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3.
Medicine (Baltimore) ; 99(27): e21092, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629741

RESUMO

RATIONALE: Univentricular dextrocardia is a rare congenital heart disease that usually presents cyanotic manifestations from childhood. Due to the sustained dysfunction of blood oxygenation, it is very difficult to keep an asymptomatic survival. Herein, we described an interesting case of univentricular dextrocardia who suffered from initial symptoms in his middle age. PATIENT CONCERNS: A 54-year-old male patient with numbness and tingling of limbs was admitted to hospital due to the secondary manifestations of congenital heart disease. DIAGNOSIS: The patient was diagnosed as univentricular dextrocardia with pulmonary hypertension and secondary erythrocytosis based on computed tomography (CT) scan, echocardiography, and laboratory examinations. INTERVENTIONS: Intravenous hydration therapy with normal saline successfully eliminated his hyperviscosity associated symptoms. In view of socio-economic reasons, this patient refused surgical evaluation and further medical interventions. OUTCOMES: During 18-month follow up, he received no drug except for regular water intake. Fortunately, his life quality was satisfactory, and no other symptoms emerged except for mild numbness of limbs. LESSONS: In univentricular dextrocardia, it is possible to keep a long-term asymptomatic period due to the slow progress of pathophysiology. In this population, regular cardiac function evaluation and avoiding dehydration may help improve the quality of life.


Assuntos
Desidratação/prevenção & controle , Dextrocardia/diagnóstico por imagem , Cardiopatias Congênitas/complicações , Assistência ao Convalescente , Grupo com Ancestrais do Continente Asiático/etnologia , Dextrocardia/fisiopatologia , Dextrocardia/terapia , Ecocardiografia/métodos , Hospitalização , Humanos , Hipertensão Pulmonar/etiologia , Masculino , Pessoa de Meia-Idade , Policitemia/etiologia , Policitemia/terapia , Qualidade de Vida , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
4.
Diabetes Res Clin Pract ; 162: 108127, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32224163

RESUMO

SGLT-2 inhibitors are known to increase hematocrit. We present two cases with marked asymptomatic erythrocytosis developing after taking SGLT-2 inhibitors. No other predisposing or causative factor was found and SGLT-2 inhibitor drug was the most likely cause in both cases. Both patients underwent phlebotomy and haematocrit came down after withdrawing the offending drug.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Hipoglicemiantes/efeitos adversos , Policitemia/etiologia , Inibidores do Transportador 2 de Sódio-Glicose/efeitos adversos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Humanos , Hipoglicemiantes/farmacologia , Masculino , Pessoa de Meia-Idade , Inibidores do Transportador 2 de Sódio-Glicose/farmacologia
5.
Transplant Proc ; 52(4): 1169-1172, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32164957

RESUMO

INTRODUCTION: Renal transplantation presents multiple complications after its completion, some of them related to the behavior of hemoglobin levels. The objective of this study is to determine the behavior and prevalence of anemia and erythrocytosis in the first year after renal transplantation. MATERIAL AND METHODS: A retrospective, observational study was conducted of a cohort of patients of the 21st Century National Medical Center in Mexico of transplants performed from January 1, 2013 to December 31, 2017. A total of 649 met the inclusion criteria. Pre-transplant hemoglobin (Hb) levels were determined, as well as levels 1 month, 3, 6, 9, and 12 months after transplantation, and the prevalence of anemia and erythrocytosis was determined in each month. Descriptive analysis was performed with measures of central tendency and measures of dispersion. The statistical program SPSS version 25 was used. RESULTS: The mean pre-transplant Hb was 10.69 g/dL (standard deviation [SD] 2.04). One year after the renal transplant, Hb averaged 14.45 g/dL (SD 2.30), which meant an increase over the first year after renal transplantation of 3.76 g/dL. Pre-transplant anemia occurred in 73.1% of patients, and erythrocytosis in 0.1%; 12.9% of patients and 5.9% in erythrocytosis continued with anemia for a year. CONCLUSIONS: Renal transplantation allows Hb levels to recover in a multifactorial way; however, the persistence of anemia and erythrocytes creates a study challenge in any transplant unit, due to their prevalence of 12.9 and 5.9% respectively.


