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1.
Ideggyogy Sz ; 73(1-2): 70-72, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32057208

RESUMO

Introduction - Valproic acid is an effective antiepileptic and mood stabilizer used in the treatment of many neurological and psychiatric disorders. Although there are frequently seen side effects, effusions between layers of pleural and pericardial membranes are rare to be seen. Case - Pleuropericardial effusion was detected in a 23 years old woman who was under valproic acid treatment because of epileptic seizure. After 1 year of valproic acid treatment, patient complained of dyspnea. As all the researches intended on etiology were usual, valproic acid has been thought to be responsible for the matter. Control examination after 1.5 months regarding the end of treatment revealed complete recovery of pleuropericardial effusion. Discussion - Pleural and pericardial effusions are rarely seen complications related to the use of valproic acid. It must also be kept in mind that valproic acid causes a potential for such side effects which can be blamed etiologically when the other possibilities for patients are excluded.


Assuntos
Anticonvulsivantes , Derrame Pericárdico , Derrame Pleural , Ácido Valproico , Anticonvulsivantes/efeitos adversos , Epilepsia/tratamento farmacológico , Feminino , Humanos , Derrame Pericárdico/induzido quimicamente , Derrame Pleural/induzido quimicamente , Ácido Valproico/efeitos adversos , Adulto Jovem
2.
J Med Case Rep ; 13(1): 200, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31256758

RESUMO

BACKGROUND: Yellow nail syndrome is a rare condition associated with a triad of symptoms: yellow nails, lung lesions, and lymphedema. We report a case of yellow nail syndrome caused by titanium exposure from multiple artificial joint replacements. CASE PRESENTATION: A 78-year-old Asian woman presented to our outpatient department with chief complaints of cough, fever, and nausea. The patient was hospitalized for observation because of the presence of hypoxemia and bilateral pleural effusion. Her medical history included knee joint replacement and two spinal fusion surgeries. Her physical examination conducted following hospitalization revealed yellow nails on both hands and feet. This finding, combined with the observation of bilateral pleural effusion, raised suspicion for yellow nail syndrome. Blood analysis yielded negative results, as did the tests for sputum culture, interferon liberation, pleural effusion culture, and pleural effusion cytology. Pleural histopathological analysis and imaging yielded negative results. Considering the possibility of titanium exposure from artificial joints based on the patient's medical history, we examined a chest radiograph obtained before the second spinal fusion surgery; however, no pleural effusion was observed. Pleural effusion was observed, however, following the surgery. On the basis of these findings, the patient was diagnosed with yellow nail syndrome due to titanium exposure. CONCLUSIONS: Clinicians should examine the nails of patients with unexplained pleural effusion. Moreover, they should inquire about titanium exposure when obtaining the patient's medical history.


Assuntos
Fixadores Internos/efeitos adversos , Prótese do Joelho/efeitos adversos , Titânio/efeitos adversos , Síndrome das Unhas Amareladas/induzido quimicamente , Idoso , Artroplastia do Joelho , Feminino , Humanos , Derrame Pleural/induzido quimicamente , Fusão Vertebral
3.
Intern Med ; 58(21): 3139-3141, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31292394

RESUMO

Dasatinib-related chylothorax is a rare adverse event, and the mechanism underlying its occurrence is still not fully understood. We herein report the case of a 73-year-old woman with chronic myeloid leukemia (CML) who developed dasatinib-related chylothorax refractory to conventional treatments, except for steroids. To the best of our knowledge, this is the first case of dasatinib-related chylothorax which was successfully controlled by combining diuretics with the Japanese herbal medicine "Goreisan." "Goreisan" is known to inhibit aquaporin channels and regulate the water flow. Our findings showed that "Goreisan" is an effective treatment option for uncontrollable dasatinib-related chylothorax.


