The American journal of the medical sciences
-
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.
-
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.
-
Porphyrias are a group of rare diseases leading to dysregulation in heme biosynthesis and the accumulation of heme precursors, including porphyrinogens, which in their oxidized states [porphyrins] are reddish or purple. Acute hepatic porphyrias (AHP) comprise four diseases that cause acute debilitating neurovisceral attacks. Despite diagnostic advances, AHP is often undiagnosed or misdiagnosed due to a lack of disease awareness, low clinical suspicion, variable presentation, and nonspecific symptoms that mimic more common diseases. Delays in diagnosis and treatment increase the risk of serious acute and chronic complications. ⋯ The clinical features of AHP continue to be severe pain, especially pain in the abdomen. Other features that should raise suspicion are autonomic, peripheral, or central neuropathies, hyponatremia, and red-purple urine color.