AJP Reports最新文献_第2页

Drug-induced Liver Injury from Intravenous Immunoglobulin for Prevention of Recurrent Gestational Alloimmune Liver Disease: A Clinical Catch-22.

IF 0.8

AJP Reports Pub Date : 2024-11-13 eCollection Date: 2024-07-01 DOI: 10.1055/a-2444-7155

Jessica A Meyer, Jenna S Silverstein, Kristen M Thomas, Sara G Brubaker, Judith L Chervenak

{"title":"Drug-induced Liver Injury from Intravenous Immunoglobulin for Prevention of Recurrent Gestational Alloimmune Liver Disease: A Clinical Catch-22.","authors":"Jessica A Meyer, Jenna S Silverstein, Kristen M Thomas, Sara G Brubaker, Judith L Chervenak","doi":"10.1055/a-2444-7155","DOIUrl":"https://doi.org/10.1055/a-2444-7155","url":null,"abstract":"Gestational alloimmune liver disease (GALD) is a rare autoimmune syndrome in which maternal antibodies lead to in utero fetal hepatocyte destruction, often presenting as neonatal liver failure and hemochromatosis. Antenatal intravenous immunoglobulin (IVIG) is generally accepted to be safe in pregnancy with demonstrable benefits for reducing GALD recurrence risk in subsequent pregnancies. Here we present a case of a 33-year-old woman with a prior neonatal demise due to GALD who received multiple prophylactic IVIG infusions in a subsequent twin pregnancy complicated by maternal jaundice and acute hepatitis. A liver biopsy demonstrated hepatocellular injury with bridging necrosis and cholestatic features consistent with drug-induced liver injury. This case demonstrates the importance of close clinical monitoring during IVIG therapy and the need for further research into alternative prophylaxis options for GALD. Key Points GALD is a rare antibody-mediated autoimmune syndrome with high recurrence risk.IVIG can be effective in reducing risk of GALD recurrence and fetal loss.Patient's receiving ongoing IVIG therapy should be closely monitored for developing adverse effects, including DILI.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"14 4","pages":"e254-e258"},"PeriodicalIF":0.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neuroleptic Malignant Syndrome in a 10-Month-Old Ex-Preterm Infant with Delirium. 一名 10 个月大的早产儿出现神经性恶性综合征并伴有谵妄。

IF 0.8

AJP Reports Pub Date : 2024-11-12 eCollection Date: 2024-07-01 DOI: 10.1055/a-2441-4217

Gloria Akuamoah-Boateng, Kayla A Buttafuoco, Courtney C Sutton, Brian P Hackett

{"title":"Neuroleptic Malignant Syndrome in a 10-Month-Old Ex-Preterm Infant with Delirium.","authors":"Gloria Akuamoah-Boateng, Kayla A Buttafuoco, Courtney C Sutton, Brian P Hackett","doi":"10.1055/a-2441-4217","DOIUrl":"https://doi.org/10.1055/a-2441-4217","url":null,"abstract":"In recent times, atypical antipsychotics are increasingly being used in the neonatal intensive care unit (NICU) for the management of neonatal delirium. As the recognition of delirium in NICU infants increases, caution should be exercised with use of antipsychotics for management, given associated adverse effects. Neuroleptic malignant syndrome (NMS) is a rare adverse drug reaction associated with exposure to antipsychotics and other antidopaminergic medications. Most reported cases of NMS in pediatric patients have been in older children on antipsychotic medications. We present a case of a 10-month-old former preterm infant who developed clinical signs suggestive of NMS after exposure to olanzapine for treatment of delirium. Our case report details the clinical course of this infant, delves into the condition, and outlines some useful lessons for the clinician in the identification and management of this rare but life-threatening adverse effect. Key Points NMS is a rare side effect of antipsychotic medications.Hyperthermia with mental status changes could be due to NMS.Antipsychotics should be used cautiously in infants.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"14 4","pages":"e259-e261"},"PeriodicalIF":0.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142611802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hemorrhaging Uterine Fibroid Leading to Emergent Early Term Cesarean Delivery: A Case Report. 子宫肌瘤大出血导致紧急早产剖宫产：病例报告。

IF 0.8

AJP Reports Pub Date : 2024-10-22 eCollection Date: 2024-07-01 DOI: 10.1055/a-2434-5650

