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Fulminant Type 1 Diabetes Mellitus Leading to Diabetic Ketoacidosis and Mesenteric Ischemia With Necrosis Following Pembrolizumab Administration: A Case Report.
Cureus
December 2024
Department of Obstetrics and Gynecology, Osaka Metropolitan University Graduate School of Medicine, Osaka, JPN.
Immune checkpoint inhibitors (ICIs), such as pembrolizumab, have revolutionized cancer therapy but can lead to severe immune-related adverse events (irAEs). We present a case of fulminant type 1 diabetes mellitus (T1DM) with diabetic ketoacidosis (DKA) and mesenteric ischemia in a 78-year-old woman with recurrent stage IIIC1 cervical cancer treated with pembrolizumab. Thirty-four days after initiating a pembrolizumab-containing regimen, she presented with vomiting, severe hyperglycemia, metabolic acidosis, and strongly positive urine ketones.
View Article and Find Full Text PDFSevere pulmonary arterial hypertension and cardiogenic shock in acute systemic lupus erythematosus.
BMJ Case Rep
January 2025
Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia.
We describe a woman in her late 20s with newly diagnosed systemic lupus erythematosus (SLE), who presented with fulminant pulmonary arterial hypertension (PAH) requiring inotropic and extracorporeal support. She was established on triple pulmonary vasodilator therapy with concurrent aggressive immunosuppression; however, treatment was complicated by infection and diffuse alveolar haemorrhage, necessitating delays in immunosuppression and withdrawal of epoprostenol. Despite this, with ongoing suppression of her SLE, her pulmonary haemodynamics improved, with normal pressures on right heart catheterisation several months later allowing stepdown to sildenafil monotherapy.
View Article and Find Full Text PDFA Case Report of Mycophenolate Mofetil-Induced Fulminant Colitis in a 76-Year-Old Renal Transplant Recipient.
Cureus
December 2024
Pathology and Laboratory Medicine, Tufts Medical Center, Boston, USA.
Mycophenolate mofetil (MMF) is a widely utilized immunosuppressive medication to prevent organ rejection in transplant recipients and manage autoimmune diseases. While gastrointestinal side effects, such as diarrhea and abdominal discomfort, are common, fulminant colitis is a rare complication. This case report describes the occurrence of fulminant colitis in a 76-year-old renal transplant recipient.
View Article and Find Full Text PDFCeftazidime-resistance in pediatric melioidosis: A case report and literature review.
IDCases
January 2025
Institute of Health and Community Medicine, Universiti Malaysia Sarawak, Sarawak, Malaysia.
We report a first case of ceftazidime-resistant pediatric melioidosis involving a previously healthy seven-year-old boy who presented with right lobar pneumonia complicated with a 5-cm lung abscess. Ceftazidime was initiated on Day-6 of admission when (ceftazidime-susceptible, minimum inhibitory concentration [MIC] 1.0 mcg/mL) was isolated from blood.
View Article and Find Full Text PDFSuccessful management of coagulation dysfunction in a patient with fulminant myocarditis: a case report.
Front Cardiovasc Med
January 2025
Department of Clinical Laboratory, Wuhan Asia Heart Hospital, Wuhan, China.
Fulminant myocarditis (FM) is an acute, diffuse inflammatory myocardial disease characterized by abrupt onset and extremely rapid progression. Patients typically exhibit haemodynamic abnormalities that may lead to respiratory failure, liver and renal failure, and subsequent coagulopathy. Collectively, these complications significantly increase the risk of early mortality.
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