Paroxysmal cold haemoglobinuria (PCH) is an acquired cause of haemolytic anaemia. It is caused by the biphasic IgG antibodies that sensitize and attach the red cells at lower temperature; detach and rebind on rewarming. Donath-Landsteiner antibody test is the diagnostic test for PCH. Management of PCH mainly includes supportive care but sometimes disease becomes severe and lifethreatening. We describe a similar severe and life-threatening case of PCH who was managed by plasma exchange followed by packed red cell transfusion.
Malaria is a vector-borne tropical disease well known for causing a multitude of complications. One such rare but familiar complication is symmetrical peripheral gangrene (SPG). SPG is a distinct entity resulting from a horde of infectious and non-infectious illnesses. We report the case of a 32-year-old male infected with Plasmodium falciparum malaria and Human Immunodeficiency Virus who presented to us with renal failure and developed SPG of both feet 3 days into admission.
Chylothorax is an infrequent cause of pleural effusion that is most commonly caused by the obstruction or disruption of the thoracic duct. Chylothorax is rare in nephrotic syndrome. Unilateral chylothorax of the right side is due to the transdiaphragmatic shunting of chylous ascites. It is usually transient and self-limiting but a massive chylothorax requiring therapeutic thoracentesis can also be encountered. Here, we present a rare cause of chylous ascites–nephrotic syndrome resulting in chylothorax, where initially therapeutic thoracentesis is done followed by the management of nephrotic syndrome with modified Ponticelli regimen. This case highlights the need to consider chylous ascites as a cause of chylothorax via transdiaphragmatic shunting in patients with nephrotic syndrome to institute the appropriate treatment.
Concomitant Tuberculosis (TB) and Hodgkin’s Lymphoma (HL) is a rare entity, more commonly reported in the paediatric and adolescent populations. HL presents with fever, weight loss and lymphadenopathy. Disseminated TB also presents with fever, weight and appetite loss and generalised or localised lymphadenopathy with/without pulmonary symptoms. Both diseases together pose a diagnostic challenge for the clinicians because of the similar mode of presentation. This case report discusses the clinical scenario of a 48-year-old lady presenting with generalised lymphadenopathy and was initially diagnosed with disseminated TB. Due to clinical worsening despite regular Anti-TB Therapy (ATT), she was re-evaluated and later turned out to have co-existing HL.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.