Nicholas Racchi, Lisa Bird, Samantha Mullan, William Schnettler, Nanci Billock

{"title":"Hemorrhaging Uterine Fibroid Leading to Emergent Early Term Cesarean Delivery: A Case Report.","authors":"Nicholas Racchi, Lisa Bird, Samantha Mullan, William Schnettler, Nanci Billock","doi":"10.1055/a-2434-5650","DOIUrl":"https://doi.org/10.1055/a-2434-5650","url":null,"abstract":"Background The incidence of uterine leiomyomas, or fibroids, affecting pregnant individuals is estimated to be 10%, but there are no guidelines or recommendations for fetal or maternal surveillance in pregnancies affected by them. Risks associated with fibroids during pregnancy include potential for pain, preterm birth, fetal growth restriction, higher cesarean delivery rate, fetal malpresentation, placenta abruption, and postpartum hemorrhage. Case Presentation This case describes a 26-year-old gravida 1 para 0 who presented at early term for severe abdominal pain and was found to have acute abdomen accompanied by a nonreassuring fetal heart rate tracing. With emergent cesarean delivery, it was found that the patient was hemorrhaging from a ruptured vessel of a pedunculated fibroid and myomectomy was subsequently performed. Conclusion While rare, hemorrhage from a uterine fibroid should be considered a part of the differential diagnosis of abdominal pain in pregnant patients with fibroids, particularly when accompanied by concurrent indicators such as free fluid, hypotension/tachycardia, or concerning changes in fetal heart rate, especially in a patient without risk factors for uterine rupture.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"14 4","pages":"e250-e253"},"PeriodicalIF":0.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Obstetrical Management of Severe Hypertriglyceridemia in Pregnancy: A Case Report. 妊娠期严重高甘油三酯血症的产科治疗：病例报告。

IF 0.8

AJP Reports Pub Date : 2024-10-11 eCollection Date: 2024-07-01 DOI: 10.1055/a-2413-2465

Nigel Madden, Nevin Kamal, Jared Friedman, Priya Freaney, Susan E Gerber, Emily D Szmuilowicz

{"title":"Obstetrical Management of Severe Hypertriglyceridemia in Pregnancy: A Case Report.","authors":"Nigel Madden, Nevin Kamal, Jared Friedman, Priya Freaney, Susan E Gerber, Emily D Szmuilowicz","doi":"10.1055/a-2413-2465","DOIUrl":"https://doi.org/10.1055/a-2413-2465","url":null,"abstract":"Background Pregnant people with baseline hypertriglyceridemia are at increased risk of severe hypertriglyceridemia and the associated complications, yet there are no formal recommendations to guide management of these patients during pregnancy. Case We report a case of a patient with presumed familial hypertriglyceridemia who was taken off triglyceride-lowering medications preconception and developed acute pancreatitis at 23 weeks of gestation. She was managed with a very-low-fat diet, exercise, fenofibrate, omega-3-fatty acids, pravastatin, insulin infusion, and plasmapheresis. She delivered at 33 weeks of gestation after presenting with a placental abruption and subcapsular liver hematoma associated with HELLP (hemolysis, elevated liver enzyme levels, and low platelet) syndrome. Conclusion While rare in pregnancy, severe hypertriglyceridemia is associated with serious maternal risks. Preconception and antepartum obstetric management should incorporate shared decision-making considering both the potential fetal risks of treatment and the objective maternal risks of untreated disease.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"14 4","pages":"e244-e249"},"PeriodicalIF":0.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Distinction between Pneumothorax and Pneumomediastinum Using Point of Care Ultrasound (POCUS): Role of Still Lung Point. 使用护理点超声（POCUS）区分气胸和气胸：静止肺点的作用。

IF 0.8

AJP Reports Pub Date : 2024-10-08 eCollection Date: 2024-07-01 DOI: 10.1055/a-2415-5318

Anna E Sagaser, Ashley Reeves, Tamara Arnautovic, Juan Sanchez-Esteban

{"title":"Distinction between Pneumothorax and Pneumomediastinum Using Point of Care Ultrasound (POCUS): Role of Still Lung Point.","authors":"Anna E Sagaser, Ashley Reeves, Tamara Arnautovic, Juan Sanchez-Esteban","doi":"10.1055/a-2415-5318","DOIUrl":"10.1055/a-2415-5318","url":null,"abstract":"The rapid identification and management of air leak syndrome in the neonatal intensive care unit is critical to prevent and/or minimize short- and long-term complications. Traditionally, chest X-ray is used to diagnose pneumothorax or pneumomediastinum. However, point-of-care ultrasound is increasingly being used for procedural and diagnostic purposes. Current ultrasound guidelines recommend specific criteria to diagnose pneumothorax in newborns including sharp A-lines, absence of B-lines, lack of shimmering of the pleural line, and the presence of a lung point. Pneumomediastinum may have similar ultrasound characteristics. In this case report, we present two cases of pneumomediastinum in newborns, describe the associated ultrasound findings, and review some of the criteria to differentiate from pneumothorax, including the presence of a still lung point. A high index of suspicion for pneumomediastinum should be maintained when using ultrasound to diagnose air leak given the overlapping sonographic features with pneumothorax. This distinction is of particular importance if evacuation of air by needle thoracentesis or the placement of a chest tube is under consideration.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"14 3","pages":"e239-e243"},"PeriodicalIF":0.8,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Necrotizing Fasciitis Post-Cesarean Section Leading to Transabdominal Hysterectomy. 剖腹产后导致经腹子宫切除术的坏死性筋膜炎。

