BACKGROUND Since its discovery in Wuhan,China in December of 2019,the novel coronavirus has progressed to become one of the worst pandemics seen in the last 100 years.Recently,there has been an increased interest in t...BACKGROUND Since its discovery in Wuhan,China in December of 2019,the novel coronavirus has progressed to become one of the worst pandemics seen in the last 100 years.Recently,there has been an increased interest in the hepatic manifestations of coronavirus disease 19(COVID-19).AIM To describe the demographic and clinical characteristics of COVID-19 positive patients and study the association between transaminitis and all-cause mortality.METHODS This is a descriptive retrospective cohort study of 130 consecutive patients with a positive COVID PCR test admitted between March 16,2020 to May 14,2020 at a tertiary care University-based medical center.The Wilcoxon-rank sum test and paired t-test were used for comparing non-parametric and parametric continuous variables respectively and a multivariable logistic regression models to study the association between transaminitis and mortality using SAS version 9.4(SAS Institute,Cary,NC,United States).RESULTS Out of the 130 patients,73(56%)patients were found to have transaminitis and 57(44%)did not.When compared to patients without transaminitis,the transaminitis group was found to have a higher median body mass index(30.2 kg/m2 vs 27.3 kg/m2,P=0.04).In the multivariate analysis those with transaminitis were found to have 3.4 times higher odds of dying as compared to those without transaminitis adjusting for gender,the Age-adjusted Charlson Comorbidity Index and admission to the intensive care unit(P=0.03).CONCLUSION Our study showed that transaminitis on admission was associated with severe clinical outcomes such as admission to the intensive care unit,need for mechanical ventilation,and mortality.展开更多
Duchenne muscular dystrophy (DMD) is a fatal X-linked genetic disease of the neuromuscular system and is the most serious type of muscular dystrophy in humans. The disease is characterized by progressive muscular atro...Duchenne muscular dystrophy (DMD) is a fatal X-linked genetic disease of the neuromuscular system and is the most serious type of muscular dystrophy in humans. The disease is characterized by progressive muscular atrophy and a poor prognosis. The incidence rate is 1/3500, and symptoms appear at age of 5 years-old. Some patients present with abnormal aminotransferases as the first symptom. In addi-tion to the clinical characteristics and genetic history, electro-myography examination, muscle biopsy, serum enzyme examination, and measures of creatine kinase (CK), CK isoenzyme, and serum lactate dehydrogenase are important features of auxiliary examination. Clinicians who encounter unknown causes of transaminitis should consider the possi-bility of DMD. We describe here a 3 year-old pediatric patient with increased aminotransferases who had elevated CK and a family genetic history but without liver damage on computed tomography. He was suspected as having inherited the disorder and was finally diagnosed as having DMD by next-generation sequencing.展开更多
Rationale:Fever with myositis and rhabdomyolysis is a medical emergency requiring prompt diagnosis and management.Scrub typhus associated myositis with rhabdomyolysis is rare.Patient concerns:A 36-year-old female pres...Rationale:Fever with myositis and rhabdomyolysis is a medical emergency requiring prompt diagnosis and management.Scrub typhus associated myositis with rhabdomyolysis is rare.Patient concerns:A 36-year-old female presented with intermittent fever up to 38.6℃,jaundice and progressive weakness of all four limbs.Diagnosis:Scrub typhus associated myositis and rhabdomyolysis.Intervention:Doxycycline 100 mg twice daily and injection of ceftriaxone 1 gm twice daily along with continuous intravenous fluids.Outcome:Fever resolved with normalization of liver function and recovery of muscle power.Lessons:Presence of myositis and rhabdomyolysis is uncommon in scrub typhus;high clinical suspicion should be kept in patients with atypical manifestations of scrub typhus.展开更多
Dengue virus infection continues to be major public health problem in large part of world.The epidemiology of dengue viral infection is becoming increasingly complex and has substantially changed over almost past six ...Dengue virus infection continues to be major public health problem in large part of world.The epidemiology of dengue viral infection is becoming increasingly complex and has substantially changed over almost past six decades not only in terms of prevalent strains and geographical locations but also in terms of disease severity and atypical presentations.Though liver is the most common organ affected but is generally asymptomatic.We present a case of infant with severe dengue who died of fulminant hepatic failure and showed pan lobular necrosis on post mortem liver biopsy.The case is being presented to highlight life threatening complication of dengue in young children,and dengue viral infection as a cause of acute liver failure in endemic areas.Thus dengue fever should also be considered as one of the differential diagnosis in children presenting with fever and fulminant hepatic failure in endemic regions.展开更多
