Pulmonary hypertension in a patient with Schmidt syndrome.

We describe a 26-year-old patient with long-standing autoimmune hypothyroidism. She was doing well until she developed Addisonian crisis accompanied by severe metabolic acidosis, hypoglycemia, hypomagnesemia, and hypokalemia. Subsequently she developed a life-threatening cardiac arrhythmia due to QT prolongation secondary to electrolyte imbalance.

Haloperidol-induced neuroleptic malignant syndrome complicated by hyperosmolar hyperglycemic state.

Neuroleptic malignant syndrome (NMS) is a life-threatening neurologic emergency that may be caused by neuroleptic agents of any class. The association with hyperosmolar hyperglycemic state (HHS) is rare and carries a grave prognosis. We describe the case of a 25-year-old male patient with haloperidol-induced NMS complicated by HHS that culminated in the patient's death despite all treatment efforts.

Eosinophilic pancreatic infiltration as a manifestation of lung carcinoma.

A 68-year-old man reported upper abdominal pain during the previous 3 months that worsened in the last 2 days. He had a history of lung squamous cell carcinoma for which he underwent right lung lobectomy 3 years earlier. Preliminary blood tests showed leucocytosis with marked eosinophilia.

Bartonella quintana endocarditis in east Africa.

Bartonella quintana endocarditis is characterized by sub-acute evolution and severe valvular damage, and is associated with homelessness, alcoholism, and lice infestation. We present a case of B. quintana endocarditis in an Ethiopian immigrant without known risk factors for disease acquisition.

Recurrent severe hypercalcemia caused by bone marrow sarcoidosis.

A 71-year-old woman with recurrent severe hypercalcemia was found to have multiple noncaseating granulomas in the bone marrow with low parathyroid hormone levels and high levels of [1,25 dihydroxycholecalciferol] that later decreased to normal levels with the normalization of calcium levels. No organ involvement other than of the bone marrow was detected, and the angiotensin-converting enzyme level was elevated. The diagnosis of bone marrow sarcoidosis is suggested.

Sweet's syndrome after pneumonectomy.

We report the case of a 38-year-old woman in whom typical skin lesions of Sweet's syndrome developed 2 days after undergoing left pneumonectomy, which was done because of severe bronchiectasis related to remote chemotherapy and radiotherapy given for lung sarcoma at the age of 8 years. Later fever and leukocytosis appeared, and biopsy results of the skin lesions showed neutrophilic infiltration of the dermis compatible with the diagnosis of Sweet's syndrome. Postoperative Sweet's syndrome has been reported only twice in the world literature.

Unilateral pulmonary edema: a rare presentation of congestive heart failure.

The authors present a case of an 85-year-old woman known to suffer from severe congestive heart failure who presented with dyspnea and a unilateral infiltrate in the right lung on chest x-ray. Following clinical judgment, she was diagnosed with unilateral pulmonary edema and was treated accordingly, with rapid improvement of symptoms and disappearance of the infiltrate within 12 hours. The patient had been hospitalized many times during the previous years with pulmonary edema affecting both lung fields.

[Contralateral hemothorax: a late complication of subclavian vein catheterization].

Central venous catheterization is extensively used in unstable patients who need hemodynamic monitoring and in patients who require prolonged treatment such as, chemotherapy, antibiotics therapy, parenteral nutrition, or temporary hemodialysis. Subclavian vein catheterization is the preferred approach for hemodialysis, especially as it does not restrict the patient. Most of the complications related to this procedure are insignificant, however, occasionally they may be life threatening and require surgical intervention.

Sweet's syndrome affecting the external auditory canal and tympanic membrane.

We report a patient who developed left ear pain, dry cough, and fever. The external auditory canal was tender, swollen, erythematous and full of debris. Later the patient developed widespread tender and red skin nodules and pustules that subsequently coalesced to form plaques.

Systemic lupus erythematosus among Arabs.

Background: The prevalence of clinical manifestations and laboratory parameters in systemic lupus erythematosus differ among various ethnic groups. Few studies have reported on SLE in Arabs.

Objectives: To summarize the demographic, clinical and laboratory features of Arab SLE patients and to compare them with other series from different Arab countries.

Tumor lysis syndrome after hydrocortisone treatment in metastatic melanoma: a case report and review of the literature.

Tumor lysis syndrome (TLS) is 1 of the complications that usually follows chemotherapy treatment of myelo-lymphoproliferative diseases. Corticosteroids (CS) could also induce TLS in this type of malignancies. On the other hand, TLS in solid tumors is less frequent, and CS treatment was never reported to be associated with TLS in solid tumor.

Pure red cell aplasia and lupus.

Objective: To review the clinical and laboratory features of all reported patients with systemic lupus erythematosus (SLE) and pure red cell aplasia (PRCA).

Methods: In addition to our patient, we identified cases reported during the years 1966-2000 by searching the MEDLINE literature (Winspirs). Clinical and laboratory features were compared with those reported in large series of patients with SLE but without PRCA.