Assuntos
Anemia/epidemiologia , Transplante de Rim/efeitos adversos , Policitemia/epidemiologia , Adulto , Anemia/etiologia , Estudos de Coortes , Feminino , Hemoglobinas/análise , Humanos , Masculino , México , Pessoa de Meia-Idade , Policitemia/etiologia , Prevalência , Estudos Retrospectivos , Adulto Jovem
6.
Medicine (Baltimore) ; 99(1): e18486, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31895781

RESUMO

We have been examining the Comprehensive Health Check of the Fukushima Health Management Survey of residents of 13 municipalities who were forced by the government to evacuate due to the 2011 Great East Japan Earthquake (GEJE). Our findings showed that evacuation is a risk factor for polycythemia and suggested that experiencing an unprecedented disaster and exposure to chronic stress due to evacuation might be a cause of polycythemia.We analyzed the relationship between the prevalence of polycythemia and the following factors observed in the Mental Health and Lifestyle Survey in an observational study with a cross-sectional design: traumatic symptoms, depression status, socioeconomic factors such as residential environment, and working situation after the GEJE. Target population of the survey included men and women who were at least 15 years of age and who lived in the evacuation zones specified by the government. Participants analyzed consisted of 29,474 persons (12,379 men and 16,888 women) who had participated in both the 2011 Comprehensive Health Check and Mental Health and Lifestyle Survey from June 2011 through March 2012.The prevalence of polycythemia was not associated with mental states associated with traumatic symptoms (Post-Traumatic Stress Disorder Checklist Scale ≥ 44) and depression status (Kessler 6-item Scale ≥ 13). Furthermore, multivariate analysis showed that there was a tendency for males to develop polycythemia, with characteristics such as being aged 65 years and older, highly educated, obese (body mass index ≥ 25), hypertensive, diabetic, having liver dysfunction, and a smoker being significantly related to the prevalence of polycythemia.Our findings conclusively demonstrated that polycythemia was not significantly related to psychological factors, but was significantly related to the onset of lifestyle-related disease after the GEJE.


Assuntos
Acidente Nuclear de Fukushima , Policitemia/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Causalidade , Comorbidade , Terremotos , Feminino , Humanos , Japão/epidemiologia , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Policitemia/etiologia , Policitemia/psicologia , Prevalência , Tsunamis , Adulto Jovem
7.
Top Companion Anim Med ; 36: 9-11, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31472727

RESUMO

A 7-year-old mixed breed dog was evaluated for erythrocytosis with an initial hematocrit of 82.3%. Abdominal ultrasound revealed a 6 cm mass on the cranial pole of the right kidney. Daily therapeutic phlebotomies were performed, reducing the hematocrit to 54%. The dog underwent a right nephroureterectomy, recovered without complications, and was discharged 3 days after surgery. Histopathologic evaluation revealed a completely excised grade II soft tissue sarcoma. The preoperative erythropoietin level was 7.00 mU/mL (RI 1.90-22.90 mU/mL) and the 3-day postoperative erythropoietin level was 0.99 mU/mL, supporting a diagnosis of inappropriate secondary erythrocytosis due to the renal tumor. Secondary erythrocytosis resulting from renal soft tissue sarcoma is rare. Confirmatory testing with erythropoietin levels can assist in the diagnosis of secondary erythrocytosis. Erythropoietin levels that are normal or increased in the face of erythrocytosis indicate a source of inappropriate erythropoietin production.


Assuntos
Doenças do Cão/etiologia , Neoplasias Renais/veterinária , Policitemia/veterinária , Sarcoma/veterinária , Animais , Doenças do Cão/sangue , Doenças do Cão/patologia , Cães , Eritropoetina/sangue , Feminino , Neoplasias Renais/cirurgia , Policitemia/etiologia , Sarcoma/cirurgia
8.
Semin Pediatr Surg ; 28(4): 150825, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31451170

RESUMO

The increase in multiple gestation pregnancies has resulted in significant health care implications for both mother and child. Our ability to diagnose and intervene on an at-risk multi-gestation pregnancy has dramatically improved. It is important for the pediatric surgeon to be equipped with a basic fund of knowledge concerning these pregnancies. An understanding of amnionicity and chorionicity will equip the practitioner with the ability to identify which pregnancies are at risk for specific complications. This article highlights multi-gestation pregnancies that are monochorionic (single shared placenta) and can be complicated by twin-twin transfusion syndrome (TTTS), twin reversed arterial perfusion (TRAP) sequence, twin anemia polycythemia sequence (TAPS), or selective fetal intrauterine growth restriction (sIUGR). The risk of fetal demise is significant in these pregnancies. Understanding recommended surveillance and warning signs can alert surgeons to developing complications. Specialized fetal care centers possess the ability to intervene on these pregnancies in utero.


