Clopidogrel-induced thrombotic thrombocytopenic purpura: a case report.

Thrombotic thrombocytopenic purpura (TTP) is a rare variant of thrombotic microangiopathy. We report a case of TTP in a Nigerian chronic kidney disease (CKD) patient who was previously on clopidogrel. The features of TTP resolved soon after clopidogrel was withdrawn.

Awareness, Use, and Opinions of Individual Fit Testing of Hearing Protection Devices Among Practicing Michigan Occupational and Environmental Medicine Association Health Care Providers.

Objective: The aim of this study is to examine the awareness, opinions, and use of individual fit testing of hearing protection devices (HPDs) among occupational medicine practitioners.

Methods: Members of the Michigan Occupational and Environmental Medicine Association completed a 21-question survey on individual fit testing of HPDs.

Results: The survey response rate was 67%, 53% reported having heard of individual fit testing of HPDs, and 24% reported that their clinic/site performed the testing.

A curious case of persistently relapsing hyperkalemia in an ESRD patient on maintenance hemodialysis following bioprosthetic aortic valve replacement - a potential case for the use of the new agent, patiromer, for hyperkalemia management.

Hyperkalemia is not uncommon in patients with end-stage renal disease (ESRD) on maintenance hemodialysis, often related to dietary indiscretion, following the prolonged inter-dialytic weekend interval in patients on thrice weekly hemodialysis treatments, and sometimes the adverse effects of medications such as RAAS blocking agents. Moreover, hyperkalemia following extended cardiac surgery can result from the use of high-potassium containing cardioplegic solutions used during cardiopulmonary bypass. Nevertheless, different from the foregoing, in the nephrology literature, there have been very rare reports of potentially life-threatening hyperkalemia following cardiac valve replacement procedure.

Pleuritic chest pain from portal hypertensive gastropathy in ESRD patient with autosomal dominant polycystic kidney disease misdiagnosed as pericarditis.

Portal hypertensive gastropathy (PHG) is a gastric mucosal lesion complicating portal hypertension, with higher prevalence in decompensated cirrhosis. PHG can sometimes complicate autosomal dominant polycystic kidney disease (ADPKD) due to the presence of multiple liver cysts. Besides, PHG is known to present as chest pain, with or without hematemesis.