The American journal of the medical sciences
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Review Case Reports
Disseminated Cryptococcosis in An Immunocompetent Host Presenting As Osteomyelitis and Leading to Adrenal Insufficiency.
Disseminated cryptococcosis infection typically occurs in immunocompromised patients, often through pneumonia or meningoencephalitis. Cases in immunocompetent patients are uncommon, and presentation in either bone or adrenal glands are rare. ⋯ Clinicians should be aware of atypical presentations of cryptococcal disease. In this review of the literature on cryptococcosis in immunocompetent patients, we find that while rare, cryptococcosis can affect varied organs and should be considered in the differential of infectious diseases.
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Multicenter Study
Higher Mean Corpuscular Hemoglobin Concentration is Associated with Worse Prognosis of Hepatorenal Syndrome: A Multicenter Retrospective Study.
Hepatorenal syndrome (HRS) is a severe complication of decompensated cirrhosis with high mortality. However, few prognostic factors have been identified and studies are urgently needed to facilitate precise treatment. ⋯ Higher MCHC was associated with worse prognosis in HRS.
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Review Case Reports
Adrenal Medullary Hyperplasia, An Under the Radar Cause of Endocrine Hypertension.
Adrenal medullary hyperplasia is a cause of increased secretion of catecholamines by the adrenal gland that is rarely considered among the differential diagnoses of endocrine hypertension. We report the case of a 48-year-old Hispanic woman who presented for evaluation of resistant hypertension with several episodes of hypertensive crisis. ⋯ After surgery, blood pressure control was achieved with one antihypertensive drug, and the patient did not have recurrent hypertensive crisis. Relevant findings obtained from a whole genomic sequence done on a whole blood DNA sample from the patient are discussed.
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Review Case Reports
Immune Thrombocytopenia in a Kidney Transplant Recipient Treated with Romiplostim.
We present a case of immune thrombocytopenia following a living donor kidney transplant. Thrombocytopenia started two days after transplant and continued up to seven weeks after transplant, despite an extensive workup, treatment with steroids, intravenous immune globulin, and alterations in immunosuppression and other medications. ⋯ The patient's graft function has also been stable. This experience suggests romiplostim is safe and effective for persistent immune thrombocytopenia in kidney transplant recipients.