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Article: A Case of Profound Hypertriglyceridemia Causing Pseudohypobicarbonatemia.

Garg, Deepshikha / Chatterjee, Tulika

2023 Volume 15, Issue 4, Page(s) e37489

Abstract: The light-scattering effect of hypertriglyceridemia may interfere with the photometric analysis of the electrolytes, leading to errors in laboratory values. We present a case of erroneously low bicarbonate levels due to the presence of severe ... ...

Abstract	The light-scattering effect of hypertriglyceridemia may interfere with the photometric analysis of the electrolytes, leading to errors in laboratory values. We present a case of erroneously low bicarbonate levels due to the presence of severe hypertriglyceridemia. A 49-year-old male was admitted for knee cellulitis. A comprehensive metabolic panel showed very low bicarbonate of <5 mmol/L, and an elevated anion gap of 26 mmol/L. The lactic acid, salicylic acid, ethanol, and methanol levels were normal. The lipid panel showed a remarkably high triglyceride level of 4846 mg/dL. An arterial blood gas (ABG) showed a normal pH of 7.39 and a bicarbonate level of 28 mmol/L, which was inconsistent with the metabolic acidosis seen in the blood test. The discrepancy between acidosis seen in the metabolic panel and ABG was explained by a lab error in the measured bicarbonate levels, which occurs in the presence of elevated triglyceride levels. Most laboratories use either an enzymatic/ photometric or an indirect ion-selective electrode method to measure bicarbonate. Hyperlipidemia interferes with photometric analysis due to its light-scattering effect. An ABG analyzer uses a direct ion-selective electrode method that is free of the errors of a photometric analyzer. Knowing about conditions like hypertriglyceridemia, which can interfere with the measurement of electrolytes, is important in everyday clinical medicine, as it can prevent unnecessary investigation and intervention.
Language	English
Publishing date	2023-04-12
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.37489
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Asymptomatic Gangrenous Acute Cholecystitis: A Life-Threatening Condition.

Medina, Victor J / Martial, Annia M / Chatterjee, Tulika

Cureus

2023 Volume 15, Issue 3, Page(s) e36672

Abstract: Gangrenous gallbladder (GGB) is a life-threatening complication of acute cholecystitis, which happens due to gallbladder (GB) wall ischemia and necrosis. Delaying the diagnosis of GGB is life-threatening and may happen in asymptomatic patients. We ... ...

Abstract	Gangrenous gallbladder (GGB) is a life-threatening complication of acute cholecystitis, which happens due to gallbladder (GB) wall ischemia and necrosis. Delaying the diagnosis of GGB is life-threatening and may happen in asymptomatic patients. We present a case of an elderly male patient with a history of gastric carcinoid tumor, with partial gastric resection, who presented with generalized weakness and jaundice. His total bilirubin was elevated and an ultrasonography and computed tomography (CT) scan of the abdomen showed evidence of acute cholecystitis. An endoscopic retrograde cholangiopancreatography (ERCP) the day after admission showed no evidence of choledocholithiasis or cholangitis. It was during laparoscopic cholecystectomy three days later that the diagnosis of GGB was made as the GB was found to be necrotic with extensive adhesions. The patient also required intravenous antibiotics prior to discharge. This case illustrates risk factors for the development of gangrenous cholecystitis, physical findings in asymptomatic patients, and the importance of early diagnosis in order to reduce morbidity in this patient population.
Language	English
Publishing date	2023-03-25
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.36672
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Article ; Online: Extreme Hypernatremia due to Dehydration.

Kamatam, Sravani / Waqar, Ayesha / Chatterjee, Tulika

Journal of medical cases

2023 Volume 14, Issue 7, Page(s) 232–236

Abstract: Hypernatremia is defined as having a serum sodium concentration exceeding 145 mmol/L (normal range is 136 - 145 mmol/L). When the serum sodium level surpasses 160 mmol/L and 190 mmol/L, it is classified as severe and extreme hypernatremia, respectively. ... ...