Assuntos
Antineoplásicos/efeitos adversos , Quilotórax/tratamento farmacológico , Dasatinibe/efeitos adversos , Medicina Kampo , Fitoterapia , Extratos Vegetais/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Quilotórax/induzido quimicamente , Quilotórax/diagnóstico por imagem , Feminino , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Derrame Pleural/induzido quimicamente , Derrame Pleural/diagnóstico por imagem , Radiografia Torácica
4.
Toxicon ; 164: 16-19, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30946913

RESUMO

The aim of this paper was to report an outbreak of avocado poisoning in rabbits in Salta, Argentina. Fourteen rabbits died of congestive heart failure within 30 h of ingesting fresh avocado leaves from pruned trees. They showed clinical signs of respiratory and cardiac distress. Full necropsies of four rabbits were performed and samples were collected for histopathology. The gross pathological observation included pleural and pericardial effusion, pulmonary oedema, slight ascites; the hearts appeared flabby and markedly pale. In addition, the stomach content consisted mostly of green feed with large amounts of avocado leaves. Epidermal fragments of Persea americana were identified by microhistological analysis of gastric content to get most efficiently to a correct diagnosis. Histopathological examination revealed degeneration and necrosis of myocytes and a mononuclear cellular infiltration mainly involving the myocardium and, to a lesser extent, the liver, lung and kidneys. Our observations indicate that avocado leaves should be avoided in the green diet of rabbits.


Assuntos
Insuficiência Cardíaca/veterinária , Persea/envenenamento , Folhas de Planta/envenenamento , Intoxicação por Plantas/veterinária , Animais , Insuficiência Cardíaca/induzido quimicamente , Insuficiência Cardíaca/patologia , Derrame Pericárdico/induzido quimicamente , Derrame Pericárdico/veterinária , Intoxicação por Plantas/patologia , Derrame Pleural/induzido quimicamente , Derrame Pleural/veterinária , Edema Pulmonar/induzido quimicamente , Edema Pulmonar/patologia , Edema Pulmonar/veterinária , Coelhos
5.
Artigo em Inglês | MEDLINE | ID: mdl-30818785

RESUMO

Air pollution is known to increase the risk of pneumonia. However, the effects of air pollution on the pleural effusion of patients with pneumonia are unclear. The objective of this study was to investigate alterations in inflammatory⁻immune biomarkers by air pollution in patients with pneumonia by analyzing their pleural effusion. Patients who had undergone thoracentesis to drain their pleural effusion in a hospital were recruited for this study. Patients with pneumonia and those with congestive heart failure respectively served as the case and control groups. We observed that an increase of 1 ppb in one-year NO2 was associated with a decrease of 0.105 ng/mL in cluster of differentiation 62 (CD62) (95% confidence interval (CI) = -0.085, -0.004, p < 0.05) in the pleural effusion. Furthermore, we observed that an increase in one-year 1 ppb of NO2 was associated with a decrease of 0.026 ng/mL in molybdenum (Mo) (95% CI = -0.138, -0.020, p < 0.05). An increase in one-year 1 ppb of SO2 was associated with a decrease of 0.531 ng/mL in zinc (95% CI = -0.164, -0.006, p < 0.05). Also, an increase in one-year 1 ppb of O3 was associated with a decrease of 0.025 ng/mL in Mo (95% CI = -0.372, -0.053, p < 0.05). In conclusion, air pollution exposure, especially gaseous pollution, may be associated with the regulation of immune responses and changes in metal levels in the pleural effusion of pneumonia patients.


