China
Africa
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The Nutrition-Focused History and Physical Examination (NFPE) in Malnutrition
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
Peripheral edema occurs for a number of reasons, most commonly because of a cardiovascular etiology. Anasarca may be caused by hepatic and renal failure, as well as by nephrotic syndrome. Lymphedema can occur after surgery, injury and other causes. Myxedema is a manifestation of hypothyroidism.
Management of Conditions and Symptoms
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Amy J. Litterini, Christopher M. Wilson
Although commonly observed in cancer survivors, 85% of individuals with advanced non-cancer diagnoses at the end of life have reported the presence of edema among 277 survey respondents from China.46 Extreme generalized edema, referred to as anasarca, is widespread edema throughout the body most often occurring as a result of major organ failure. A separate global health concern arising from a different etiology, lymphatic filariasis (LF) is a swelling condition caused by infection with filarial parasites transmitted by mosquitoes, which is estimated to impact 40 million individuals worldwide.64 The parasitic infection of the lymphatic vessels disrupts normal lymphatic function resulting in increased risk for infection, and lymphedema and/or hydrocele, and in severe cases, disfiguring elephantiasis. The world regions most significantly impacted by LF include the continent of Africa, the Caribbean Islands, South America, the Eastern Mediterranean, Southeast Asia, and the Western Pacific.64
The Nephrologists
Published in Maria Ribeiro, Sound Diagnosis, 2018
ARF is an incidental finding usually diagnosed during hospitalization for another condition. It is ∴ an additional serious complication that commonly develops in the severely ill patient. Most cases are partly iatrogenic e.g. nephrotoxin is given while patient is fluid-deprived. Deterioration of renal function is usually due to combined insults - systemic infection compounded by dehydration and nephrotoxicity. Patient may be dry; or distressed and fluid-overloaded with anasarca.
AL type cardiac amyloidosis: a devastating fatal disease
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Adeel Nasrullah, Anam Javed, Thejus T Jayakrishnan, Aaron Brumbaugh, Ariel Sandhu, Brent Hardman
The patient reported that the generalized body swelling had started as bilateral lower extremity edema deteriorating into anasarca that was unresponsive to diuresis. Vitals at admission were temperature 36.7 degrees Celsius, blood pressure 124/81 mm Hg, heart rate 90 beats/minute, respiratory rate 16, and oxygen saturation 95% on room air. Examination revealed anasarca with significant scrotal edema and 3+ pitting edema involving bilateral upper and lower extremities. Significant laboratory findings included serum creatinine-1.68 mg/dl, elevated alkaline phosphatase-450 U/L, total bilirubin 5.4 mg/dl (Direct predominant), and troponin 0.12 ng/ml and pro-BNP 20,730 pg/ml, indicating multiorgan dysfunction. EKG showed sinus rhythm with 1st degree AV block, low voltage QRS in all leads, and right axis deviation, as shown in Figure 1.
Sequential change in serum VEGF levels in a case of tocilizumab-resistant TAFRO syndrome treated effectively with rituximab
Published in Modern Rheumatology Case Reports, 2021
Risa Wakiya, Tomohiro Kameda, Yohei Takeuchi, Hiroki Ozaki, Shusaku Nakashima, Hiromi Shimada, Norimitsu Kadowaki, Hiroaki Dobashi
A 62-year-old Japanese man had undergone antibiotic treatment for infectious gastroenteritis in a local hospital because of fever, abdominal pain and diarrhoea. Although abdominal pain and diarrhoea were improved with antibiotics, his fever remained. He underwent a series of medical tests. Laboratory studies showed elevation of his white blood cell count (WBC), C-reactive protein (CRP), alkaline phosphatase (ALP), γ-glutamyltransferase (γ-GT), total bilirubin (T-Bil), aspirate transaminase (AST), alanine transaminase (ALT), and creatinine (Cre) and thrombocytopenia. A computed tomography (CT) scan revealed mild hepatosplenomegaly, lymphadenopathy and swelling of the adrenal glands. He was then referred to our hospital for further diagnostic assessment. Upon physical examination, anasarca and abdominal distension were observed. No skin lesions were observed, and his superficial lymph nodes were not palpable.
Myositis-specific autoantibodies in Japanese patients with juvenile idiopathic inflammatory myopathies
Published in Modern Rheumatology, 2019
Masahiro Ueki, Ichiro Kobayashi, Shunichiro Takezaki, Yusuke Tozawa, Yuka Okura, Masafumi Yamada, Masataka Kuwana, Tadashi Ariga
Consistent with previous reports, anti-MJ/NXP2 antibodies are associated with severe myositis. Although association of calcification with the autoantibody has been reported [3–5], only one patient showed mild calcification in our series. Given the short interval between onset and diagnosis (0.5–2 months) possibly because of apparent weakness and stiffness of the muscles, early intensive treatment could have reduced calcification even in this high-risk group. One patient with the antibodies showed anasarca and died suddenly during mPSL pulse therapy. Although anasarca is a rare complication of juvenile and adult DM/PM, the mechanism has not been elucidated [18–21]. Anasarca is a major symptom of systemic capillary leak syndrome which is characterized by increased vascular permeability possibly associated with vasculopathy and has been reported in a case of polymyositis [21]. Given that vasculopathy is a common feature of JDM, similar mechanisms may be involved in the pathology of anasarca associated with JDM.