Abstract	Hypernatremia is defined as having a serum sodium concentration exceeding 145 mmol/L (normal range is 136 - 145 mmol/L). When the serum sodium level surpasses 160 mmol/L and 190 mmol/L, it is classified as severe and extreme hypernatremia, respectively. Extreme hypernatremia is an uncommon occurrence and is associated with significant risks of mortality and morbidity. The most frequently reported causes of extreme hypernatremia are accidental or intentional salt ingestion and diabetes insipidus, while dehydration due to poor water intake as a trigger for extreme hypernatremia is rarely documented. Here, we present a case study of an elderly patient who experienced extreme hypernatremia with a serum sodium level of 191 mmol/L due to dehydration and had altered mental status and ventriculomegaly as a complication.
Language	English
Publishing date	2023-07-31
Publishing country	Canada
Document type	Case Reports
ZDB-ID	2586383-6
ISSN	1923-4163 ; 1923-4163
ISSN (online)	1923-4163
ISSN	1923-4163
DOI	10.14740/jmc4124
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Article ; Online: Rare Case of Benign Prostatic Hyperplasia Causing Deep Vein Thrombosis.

Kaur, Harveen / Chatterjee, Tulika / Bansal, Saurabh

The American journal of medicine

2023 Volume 136, Issue 11, Page(s) e218–e219

Language	English
Publishing date	2023-07-20
Publishing country	United States
Document type	Case Reports
ZDB-ID	80015-6
ISSN	1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
ISSN (online)	1555-7162 ; 1873-2178
ISSN	0002-9343 ; 1548-2766
DOI	10.1016/j.amjmed.2023.07.006
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Article: An Unusual Case of Dual Pancreatic Tumors.

Chatterjee, Tulika / Reddy, Yeshaswini / Badshah, Maaz / Puli, Srinivas

ACG case reports journal

2023 Volume 10, Issue 10, Page(s) e01190

Abstract: We report a simultaneous occurrence of pancreatic adenocarcinoma and pancreatic neuroendocrine tumor. A 64-year-old woman presented with abdominal pain and weight loss. Abdominal computed tomography revealed a pancreatic head mass with a mesenteric ... ...

Abstract	We report a simultaneous occurrence of pancreatic adenocarcinoma and pancreatic neuroendocrine tumor. A 64-year-old woman presented with abdominal pain and weight loss. Abdominal computed tomography revealed a pancreatic head mass with a mesenteric artery encasement. Endoscopic ultrasound revealed a second mass in the tail of the pancreas. Pathology reported adenocarcinoma of the head of the pancreas and a neuroendocrine tumor in the tail of the pancreas. The neuroendocrine tumor was nonfunctional, with no symptoms or signs present on assessment. The patient had advanced unresectable carcinoma, so she was treated with chemotherapy.
Language	English
Publishing date	2023-10-18
Publishing country	United States
Document type	Case Reports
ZDB-ID	2814825-3
ISSN	2326-3253
ISSN	2326-3253
DOI	10.14309/crj.0000000000001190
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Article ; Online: Pericardial Effusion with Tamponade in Untreated Hypothyroidism.

Mujuni, Daniel / Swantek, Courtney / Requena Amas, Carlos / Chatterjee, Tulika

The American journal of case reports

2023 Volume 24, Page(s) e938520

Abstract: BACKGROUND Small pericardial effusions are common with chronic hypothyroidism, but large pericardial effusion with tamponade or pre-tamponade physiology is a rare complication of severe uncontrolled hypothyroidism. Presentation of pericardial effusion of ...