Assuntos
Poluição do Ar/efeitos adversos , Inflamação/induzido quimicamente , Inflamação/fisiopatologia , Metais/efeitos adversos , Derrame Pleural/induzido quimicamente , Derrame Pleural/fisiopatologia , Pneumonia/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Monitoramento Ambiental , Feminino , Insuficiência Cardíaca/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade
6.
J Oncol Pharm Pract ; 25(5): 1248-1252, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29933727

RESUMO

Azacitidine, a deoxyribonucleic acid hypomethylating agent, is used in the treatment of myelodysplastic syndrome. Common adverse effects of azacitidine include bone marrow suppression, injection site reactions, nausea, vomiting, diarrhea, and fatigue. This report focuses on pleuropericardial effusions, an infrequently reported and potentially reversible adverse effect of azacitidine. In this case report, pleuropericardial effusion manifested as the sole radiographic finding in the evaluation of cough occurring during the eighth cycle of treatment with azacitidine. Symptoms and radiographic abnormalities resolved with corticosteroids and diuretics, and the patient could continue with therapy.


Assuntos
Antimetabólitos Antineoplásicos/efeitos adversos , Azacitidina/efeitos adversos , Síndromes Mielodisplásicas/tratamento farmacológico , Derrame Pericárdico/induzido quimicamente , Derrame Pleural/induzido quimicamente , Idoso , Humanos , Masculino
8.
BMJ Case Rep ; 20182018 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-29735508

RESUMO

We report the case of a 41-year-old woman who presented with a unilateral exudative effusion with prominent eosinophils on pleural cytology. Carbimazole had been started 4 weeks prior to presentation. No immediate cause was identified on imaging or laboratory testing. The effusion persisted at 2-month follow-up. Further investigation at this time, including autoimmune serology was negative. At 2-month follow-up, the effusion was loculated on ultrasound imaging and had a low fluid pH on diagnostic aspiration, in keeping with an empyema. The patient received treatment for pleural empyema, including antibiotics, intercostal drain insertion and video-assisted thoracoscopic pleural biopsy. Carbimazole was stopped, and following treatment for the empyema, the effusion did not reaccumulate.This case illustrates the diagnostic difficulties that pleural effusions may present. It demonstrates that drug reactions should be considered in the differential diagnosis following thorough investigation for other potential causes and also describes the complications that may occur.


Assuntos
Carbimazol/efeitos adversos , Empiema Pleural/patologia , Exsudatos e Transudatos/química , Pleura/patologia , Derrame Pleural/induzido quimicamente , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Antitireóideos/efeitos adversos , Diagnóstico Diferencial , Empiema Pleural/diagnóstico por imagem , Empiema Pleural/tratamento farmacológico , Empiema Pleural/cirurgia , Eosinófilos/citologia , Eosinófilos/patologia , Exsudatos e Transudatos/citologia , Exsudatos e Transudatos/microbiologia , Feminino , Humanos , Pleura/citologia , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/microbiologia , Streptococcus oralis/isolamento & purificação , Cirurgia Torácica Vídeoassistida/métodos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Ultrassonografia/métodos
11.
Medicine (Baltimore) ; 97(7): e9996, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29443793

RESUMO

RATIONALE: Eosinophilic pleural effusion (EPE) is an eosinophil count ≥10% in pleural effusion, which is a rare condition in drug therapy. PATIENT CONCERNS: We describe the case of a 70-year-old Alzheimer patient who was taking olanzapine for 2 months for the treatment of depression, and developed peripheral eosinophilia and bilateral EPE. DIAGNOSES: Olanzapine-induced peripheral eosinophilia and eosinophilic pleural effusion was diagnosed. INTERVENTIONS: Olanzapine was discontinued, and repeated drainage of fluid from the pleural cavity was performed. OUTCOMES: All symptoms-as well as the EPE-were resolved 6 months later. LESSONS: This case is a reminder that olanzapine may be a potential agent for EPE, and that this should be considered in clinical practice.