Assuntos
Retardo do Crescimento Fetal , Transfusão Feto-Fetal , Anemia/diagnóstico , Anemia/etiologia , Anemia/terapia , Feminino , Retardo do Crescimento Fetal/diagnóstico , Retardo do Crescimento Fetal/terapia , Transfusão Feto-Fetal/diagnóstico , Transfusão Feto-Fetal/cirurgia , Fetoscopia , Humanos , Fotocoagulação , Policitemia/diagnóstico , Policitemia/etiologia , Policitemia/terapia , Gravidez , Gêmeos Dizigóticos , Gêmeos Monozigóticos , Ultrassonografia Pré-Natal
10.
Am J Case Rep ; 20: 1114-1119, 2019 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-31352464

RESUMO

BACKGROUND Pulmonary alveolar microlithiasis is an autosomal recessive disease in which a mutation in the SLC34A2 gene that codes for a sodium phosphate type IIb transporter protein (expressed in human epithelial tissues and functions in the clearance of phosphate ions) leads to the formation of extensive pulmonary intra-alveolar microliths. The subsequent characteristic clinical features of dyspnea and hypoxia are a manifestation of these microliths. There have been fewer than 1000 cases of pulmonary alveolar microlithiasis reported worldwide, and there have been 19 reported lung-transplanted patients. CASE REPORT A 49-year-old Saudi male patient presented with longstanding history of easy fatigability and tiredness on exertion since he was 16 years old. Throughout his follow-up in different hospitals (1986-1989), tuberculosis and pulmonary fibrosis were suspected. The patient was lost to follow-up between 1989 and 2001. In 2002, he presented to the emergency room with coughing, shortness of breath on exertion, abdominal swelling, and pedal edema. An investigation with chest x-rays, CT scan, electrocardiogram, and an echocardiogram was conducted. After referral to a tertiary care center, the patient was diagnosed with pulmonary alveolar microlithiasis. He subsequently developed pulmonary hypertension and polycythemia and therefore received a bilateral lung transplant in 2016. Following the lung transplant, he developed a mild reperfusion injury and tonic-clonic seizures, requiring ICU admission. After a successful extubatation with stable vitals and good recovery, he was discharged home in stable condition with planned follow-up. CONCLUSIONS We report a case of pulmonary alveolar microlithiasis successfully treated with a bilateral lung transplant. Although pulmonary alveolar microlithiasis is a rare entity, healthcare providers should consider it in the differential diagnoses of parenchymal lung diseases and differentiate it from tuberculosis and pulmonary fibrosis.


Assuntos
Calcinose/cirurgia , Doenças Genéticas Inatas/cirurgia , Hipertensão Pulmonar/cirurgia , Pneumopatias/cirurgia , Transplante de Pulmão , Policitemia/etiologia , Calcinose/complicações , Calcinose/diagnóstico por imagem , Doenças Genéticas Inatas/complicações , Doenças Genéticas Inatas/diagnóstico por imagem , Humanos , Hipertensão Pulmonar/etiologia , Pneumopatias/complicações , Pneumopatias/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
11.
BMC Nephrol ; 20(1): 235, 2019 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266452

RESUMO

BACKGROUND: For patients with end stage renal disease undergoing hemodialysis, erythrocytosis occurs rarely. Erythrocytosis increases the risk of thrombosis, which is a common complication in hemodialysis patients. The risk of thrombosis may also be increased by hypotension. The purpose of our report is to examine the relationship between intradialytic hypotension and erythrocytosis. CASE PRESENTATION: We present a series of five patients with end stage renal disease and erythrocytosis (peak hemoglobin range 15.2-18.5 g/dL). All were erythropoiesis-stimulating agent naïve and non-smokers. Prior to developing erythrocytosis, each patient developed recurring episodes of intradialytic hypotension over several months. A statistically significant inverse correlation was observed between nadir intradialytic systolic blood pressure and hemoglobin concentration. In the index case, midodrine treatment resulted in resolution of the hypotension and erythrocytosis. Most of the patients had multiple acquired renal cysts, which is a potential source of erythropoietin. Four of the five cases developed arteriovenous dialysis access or deep venous thrombosis. CONCLUSIONS: An association between intradialytic hypotension and erythrocytosis was observed in five cases. We postulate that chronic intermittent hypotension and renal ischemia may lead to erythropoietin secretion, and this cascade could represent a newly recognized cause of secondary erythrocytosis.