IF 0.8

AJP Reports Pub Date : 2024-09-30 eCollection Date: 2024-07-01 DOI: 10.1055/a-2414-7696

Alvina Liang, Mary Boluwatife Idowu, Steven Joseph Eskind, Soha S Patel

{"title":"Necrotizing Fasciitis Post-Cesarean Section Leading to Transabdominal Hysterectomy.","authors":"Alvina Liang, Mary Boluwatife Idowu, Steven Joseph Eskind, Soha S Patel","doi":"10.1055/a-2414-7696","DOIUrl":"10.1055/a-2414-7696","url":null,"abstract":"Necrotizing fasciitis (NF) is a rare but life-threatening disease characterized by rapidly spreading inflammation and subsequent necrosis of the fascial planes and surrounding tissues. Limited literature has described NF as involving an adjacent solid organ beyond fascial planes that has required its removal. We present a case of a 25-year-old white female who underwent a cesarean section and subsequently developed NF involving her uterus and abdominal wall that necessitated a total abdominal hysterectomy, serial surgical debridement of necrotic tissue, and wound vacuum assisted closure (VAC) placement. Her pathology report described her uterus infiltrated by polybacteria, confirming a diagnosis of NF. Despite NF's progressive nature and potential lethality, NF can be challenging to diagnose clinically due to a lack of pathognomonic signs and symptoms. However, early detection of NF with the aid of Laboratory Risk Indicator for Necrotizing Fasciitis score calculation using laboratory values such as white blood cell count, hemoglobin, sodium, glucose, serum creatinine, and C-reactive protein is critical for optimal patient outcomes. A multidisciplinary team approach is vital in treating these patients to debride necrotizing tissue and control the potential sequelae from the infection, particularly for postpartum patients.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"14 3","pages":"e235-e238"},"PeriodicalIF":0.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anti-D Alloimmunization in Index Pregnancy after Appropriate Rho(D) Immune Globulin Injection in Two Obese Rh-Negative Patients. 两名肥胖的 Rh 阴性患者在注射适当的 Rho(D) 免疫球蛋白后在指数妊娠中出现抗 D 免疫。

IF 0.8

AJP Reports Pub Date : 2024-09-30 eCollection Date: 2024-07-01 DOI: 10.1055/s-0044-1791525

Stephanie Rodriguez, Phillip J DeChristopher, Kristen Krum, Ann Lal

{"title":"Anti-D Alloimmunization in Index Pregnancy after Appropriate Rho(D) Immune Globulin Injection in Two Obese Rh-Negative Patients.","authors":"Stephanie Rodriguez, Phillip J DeChristopher, Kristen Krum, Ann Lal","doi":"10.1055/s-0044-1791525","DOIUrl":"10.1055/s-0044-1791525","url":null,"abstract":"Background The rhesus factor D (RhD)-negative patients who give birth to an RhD-positive newborn or who are otherwise exposed to RhD-positive red blood cells are at risk of developing anti-D antibodies. These antibodies may cause hemolytic disease of the fetus and newborn (HDFN). During pregnancy, prevention of alloimmunization is completed with a Rho(D) immune globulin (RhIg). Cases We report two cases, where obese patients developed alloimmunization, with high neonatal titers, after appropriate RhIG prophylaxis during the index pregnancy. Conclusion Our cases demonstrate cases of anti D-alloimmunization in an index pregnancy, with high neonatal titers. Both patients are obese, with BMI > 35 mg/m 2 . Key Points RhIG can be administered via intramuscular or intravenous formulations. Overall, it appears that both formulations are equally effective. The optimal administration, especially with obese women, is not clearly established.Our cases demonstrate that obesity is a risk factor for failure of RhIG, and could lead to an increase in HDFN.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"14 3","pages":"e228-e230"},"PeriodicalIF":0.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early Challenges: A Case Report of a Premature Baby with Down Syndrome and Uterine Rupture. 早期挑战：唐氏综合症早产儿和子宫破裂的病例报告。

