT is crucial in patients with amiodarone therapy.