Assuntos
Hipotensão/diagnóstico por imagem , Hipotensão/etiologia , Policitemia/diagnóstico por imagem , Policitemia/etiologia , Diálise Renal/efeitos adversos , Adulto , Feminino , Humanos , Falência Renal Crônica/diagnóstico por imagem , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade
12.
J S Afr Vet Assoc ; 90(0): e1-e5, 2019 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-31038324

RESUMO

Hepatoblastoma was diagnosed in a 3-year-old Thoroughbred gelding presented with forelimb lameness with bilateral fatigue fractures of the proximal third metacarpal bones. An abdominal mass was detected on ultrasound examination of the abdomen. Absolute erythrocytosis was diagnosed after clinical and haematological evaluation. The fractured metacarpal bones were surgically removed but complications after surgery were fatal. The liver mass was diagnosed as a hepatoblastoma based on histology and immunochemical staining. The combination of hepatoblastoma and fatigue fractures has not been described previously in horses. A potential link between the hepatic and orthopaedic pathologies is hypothesised.


Assuntos
Fraturas Espontâneas/veterinária , Hepatoblastoma/veterinária , Doenças dos Cavalos/patologia , Neoplasias Hepáticas/veterinária , Policitemia/veterinária , Animais , Evolução Fatal , Fraturas Espontâneas/etiologia , Fraturas Espontâneas/patologia , Hepatoblastoma/complicações , Hepatoblastoma/diagnóstico , Hepatoblastoma/patologia , Doenças dos Cavalos/diagnóstico , Doenças dos Cavalos/etiologia , Cavalos , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/patologia , Masculino , Ossos Metacarpais/patologia , Policitemia/etiologia
13.
Obstet Gynecol ; 133(6): 1274-1277, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31135745

RESUMO

BACKGROUND: Myomatous erythrocytosis syndrome, a form of secondary polycythemia associated with uterine leiomyomas, increases the risk of thrombosis and traditionally has been treated with hysterectomy. CASE: The patient is a 68-year-old woman with 7-year history of polycythemia initially thought to be secondary to a gastrointestinal stromal tumor that persisted after resection. A subsequent search for an alternative etiology led to the discovery of an 11.2-cm submucosal leiomyoma and likelihood of myomatous erythrocytosis syndrome. The patient declined surgical management and continued to undergo recurrent phlebotomy to maintain a hematocrit of less than 45% until consultation with an interventional radiology specialist. She underwent uterine artery embolization in July 2017, and her hematocrit has remained within normal limits through 17 months of follow-up. CONCLUSION: Uterine artery embolization is an effective alternative treatment modality for myomatous erythrocytosis syndrome.


Assuntos
Leiomioma/cirurgia , Policitemia/etiologia , Embolização da Artéria Uterina , Neoplasias Uterinas/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Síndrome , Resultado do Tratamento
14.
Hypertension ; 73(6): 1327-1335, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31006327

RESUMO

Excessive erythrocytosis (EE; hemoglobin concentration [Hb] ≥21 g/dL in adult males) is associated with increased cardiovascular risk in highlander Andeans. We sought to quantify shear stress and assess endothelial function via flow-mediated dilation (FMD) in male Andeans with and without EE. We hypothesized that FMD would be impaired in Andeans with EE after accounting for shear stress and that FMD would improve after isovolemic hemodilution. Brachial artery shear stress and FMD were assessed in 23 male Andeans without EE (age: 40±15 years [mean±SD]; Hb<21 g/dL) and 19 male Andeans with EE (age: 43±14 years; Hb≥21 g/dL) in Cerro de Pasco, Peru (4330 m). Shear stress was quantified from Duplex ultrasound measures of shear rate and blood viscosity. In a subset of participants (n=8), FMD was performed before and after isovolemic hemodilution with blood volume replaced by an equal volume of human serum albumin. Blood viscosity and Hb were 48% and 23% higher (both P<0.001) and FMD was 28% lower after adjusting for the shear stress stimulus ( P=0.013) in Andeans with EE compared to those without. FMD was inversely correlated with blood viscosity ( r2=0.303; P<0.001) and Hb ( r2=0.230; P=0.001). Isovolemic hemodilution decreased blood viscosity by 30±10% and Hb by 14±5% (both P<0.001) and improved shear stress stimulus-adjusted FMD from 2.7±1.9% to 4.3±1.9% ( P=0.022). Hyperviscosity, high Hb, or both, actively contribute to acutely reversible impairments in FMD in EE, suggesting that this plays a pathogenic role in the increased cardiovascular risk.


