Purpose. To discuss the unusual features of topiramate-induced acute angle closure glaucoma, its pathophysiologic mechanisms, and treatment controversies, and to report the first anterior segment optical coherence tomography (OCT) of this condition. Methods. Literature review and case report with OCT findings. Results. Topiramate-induced angle closure is usually bilateral and associated ...

We report two cases of torsade de pointes directly related to intracoronary contrast media injection in patients without previous history of neither arrhythmia nor syncope but chronically treated with a drug prolonging ventricular repolarization. We discussed the effects of the contrast medium used on repolarization and concluded that three suggestions ...

Most common causes of hypercalcemia are hyperparathyroidism, malignancy, vitamin D-mediated conditions such as sarcoidosis, and vitamin D toxicity. Less commonly, hypercalcemia can be caused by drugs such as thiazide diuretics and lithium. Mild hypercalcemia is usually asymptomatic but severe hypercalcemia is associated with nausea, vomiting, abdominal pain, excessive thirst, muscle ...

In this review article, we provide a detailed and comprehensive discussion of the rationale for using modern IMRT techniques to spare the subgranular zone of the hippocampus during cranial irradiation. We review the literature on neurocognitive effects of cranial irradiation; discuss clinical and preclinical data associating damage to neural progrenitor ...

Radiation-induced medulloblastoma is an exceedingly rare phenomenon for which treatment standards have not been established. The literature suggests that these tumors are high grade with aggressive behavior. We report two cases of radiation-induced medulloblastoma which have been treated with full dose re-irradiation with curative intent. In both cases, treatment toxicity ...

We report here the case of a 12-year-old boy with erythema ab igne on his left thigh caused by the use of a laptop computer. This is the youngest of the 10 reported patients with this laptop-induced dermatosis since its first description in 2004. Erythema ab igne is a reticular, ...

Radiation recall dermatitis (RRD) is a rare phenomenon. There are a few reports in the literature reporting RRD triggered by quinolones administration after external beam radiation therapy (EBRT). We present an unusual case of RRD induced by levofloxacin 7 months after completion of EBRT. A 56-year-old Caucasian female was treated ...

About 80 years have passed since the first cases of organophosphate induced delayed polyneuropathy (OPIDP), as the consequence of human poisoning with certain organophosphorus compounds, were described in the literature. OPIDP is a relatively rare neurodegenerative disorder in humans characterized by loss of function, ataxia and paralysis of distal parts ...

Angioedema is a rare but life-threatening adverse effect of administration of angiotensin-converting enzyme inhibitors (ACEIs) administration. It has been classically associated with ACEIs, although angioedema has also been reported with angiotensin receptor blockers (ARBs). Angioedema is a deep swelling of tissues just below the skin and mucous membranes, characterized by ...

Oxaliplatin is a third-generation platinum compound and has been widely employed in the treatment of colorectal cancer. Despite its good efficacy, it is reported to induce immune-mediated cytopenia. We report the case of a 78-year-old male patient who experienced acute pancytopenia along with coagulopathy and intracranial hemorrhage after his 17th ...

To report a case of cephalosporin-induced factor V inhibitor development, an uncommon but potentially fatal condition characterized by severe hemorrhage. A 71-year-old Chinese man presented with factor V inhibitors after a 7-day cephradine course for a urinary tract infection, characterized by abnormal prothrombin time (PT) and activated partial thromboplastin time ...

To report a patient treated with infliximab for ankylosing spondylitis and HLA-B27 uveitis presenting with a scotoma in his left good eye due to infliximab-induced occipital demyelination mistaken for a uveitis recurrence. Case report. Review of clinical features, visual field, and investigational procedures. Loss of visual function could not be ...

Hypokalemia is a potentially life-threatening electrolyte disturbance in anorexia nervosa and is most frequently caused by purging behavior. We report a case of severe hypokalemia in anorexia nervosa induced by daily ingestion of approximately 20 g of licorice. To confirm the diagnosis of licorice-induced pseudohyperaldosteronism, a re-exposure trial was performed. ...

Use of supplement and alternative drugs continues to thrive and is becoming an increasing cause of concern since many of these substances may have unexpected or unexplained medical consequences. We present below the first reported case of hepatotoxicity from Hydroxycut(®) in Hawaii.

Osteonecrosis is a serious condition involving bone destruction that frequently requires surgical treatment to rebuild the joint. While there is an abundance of literature documenting corticosteroid related osteonecrosis, there is no consensus as to the relative risk of osteonecrosis after administration of steroids via parenteral, oral, topical, inhaled and other ...

4,4'-Methylenedianiline (MDA) is a chemical used in manufacturing and insulation processes and is a well-known hepatotoxin. We report the case of a 42-year-old construction-site worker who was accidentally exposed to large amounts of MDA and developed acute liver damage. The clinical course is described, with particular emphasis on the timely ...

Warfarin-induced skin necrosis (WISN) and calciphylaxis share similar early clinical findings and can both lead to significant morbidity and mortality. The authors reviewed the literature on both conditions and describe a case of extensive skin necrosis in a patient with end-stage renal disease who was initially suspected to have calciphylaxis. ...