文摘BACKGROUND Since its discovery in Wuhan,China in December of 2019,the novel coronavirus has progressed to become one of the worst pandemics seen in the last 100 years.Recently,there has been an increased interest in the hepatic manifestations of coronavirus disease 19(COVID-19).AIM To describe the demographic and clinical characteristics of COVID-19 positive patients and study the association between transaminitis and all-cause mortality.METHODS This is a descriptive retrospective cohort study of 130 consecutive patients with a positive COVID PCR test admitted between March 16,2020 to May 14,2020 at a tertiary care University-based medical center.The Wilcoxon-rank sum test and paired t-test were used for comparing non-parametric and parametric continuous variables respectively and a multivariable logistic regression models to study the association between transaminitis and mortality using SAS version 9.4(SAS Institute,Cary,NC,United States).RESULTS Out of the 130 patients,73(56%)patients were found to have transaminitis and 57(44%)did not.When compared to patients without transaminitis,the transaminitis group was found to have a higher median body mass index(30.2 kg/m2 vs 27.3 kg/m2,P=0.04).In the multivariate analysis those with transaminitis were found to have 3.4 times higher odds of dying as compared to those without transaminitis adjusting for gender,the Age-adjusted Charlson Comorbidity Index and admission to the intensive care unit(P=0.03).CONCLUSION Our study showed that transaminitis on admission was associated with severe clinical outcomes such as admission to the intensive care unit,need for mechanical ventilation,and mortality.
基金This study was supported by the Medical Scientific Research Project of Foshan Health Bureau(No.20200225 to JD).
文摘Duchenne muscular dystrophy (DMD) is a fatal X-linked genetic disease of the neuromuscular system and is the most serious type of muscular dystrophy in humans. The disease is characterized by progressive muscular atrophy and a poor prognosis. The incidence rate is 1/3500, and symptoms appear at age of 5 years-old. Some patients present with abnormal aminotransferases as the first symptom. In addi-tion to the clinical characteristics and genetic history, electro-myography examination, muscle biopsy, serum enzyme examination, and measures of creatine kinase (CK), CK isoenzyme, and serum lactate dehydrogenase are important features of auxiliary examination. Clinicians who encounter unknown causes of transaminitis should consider the possi-bility of DMD. We describe here a 3 year-old pediatric patient with increased aminotransferases who had elevated CK and a family genetic history but without liver damage on computed tomography. He was suspected as having inherited the disorder and was finally diagnosed as having DMD by next-generation sequencing.
文摘Rationale:Fever with myositis and rhabdomyolysis is a medical emergency requiring prompt diagnosis and management.Scrub typhus associated myositis with rhabdomyolysis is rare.Patient concerns:A 36-year-old female presented with intermittent fever up to 38.6℃,jaundice and progressive weakness of all four limbs.Diagnosis:Scrub typhus associated myositis and rhabdomyolysis.Intervention:Doxycycline 100 mg twice daily and injection of ceftriaxone 1 gm twice daily along with continuous intravenous fluids.Outcome:Fever resolved with normalization of liver function and recovery of muscle power.Lessons:Presence of myositis and rhabdomyolysis is uncommon in scrub typhus;high clinical suspicion should be kept in patients with atypical manifestations of scrub typhus.
文摘Dengue virus infection continues to be major public health problem in large part of world.The epidemiology of dengue viral infection is becoming increasingly complex and has substantially changed over almost past six decades not only in terms of prevalent strains and geographical locations but also in terms of disease severity and atypical presentations.Though liver is the most common organ affected but is generally asymptomatic.We present a case of infant with severe dengue who died of fulminant hepatic failure and showed pan lobular necrosis on post mortem liver biopsy.The case is being presented to highlight life threatening complication of dengue in young children,and dengue viral infection as a cause of acute liver failure in endemic areas.Thus dengue fever should also be considered as one of the differential diagnosis in children presenting with fever and fulminant hepatic failure in endemic regions.
