Melena, anemia, renal insufficiency, and respiratory failure in a 47-year-old woman
Article Abstract:
A case is described of a 47-year-old woman who was admitted with signs and symptoms of weakness, anemia, and melena, which is black, tarry feces resulting from the action of intestinal secretions on blood. Nine years earlier, she developed a joint disease characterized by antinuclear antibodies, or abnormal immune proteins, and an elevated erythrocyte sedimentation rate, a nonspecific indicator of disease. The year before admission, she had visited Pakistan and developed fatigue and joint pain. The patient also had evidence of hepatitis B infection. She was treated with nonsteroidal anti-inflammatory drugs and corticosteroid, but her fatigue and anemia progressed. The patient later developed pain over the stomach area and melena, and was later shown to have inflammation of the stomach. A chest X-ray showed the leakage of fluids into the lung cavity. After analysis of clinical and pathological findings, the patient was diagnosed with thrombotic thrombocytopenic purpura (TTP). This disorder is characterized by decreased numbers of blood platelets, anemia associated with rupture of red blood cells, fever, kidney failure, nerve-related symptoms, and the presence of schistocytes, which are red cell fragments. TTP is often associated with purpura, a condition characterized by bleeding into the skin, mucous membranes, internal organs, and other tissues. The clinical and pathologic findings are discussed. The patient later developed respiratory failure and died. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Sudden death in young competitive athletes: clinicopathologic correlations in 22 cases
Article Abstract:
The pathologic conditions leading to sudden death in young athletes were assessed by reviewing 22 cases. The deaths in occurred in 19 males and 3 females between January 1979 and December 1989. The ages of the athletes ranged from 11 to 35 years old. Sudden death occurred during an athletic activity in 16 cases, after the sports activity in two cases, and was the first sign of disease in 10 cases. Death resulted from cardiac arrest due to arrhythmia in 17 cases. These included six cases of right ventricular dysplasia, a heart condition characterized by abnormalities of the right heart ventricle; four cases of atherosclerotic coronary artery disease, characterized by fatty degeneration and thickening of the walls of the coronary arteries; three cases of abnormal conduction in the heart; two cases of defects in the physical structure of the right coronary artery; and two cases of mitral valve prolapse. The development of a blood clot in the lungs and rupture of the aorta occurred in two cases. Death was due to disorders affecting the brain in three athletes. All athletes with heart disease involving the right ventricle died during physical exertion and had a history of palpitations and/or fainting. These findings show that disease of the right ventricle is a common cause of sudden death among young athletes. This heart disorder is characterized by abnormalities in heart electrical activity and early symptoms, such as palpitations and fainting. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Weight loss, anemia, elevated paraprotein levels, and renal failure in a 61-year-old man (Clinicopathologic Conference)
Article Abstract:
The clinical pathological conference described the case of a 61-year-old man who was admitted to the hospital because of diminished appetite and weight loss of 15 to 20 pounds. Bone X-rays revealed a possible loss of bone mass in the iliac bone of the hip bilaterally and a deformity of the spine in the upper back. Since lab tests three months prior to this admission, the patient's hemoglobin (iron-containing, oxygen-transporting red blood pigment) had decreased and his white blood cell count had increased (which sometimes indicates infection). His hematocrit was stable, but a low reticulocyte count suggested a decrease in red blood cell production (which occurs in bone marrow). Liver cell damage was also suggested. These results point to an infiltrating process of the bone marrow. The patient also had very elevated lactic dehydrogenase (LDH), an enzyme in tissue and blood, which would indicate a possible lymphoma. Bone marrow biopsy showed changes in the architecture of the marrow; this confirmed the diagnosis of immunoblastic lymphoma. The role of paraprotein and malignancy are discussed.
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1989
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