Assuntos
Antidepressivos/efeitos adversos , Benzodiazepinas/efeitos adversos , Eosinofilia/induzido quimicamente , Derrame Pleural/induzido quimicamente , Idoso , Depressão/tratamento farmacológico , Drenagem , Humanos , Masculino , Olanzapina , Derrame Pleural/terapia
12.
Chest ; 153(2): e33-e36, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29406237

RESUMO

CASE PRESENTATION: A 68-year-old man with chronic myelogenous leukemia presents for evaluation of 2 months of dyspnea with exertion. He denies cough, fever, chest pain, weight gain, orthopnea, and edema. Since diagnosis of chronic myelogenous leukemia 5 years ago, he has been treated with dasatinib, with recent BCR-ABL1 assay showing no detectable disease in the peripheral blood. Medical history also includes hyperlipidemia, prostate enlargement, and hypothyroidism, but no prior heart or lung disease. Born in the Middle East, he immigrated to the United States 30 years ago and is working as a physician. He received the Bacillus Calmette-Guérin vaccine as a child. Quantiferon Gold test 1 year ago was positive (TB antigen response 0.91, reference range in <0.35), but he has not received treatment for this. He is a lifelong nonsmoker and rarely drinks alcohol. Medications include dasatinib, rosuvastatin, levothyroxine, tamsulosin, and dutasteride.


Assuntos
Antineoplásicos/efeitos adversos , Dasatinibe/efeitos adversos , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Derrame Pleural/induzido quimicamente , Idoso , Humanos , Masculino
15.
J Oncol Pharm Pract ; 24(7): 531-536, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28614979

RESUMO

Docetaxel has been approved by the Food and Drug Administration for the treatment of many cancer types, including breast cancer, head and neck cancer, lung cancer, and prostate cancer. Many severe to life-threatening side effects (Grades 3-5) of docetaxel have been reported in clinical trials, case reports, and Food and Drug Administration Adverse Events Reporting System. These include anaphylactic reactions, febrile neutropenia, fluid retention, acute respiratory distress, pleural effusion, pneumonia, and peripheral neuropathy. There were fewer cardiac toxicities reported for docetaxel as compared to paclitaxel, which were less severe. In this report, we present a clinical case of docetaxel-induced cardiac-respiratory arrest in a 62-year-old Hispanic male patient with stable chronic atrial fibrillation, who has been recently diagnosed with metastatic prostate cancer. The cardiac event developed within 15 min of docetaxel infusion during the second cycle of chemotherapy despite using recommended premedication with corticosteroids.


Assuntos
Antineoplásicos/efeitos adversos , Parada Cardíaca/induzido quimicamente , Taxoides/efeitos adversos , Fibrilação Atrial/complicações , Docetaxel , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pleural/induzido quimicamente , Pré-Medicação
16.
Intern Emerg Med ; 13(6): 901-906, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28965174

RESUMO

Pleural or abdominal effusions are frequent findings in ICU and Internal Medicine patients. Diagnostic gold standard to distinguish between transudate and exudate is represented by "Light's Criteria," but, unfortunately, the chemical-physical examination for their calculation is not a rapid test. Pursuing an acid-base assessment of the fluid by a blood-gas analyzer, an increase of lactate beyond the normal serum range is reported in the exudative effusions. The advantages of this test are that it is a very fast bed-side test, executable directly by the physician. The aim of this study is to evaluate whether the increase in lactate in pleural and abdominal effusions might be used as a criterion for the differential diagnosis of the nature of the fluid. Sixty-nine patients with pleural or abdominal effusions and clinical indication for thoracentesis or paracentesis were enrolled. Acid-base assessment with lactate, total protein, and LDH dosage on the serum, and acid-base assessment with lactate, total protein, and LDH dosage, cytology, and bacterial culture on the fluid were performed to each patient. Fluid-blood lactate difference (ΔLacFB) and fluid-blood lactate ratio (LacFB ratio) were calculated. A statistical analysis was carried out for fluid lactate (LacF), ΔLacFB, and LacFB ratio, performing ROC curves to find the cut-off values with best sensitivity (Sn) and specificity (Sp) predicting an exudate diagnosis: LacF: cut-off value: 2.4 mmol/L; AU-ROC 0.854 95% CI 0.756-0.952; Sn 0.77; Sp 0.84. ΔLacFB: cut-off value: 0.95 mmol/L; Au-ROC 0.876 95% CI 0.785-0.966; Sn 0.80; Sp 0.92. LacFB ratio: cut-off value: 2 mmol/L; Au-ROC 0.730 95% CI 0.609-0.851; Sn 0.74; Sp 0.65. Lactate dosage by blood-gas analyzer on pleural and abdominal effusions seems to be a promising tool to predict a diagnosis of exudate.