Assuntos
Altitude , Viscosidade Sanguínea/fisiologia , Artéria Braquial/fisiopatologia , Hemoglobinas/metabolismo , Policitemia/sangue , Fluxo Sanguíneo Regional/fisiologia , Vasodilatação/fisiologia , Adulto , Artéria Braquial/diagnóstico por imagem , Endotélio Vascular/fisiopatologia , Humanos , Masculino , Policitemia/etiologia , Policitemia/fisiopatologia , Fatores de Risco , Ultrassonografia Doppler
17.
Rev. Hosp. Ital. B. Aires (2004) ; 39(1): 19-21, mar. 2019. ilus., graf.
Artigo em Espanhol | LILACS | ID: biblio-1022121

RESUMO

La policitemia primaria es producida por una mutación adquirida o heredada en las células progenitoras de los glóbulos rojos, mientras que la poliglobulia secundaria está relacionada con un aumento de la eritropoyetina sérica como respuesta a la hipoxia tisular o a la producción autónoma tumoral. Hace más de medio siglo que se conoce que la hidronefrosis puede actuar como una rara causa de eritrocitosis debido al aumento de producción de eritropoyetina por un riñón que censa una disminución de oxígeno, mecanismo también observado en la estenosis de la arteria renal y en los quistes renales. Se describe a continuación el caso de un paciente de 38 años con poliglobulia atendido en el Hospital Italiano de San Justo (Argentina), que presenta como hallazgo una hidronefrosis unilateral severa y cuya resolución quirúrgica a través de una nefrectomía revierte el cuadro hematológico de base. (AU)


Primary polycythemia is produced by an acquired or inherited mutation in progenitor cells of red blood cells, while secondary polyglobulia is related to an increase in serum erythropoietin in response to tissue hypoxia or autonomous tumor production. Since the middle of the twentieth century, the hydronephrosis is known to be a rare etiology of secondary polycythemia, with increased erythropoietin production caused by diminished oxygen sensing by the kidney, also seen in renal artery stenosis and kidney cysts. We describe a case of a 38 year old patient with polycythemia studied in the "Hospital Italiano de San Justo" (Argentina) that presented an incidental severe unilateral hydronephrosis, and nephrectomy was carried out as a final resolution of the hematological disorder. (AU)


Assuntos
Humanos , Animais , Masculino , Adulto , Pessoa de Meia-Idade , Policitemia/diagnóstico , Pielonefrite/diagnóstico , Infecções Urinárias/complicações , Eritropoetina/sangue , Hidronefrose/diagnóstico , Nefrectomia/tendências , Policitemia/complicações , Policitemia/etiologia , Pielonefrite/sangue , Obstrução da Artéria Renal/patologia , Dor Lombar , Hipóxia-Isquemia Encefálica/patologia , Eritrócitos/fisiologia , Doenças Renais Císticas/patologia , Disuria , Febre , Hidronefrose/cirurgia , Hidronefrose/complicações , Anemia , Nefrectomia/métodos
18.
Blood Cells Mol Dis ; 76: 25-31, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30683541

RESUMO

Chronic mountain sickness (CMS) has a higher incidence in the plateau region and is characterized by excessive erythrocytosis and hypoxemia. Bcl-2 family plays an important role in the process of erythropoiesis and the regulation of apoptosis. This study aimed to examine the change in apoptosis of erythroblasts in CMS patients and explore the involvement of Bcl-2 family. Bone marrow mononuclear cells (BMMNCs) were isolated by density gradient centrifugation from 18 CMS patients and 17 control participants. The apoptotic rate, mitochondrial membrane potential (MMP), the protein expression of caspase-3, TNFR, Fas, Bcl-2, Bax and Cyt-C were examined by flow cytometry, and mRNA expression was determined by real-time PCR. The results showed that apoptotic rate of erythroblasts was lower and MMP was higher in CMS group than in control group. The mRNA and protein expression levels of Bcl-2 were higher while Bax level was lower in CMS group than in control group. In CMS group, the apoptosis rate of CD71+ erythroblasts was negatively correlated with the ratio of CD71+ cells in BMMNCs and positively correlated with hemoglobin level. In conclusion, erythroblasts apoptosis is decreased due to the regulation of the expression of Bcl-2 family members in the erythroblasts of CMS patients.