We describe an unusual case of lymphocytic pleural effusion associated with the use of cilazapril, a novel angiotensin-converting-enzyme inhibitor (ACEI). An 80-year-old male was prescribed cilazapril for hypertension. He subsequently presented with right chest pain and dry cough. He was found to have a lymphocytic pleural effusion on thoracentesis. Extensive ...

Rosuvastatin, a statin indicated for patients with primary hypercholesterolemia, mixed dyslipidemia and familial hypercholesterolemia, is well tolerated by most patients. Its most common adverse effects are gastrointestinal derangement, muscle aches and hepatitis. One rare complication of statin treatment is severe thrombocytopenia. The case of a 65-year-old patient who developed severe ...

BACKGROUND: Metabolic conditions, including hyperglycemia, can have various neurological presentations. Hemiballismus hemichorea is a rare manifestation reported to occur with severe hyperglycemia and is reversed in most cases with control of sugars. CASE REPORT: We present a case of a patient with no known diabetes history who presented with uncontrolled ...

CASE: A 49-year-old patient experienced chest discomfort while swallowing. On electrocardiogram, episodes of atrial tachyarrhythmia were recorded immediately after swallowing; 24-hour Holter monitoring recorded several events. The arrhythmia resolved after therapy with atenolol, but recurred a year later. The patient noticed that before these episodes he had been using an ...

Traumatic hair loss is a scalp injury that can cause secondary scarring alopecia. It can result from different types of physical and chemical injury. Hair loss induced by certain hair-styling techniques has been discussed, but we describe a preceding ulcerative process. We describe 3 black adolescent girls with hairpin-induced alopecia ...

Diagnosing drug-induced liver injury (DILI) relies primarily on history taking. We report 4 cases in which DILI was missed or the drug was misidentified when physicians relied solely on patient history. We reviewed 27 cases referred with possible DILI from August 1, 2009, to February 1, 2010. Four patients seemed ...

Cardiotoxicity due to 5-fluorouracil involves rare and life-threatening cardiotoxic events occurring in less than 1% of the patients. We describe a case of coronary vasospasm due to parenteral 5-fluorouracil, which did not recur with oral capecitabine. We also give a brief review of the cardiotoxicity of 5-fluorouracil, its treatment and ...

We report a case of renal tubular acidosis (RTA) secondary to capecitabine, oxaliplatin, and cetuximab administration in a 63-year-old woman with liver metastasis from colon carcinoma who had partial treatment response. On day 5 posttreatment, she arrived to the emergency room with severe weakness, and blood tests demonstrated hypokalemia with ...

Liver toxicity, although not mentioned among the possible adverse effects of corticosteroids, has been occasionally reported in literature. We observed 2 cases of hepatotoxicity after a high-dose methylprednisolone treatment of a demyelinating disease and evaluated the potential relationship in the light of available evidence. The first patient developed a histologically ...

Mrs. M.S. is a 67-year-old African American woman with a history of rheumatoid arthritis and psoriatic arthritis who presented to the emergency room with complaint of new-onset rash, chills, and fatigue after she started taking ramipril (5 mg orally every day) for her hypertension. The rash involved entire upper chest, ...

BACKGROUND AND OBJECTIVES: Cocaine inhalation has been linked to the development of pneumomediastinum. The aim of this review was to identify the clinical course and outcome of spontaneous pneumomediastinum caused by cocaine use. MATERIAL AND METHODS: We performed a literature search in English language using PubMed. We included all case ...

Capecitabine, an oral prodrug of 5-fluorouracil (5fu), has been integrated into the management of multiple cancer types because of convenience of administration and efficacy comparable with 5fu. Cardiotoxicity induced by 5fu-in particular angina-has been well described in the literature, but reports of adverse cardiac events with capecitabine are also emerging. ...

We present a case of sotalol-induced prolongation of the QT-interval with torsades de pointes in an octogenarian who was hospitalized because of gastroenteritis causing prerenal acute renal failure. Subsequent accumulation of sotalol caused a severe prolongation of the QT-interval on the surface ECG and ultimately torsades de pointes with loss ...

Sarcoid reactions are well-recognized adverse events during interferon (IFN) therapy. They are frequently underdiagnosed because misinterpreted as IFN-induced side effects. Sarcoid cutaneous lesions may therefore represent useful hints to an early diagnosis, but their incidence is unknown. We report three new cases of mono-localized, purely cutaneous IFNalpha-induced sarcoidosis. In addition, ...

Nonionic low-osmolar contrast agents are considered safe for intravenous or intra-arterial administration and are used widely in the general population, as well as in patients on hemodialysis therapy. There are data limited to case reports for contrast-induced hearing loss; however, the ototoxicity induced by contrast agents in patients with chronic ...

This report describes the case of an asymptomatic patient with a ventricular tachycardia-induced cardiomyopathy that resolved completely after successful radiofrequency ablation. This type of presentation and outcome has not been reported in the pediatric literature.