IF 0.8

AJP Reports Pub Date : 2024-09-30 eCollection Date: 2024-07-01 DOI: 10.1055/a-2413-2722

Bilel Jerbi, Hajer Chourou, Rim Ben Aziza, Wafa Belhadj Ammar, Samia Kacem, Radhouane Achour

{"title":"Early Challenges: A Case Report of a Premature Baby with Down Syndrome and Uterine Rupture.","authors":"Bilel Jerbi, Hajer Chourou, Rim Ben Aziza, Wafa Belhadj Ammar, Samia Kacem, Radhouane Achour","doi":"10.1055/a-2413-2722","DOIUrl":"10.1055/a-2413-2722","url":null,"abstract":"Introduction Uterine rupture represents one of the most severe obstetric affections. It is defined as a complete or a partial tearing of the uterine wall. Women with a prior cesarean section are reported to have a higher risk of having this situation. Moreover, maternal death and most of all middle- and long-term adverse consequences remain a great preoccupation. On another scale, neonatal death and ulterior deterioration remain very high, especially in low-income countries. Case Description A 24-year-old woman with a history of previous cesarean section presented at 35 weeks of gestation with pelvic pain without bleeding. Emergency cesarean section revealed a complete uterine rupture at the scar site from the previous cesarean section. Remarkably, the fetus managed to seal the rupture using the right temporal region, forearm, and right leg, avoiding significant complications. The mother had an uncomplicated postoperative course and was discharged after 48 hours of surveillance. Conclusion We present with this case an extraordinary case of a uterine rupture where both mother and child had a good outcome. This rare evolution was reported only one time in literature. For this reason, a history of caesarean delivery might present a huge challenge for obstetricians and neonates.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"14 3","pages":"e231-e234"},"PeriodicalIF":0.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A De novo Mutation in the COL1A1 Gene Leading to Severe Osteogenesis Imperfecta: Case Report and Review of the Literature. 导致严重成骨不全症的 COL1A1 基因新突变：病例报告和文献综述。

IF 0.8

AJP Reports Pub Date : 2024-09-12 eCollection Date: 2024-07-01 DOI: 10.1055/a-2388-3190

Yurong Lu, Yijia Tian, Jinxiu Liu, Yifan Wang, Xietong Wang

{"title":"A De novo Mutation in the COL1A1 Gene Leading to Severe Osteogenesis Imperfecta: Case Report and Review of the Literature.","authors":"Yurong Lu, Yijia Tian, Jinxiu Liu, Yifan Wang, Xietong Wang","doi":"10.1055/a-2388-3190","DOIUrl":"https://doi.org/10.1055/a-2388-3190","url":null,"abstract":"Introduction Osteogenesis imperfecta (OI) is the most common monogenic inherited skeletal dysplasia disorder. Mutations in the COL1A1/COL1A2 gene cause ∼85 to 90% of OI. Studies of cases have demonstrated that missense mutations are the primary cause of OI, with poor prognosis. Case Description We report the case of a fetus with skeletal abnormalities and subcutaneous edema. Ultrasound imaging revealed suspected skeletal malformations, including hypoplastic long bones of all four limbs, poorly ossified calvarium, unrevealing nasal bones, and generalized subcutaneous edema. Whole-exome sequencing revealed a heterozygous mutation in COL1A1 (c.2174G > T/p.(G725V), NM_000088.3). According to the American College of Medical Genetics and Genomics guidelines, it was determined to be a pathogenic variant and identified as a de novo variant (PS2 + PP3_strong + PM2_supporting), which has not been reported in the HGMD, gnomAD, ClinVar, or other databases. This variation causes a glycine-to-valine substitution at position 725, located within the Gly-Xaa-Yaa repeat in the helical domain of the collagen molecule. Conclusion The COL1A1 mutation (c.2174G > T/p.(G725V), NM_000088.3) is a novel pathogenic variant of severe OI. Our study expanded the OI COL1A1 gene variation profiles in the Chinese population and provided a theoretical foundation for prenatal diagnosis, genetic counseling, and obstetric management.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"14 3","pages":"e215-e223"},"PeriodicalIF":0.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11392588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rare Case of Twin Reversed Arterial Perfusion Acardius Acephalus Subtype Seen in a Community-Based Hospital. 社区医院中出现的罕见双子动脉灌注逆转心绞痛亚型病例

IF 0.8

AJP Reports Pub Date : 2024-09-10 eCollection Date: 2024-07-01 DOI: 10.1055/a-2384-8058

Laura Reguero Cadilla, Carlos Villafuerte Santana, Nicolle Centazzo, Daniel Faustin

引用次数: 0