Assuntos
Doença da Altitude/sangue , Apoptose , Eritroblastos/metabolismo , Policitemia/etiologia , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Antígenos CD/análise , Células da Medula Óssea/patologia , Estudos de Casos e Controles , Doença Crônica , Regulação para Baixo , Eritroblastos/patologia , Hemoglobinas/análise , Humanos , Potencial da Membrana Mitocondrial , Cultura Primária de Células , Receptores da Transferrina/análise , Proteína X Associada a bcl-2/metabolismo
19.
Sultan Qaboos Univ Med J ; 19(4): e345-e351, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31897318

RESUMO

Objectives: Cyanotic congenital heart disease (CCHD) predisposes patients to iron deficiency due to compensatory secondary erythrocytosis. This study aimed to determine the serum iron status and prevalence of iron deficiency among children with cyanotic congenital heart disease attending the Paediatric Cardiology outpatient clinic of Lagos State University Teaching Hospital, Lagos, Nigeria. Methods: This cross-sectional case-control study took place between May and October 2015 at the Lagos State University Teaching Hospital. A total of 75 children with cyanotic congenital heart disease and 75 apparently healthy age-, gender- and socioeconomically-matched controls were analysed to determine serum iron status and the prevalence of iron deficiency as defined by the World Health Organization criteria. Results: The mean age of the children was 47.5 ± 2.9 months (range: 6-144 months old). Iron deficiency was significantly more frequent among CCHD patients compared to control subjects (9.3% versus 0%; P = 0.006). While latent iron deficiency was more prevalent among children in the control group compared to those with CCHD, this difference was not statistically significant (13.3% versus 9.3%; P = 0.303). No cases of iron deficiency anaemia were observed in the studied sample. Conclusion: Neither the children in the control group nor those with CCHD had iron deficiency anaemia. However, iron deficiency was significantly more prevalent among children with CCHD in Lagos. Periodic serum iron status screening is therefore recommended for this population.


Assuntos
Anemia Ferropriva/complicações , Cianose/fisiopatologia , Cardiopatias Congênitas/fisiopatologia , Policitemia/fisiopatologia , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/fisiopatologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos Transversais , Cianose/sangue , Cianose/epidemiologia , Índices de Eritrócitos , Feminino , Cardiopatias Congênitas/sangue , Cardiopatias Congênitas/complicações , Hemoglobinas/análise , Humanos , Lactente , Ferro/sangue , Masculino , Nigéria/epidemiologia , Policitemia/sangue , Policitemia/etiologia , Prevalência
20.
Am J Emerg Med ; 37(1): 175.e1-175.e2, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30269997

RESUMO

We report an unusual case of severe hepatopulmonary syndrome with previously unrecognized cirrhosis, presenting with acute on chronic dyspnoea, extreme hypoxemia, secondary polycythemia as well as direct identification of arteriovenous communications on computed tomography angiography. Hepatopulmonary syndrome, defined as the combination of hepatopathy, arterial deoxygenation and pulmonary vascular dilatation, is increasingly recognized as a life-threatening complication in advanced liver disease and transplant candidacy. It is usually diagnosed in chronic liver disease patients following pre-transplant evaluation or mild dyspnea investigation. Diagnosis relies on the indirect evidence of pulmonary arteriovenous communications suggested by echocardiography with a bubble study. Clinicians need to be aware of this rare but potential acute presentation at the emergency room.


Assuntos
Síndrome Hepatopulmonar/diagnóstico por imagem , Hipóxia/etiologia , Cirrose Hepática Alcoólica/diagnóstico por imagem , Policitemia/etiologia , Idoso , Angiografia por Tomografia Computadorizada , Dispneia/etiologia , Ecocardiografia , Serviço Hospitalar de Emergência , Fadiga/etiologia , Feminino , Síndrome Hepatopulmonar/complicações , Humanos , Hipertensão Portal/diagnóstico por imagem , Cirrose Hepática Alcoólica/complicações
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