Assuntos
Líquido Ascítico/química , Ácido Láctico/análise , Derrame Pleural/induzido quimicamente , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Biomarcadores/análise , Biomarcadores/sangue , Técnicas e Procedimentos Diagnósticos , Exsudatos e Transudatos/química , Feminino , Humanos , Ácido Láctico/sangue , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Derrame Pleural/diagnóstico , Valor Preditivo dos Testes , Curva ROC
17.
Clin Respir J ; 12(2): 799-801, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27460941

RESUMO

Eosinophilic pleural effusions (EPE) account for 5%-8% of all exudative pleural effusions. A pleural effusion is defined as eosinophilic if it contains 10% or more eosinophils. We present the case of a 70-year-old man with EPE, blood eosinophilia and pericardial effusion due to dabigatran, a novel anti-thrombin agent.


Assuntos
Dabigatrana/efeitos adversos , Eosinofilia/induzido quimicamente , Derrame Pleural/induzido quimicamente , Trombose Venosa/tratamento farmacológico , Idoso , Dabigatrana/uso terapêutico , Eosinofilia/diagnóstico , Eosinofilia/terapia , Seguimentos , Humanos , Masculino , Multimorbidade , Derrame Pleural/diagnóstico , Derrame Pleural/terapia , Índice de Gravidade de Doença , Toracoscopia/métodos , Trombose Venosa/prevenção & controle
19.
Am J Case Rep ; 18: 1370-1376, 2017 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-29269724

RESUMO

BACKGROUND Sirolimus is a mammalian target of rapamycin (mTOR) inhibitor, which is used in immunosuppressive treatment regimens in organ transplant recipients. Although mTOR inhibitors are well tolerated, their adverse effects have been reported. Sirolimus treatment in transplant recipients has been reported to be associated with lymphedema of the skin and subcutaneous tissues, and with pleural effusion, but edema of internal organs and organomegaly have not been previously reported. A case is presented lymphedema of the transplanted kidney and abdominal wall with ipsilateral pleural effusion following kidney biopsy in a patient treated with sirolimus. CASE REPORT A 32-year-old woman with a history of end-stage renal disease of unknown etiology had undergone right renal transplantation from an unrelated living donor, eight years previously. She was referred to our hospital with dyspnea, localized abdominal pain, and swelling of the transplanted kidney. The symptoms appeared following a kidney biopsy and the replacement of cyclosporin with sirolimus four months previously. On examination, she had localized swelling of the abdominal wall overlying the transplanted kidney, and a right pleural effusion. Hydronephrosis and nephrotic syndrome were excluded as causes of kidney enlargement. Following the withdrawal of sirolimus therapy her symptoms resolved within three months. CONCLUSIONS A case is described of lymphedema of the transplanted kidney and abdominal wall with ipsilateral pleural effusion following kidney biopsy attributed to her change in anti-rejection therapy to sirolimus. This case report should raise awareness of this unusual complication of sirolimus anti-rejection therapy and its possible effects on the lymphatic system.


Assuntos
Parede Abdominal/diagnóstico por imagem , Imunossupressores/efeitos adversos , Transplante de Rim , Linfedema/induzido quimicamente , Derrame Pleural/induzido quimicamente , Sirolimo/efeitos adversos , Adulto , Biópsia , Feminino , Humanos , Rim/patologia , Linfedema/diagnóstico por imagem
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