Fibrates are used to manage mixed dyslipidemia. However, these drugs have the potential risk of inducing rhabdomyolysis. This paper gives an overview of the literature on rhabdomyolysis associated with fibrate therapy. We reported a case of rhabdomyolysis induced by fenofibrate and reviewed the published rhabdomyolysis cases associated with fibrate therapy. ...

The objective was to asses the efficacy of lipid emulsion as antidotal therapy outside the accepted setting of local anesthetic toxicity. Literature was accessed through PubMed, OVID (1966-February 2009), and EMBASE (1947-February 2009) using the search terms "intravenous" AND ["fat emulsion" OR "lipid emulsion" OR "Intralipid"] AND ["toxicity" OR "resuscitation" ...

BACKGROUND: Cytomegalovirus (CMV) is a common pathogen affecting the gastrointestinal tract in patients with AIDS. We report a case of CMV-induced pseudotumor of the duodenum in a patient with AIDS and review other reported cases of CMV-induced pseudotumors in the gastrointestinal tract. CMV-induced pseudotumor in patients with AIDS is an ...

The illegal enrichment of anabolic androgenic steroids in over-the-counter dietary supplements is well documented, but the health consequences have not been widely recognized. Three recent reports document cholestatic jaundice and nephropathy due to these compounds. We present 3 additional cases of anabolic androgenic steroid-enriched dietary supplement-induced hepatotoxicity and 1 case ...

This case report describes a digit amputation resulting from an improperly applied tubular dressing. The safe application of digital tubular dressings, and the rationale behind it, is detailed to raise emergency physician (EP) awareness. We present a case report of a recent iatrogenic-induced digit ischemia caused by improperly applied tube ...

The anti-CD20 antibody rituximab has been reported to induce a heterogeneous spectrum of lung disorders. The aim of the present study was to critically review data on the clinical presentations, causality assessments and management strategies of lung diseases possibly related to rituximab. A systematic literature review was performed on English-language ...

Nicorandil is a cardioprotective drug which is used in the prophylaxis and long-term treatment of angina pectoris. Debilitating perianal ulcer is a rare complication of Nicorandil therapy which can cause diagnostic and management dilemmas. We describe the management of a case of Nicorandil-induced perianal ulcer and review pertinent contemporary literature.

Imipramine-induced hyperpigmentation is rare with only 13 cases reported in the literature to date. We report a 64-year-old female who presented with blue-gray discoloration on her face present for 4-5 years. The patient's medications included imipramine for depression for approximately 23 years. Physical examination revealed slate-gray hyperpigmented discrete and coalescing ...

PURPOSE OF REVIEW: We will focus separately on infectious, drug-induced and caustic injury of the esophagus and their possible complications such as stricture and perforation. RECENT FINDINGS: There has been a decrease in opportunistic esophageal infection in HIV-positive patients, in particular candidiasis, which remains an important cause of inpatient charges, ...

This is a case report of myxedema coma secondary to amiodarone-induced hypothyroidism in a patient with severe congestive heart failure (CHF). To our knowledge and after reviewing the literature there is one case report of myxedema coma during long term amiodarone therapy. Myxedema coma is a life threatening condition that ...

PURPOSE OF REVIEW: We will focus separately on infectious, drug-induced and caustic injury of the esophagus and their possible complications such as stricture and perforation. RECENT FINDINGS: There has been a decrease in opportunistic esophageal infection in HIV-positive patients, in particular candidiasis, which remains an important cause of inpatient charges, ...

Although the benefits of clozapine have been well demonstrated in resistant schizophrenia, the frequency of adverse events is of particular concern: up to 76% of patients to whom clozapine was prescribed experienced an adverse event, with a discontinuation rate of 17%. In addition to its major clinical side effect, agranulocytosis, ...

We report an unusual case of minocycline-induced pigmentation mimicking persistent ecchymosis in a patient with persistent (20 months' duration) bluish black discoloration of the medial and lateral aspects of the left ankle following an avulsion fracture. We review the common presentations of minocycline-induced pigmentation as well as some of the ...

Bleomycin is a glycoprotein that is extensively used in combination with other anti-cancer agents because of its relative lack of hematological and gastrointestinal toxicity. However, pulmonary toxicity is common with bleomycin and limits its therapeutic utility. Urethral stricture as a result of bleomycin toxicity has not been reported in literature. ...

GOAL: The aim of this review is to summarize the in vitro and in vivo evidence on the performance of contemporary saliva substitutes in the treatment of xerostomia and hyposalivation caused by radiation therapy for head and neck malignancies. METHODS: A literature search was conducted during July to September 2008 ...

Severe hyperkalaemia is a life threatening electrolyte abnormality that if not treated urgently, might cause electric death. Hyperkalaemia induced electrocardiogram (ECG) alterations vary according to the levels and rate of increase of potassium concentration ([K(+)]) in the extracellular milieu but the paradox is that not all these cases provide ECG ...

The aim of this study was to collect, describe and analyze the radiation-induced gliomas in craniopharyngioma patients reported in the literature up to date. Review of the relevant literature was performed. One personal illustrative case was added. Reports of 15 patients, including the presented illustrative case, were evaluated. The average ...