A 72-year-old man with exertional dyspnea, fatigue, and extensive ecchymoses and purpuric lesions
Article Abstract:
A 72-year-old man with shortness of breath, anemia, skin hemorrhages, gum sores, apathy, and irritability was found to have scurvy after an initial diagnosis of vasculitis. Scurvy is caused by a deficiency of ascorbic acid and vitamin C resulting in the breakdown of connective tissue around blood vessels. The patient was an alcoholic with a diet that contained almost no ascorbic acid. His electrocardiogram showed an abnormal heart beat, but a radiographic scan of his chest showed no damage to the heart. He received six units of blood cells initially, verapamil, cimetidine, oxazepam, vitamin K, thiamine, and a daily multivitamin. After 20 days in the hospital he was discharged as most of his symptoms resolved. Upon review of his records and skin biopsies, the diagnosis of scurvy was made. The vitamin supplements and regular diet in the hospital probably caused his symptoms to resolve. His condition continued to improve as he followed a diet with plenty of fruit.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1995
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A 55-year-old disabled construction worker with increasing dyspnea and abnormal chest radiographs
Article Abstract:
A 55-year-old male construction worker with increasing difficulty breathing and abnormal chest x-rays was found to have silicatosis of the lung. Silicatosis involves the formation of nodules in the lungs caused by repeated inhalation of dust particles. X-rays taken 13 and 22 weeks before hospital admission indicated rapidly developing nodules in the lungs and swollen lymph nodes in the surrounding tissue. The man had a history of sandblasting at work and smoking. He was obese, had difficulty breathing at night, and often stopped breathing in his sleep. A lung biopsy did not stain positively for bacteria or fungi, thus a diagnosis of tuberculosis was eliminated. The biopsy showed nodules containing cells known as histiocytes and silica crystals. Silicatosis is similar to silicosis, though it may involve inhalation of different dust particles and slower development of fibrous tissue in the lung.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1995
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Case 12:2003: AN 82-year-old man with dyspnea and pulmonary abnormalities
Article Abstract:
An 82-year-old man with shortness of breath and fluid retention was found to have lung disease caused by the anti-arrhythmia drug amiodarone. He was taking the drug to treat a heart arrhythmia called ventricular tachycardia. He was successfully treated.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 2003
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