Abstract	BACKGROUND Small pericardial effusions are common with chronic hypothyroidism, but large pericardial effusion with tamponade or pre-tamponade physiology is a rare complication of severe uncontrolled hypothyroidism. Presentation of pericardial effusion of any etiology can range from being asymptomatic to hemodynamic instability with cardiac tamponade, depending on the amount and speed of accumulation of pericardial fluid, but pericardial effusion associated with hypothyroidism are usually small. Protracted medication non-adherence was a key factor in our patient's presentation. CASE REPORT We present a case of a woman in her 40s with a known history of autoimmune hypothyroidism with medication non-adherence for longer than 9 months who presented with fatigue, weight gain, limited physical activity, and exertional dyspnea with bilateral swelling of the upper and lower extremities. Examination revealed muffled heart sounds, positive JVD, and positive pulsus paradoxus. She had an elevated TSH, low free T4, and a high anti-thyroid peroxidase antibody level. Echocardiography revealed a large pericardial effusion with impending tamponade. Pericardiocentesis with pericardial drain was done and the patient's symptoms resolved quickly. The patient was restarted on a prior dose of levothyroxine 175 mcg. She had improved by the 3rd day of hospitalization; the pericardial drain was removed, and she was discharged with access to medication. Follow-up revealed complete resolution of her symptoms. CONCLUSIONS This case emphasizes the importance of recognition of hypothyroidism as the etiology of life-threatening large pericardial effusions, as it is treatable and recurrences are preventable. To prevent recurrence, it is important to achieve euthyroidism after treating an episode of pericardial effusion.
MeSH term(s)	Adult ; Female ; Humans ; Cardiac Tamponade/etiology ; Cardiac Tamponade/therapy ; Cardiac Tamponade/diagnosis ; Hypothyroidism/complications ; Hypothyroidism/diagnosis ; Pericardial Effusion/etiology ; Pericardial Effusion/therapy ; Pericardial Effusion/diagnosis ; Pericardiocentesis ; Thyroxine/therapeutic use ; Echocardiography
Chemical Substances	Thyroxine (Q51BO43MG4)
Language	English
Publishing date	2023-01-19
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2517183-5
ISSN	1941-5923 ; 1941-5923
ISSN (online)	1941-5923
ISSN	1941-5923
DOI	10.12659/AJCR.938520
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Article: Finding of

Chatterjee, Tulika / Roy, Moni / Reddy, Yeshaswini Panathur Sreenivasa / Ahmad, Sharjeel

Germs

2023 Volume 13, Issue 3, Page(s) 282–287

Abstract: Introduction: The annual incidence of infective endocarditis (IE) is 3-9 cases per 100000 in developed countries and most cases are due to staphylococci and streptococci. IE due to Gram-positive anaerobic cocci (GPAC) is very rare.: Case report: We ... ...

Abstract	Introduction: The annual incidence of infective endocarditis (IE) is 3-9 cases per 100000 in developed countries and most cases are due to staphylococci and streptococci. IE due to Gram-positive anaerobic cocci (GPAC) is very rare. Case report: We present a case of a 38-year-old female with Conclusions: In cases of infection with fastidious organisms like GPACs, the use of next-generation sequencing (NGS) can allow the correct identification of culprit pathogens and streamlined treatment.
Language	English
Publishing date	2023-09-30
Publishing country	Romania
Document type	Case Reports
ZDB-ID	2649305-6
ISSN	2248-2997
ISSN	2248-2997
DOI	10.18683/germs.2023.1396
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Article ; Online: A Rare Case of Combined Choriocarcinoma and Placental Site Trophoblastic Tumor Presenting as Skin Lesion: A Case Report.

Chatterjee, Tulika / Martial, Annia / Settypalli, Sahitya / Lindahl, Larry

The American journal of case reports

2022 Volume 23, Page(s) e936451

Abstract: BACKGROUND Despite the tendency to metastasize widely, Gestational Trophoblastic Neoplasia (GTN) is one of the most curable solid tumors with chemotherapy. CASE REPORT A 41-year-old female, G4P2A2, presented with a slowly growing lump on the left side of ...

Abstract	BACKGROUND Despite the tendency to metastasize widely, Gestational Trophoblastic Neoplasia (GTN) is one of the most curable solid tumors with chemotherapy. CASE REPORT A 41-year-old female, G4P2A2, presented with a slowly growing lump on the left side of the scalp associated with a headache. The patient had intermittent, sharp left eye pain which radiated to the side of her face, photophobia, early morning blurring of vision, and nausea. Palpation over scalp lesion produced deep retro-orbital pain and pain was exacerbated with bending over. An ophthalmological evaluation was unremarkable. Ultrasonography (USG) of the left scalp showed an intramuscular mass superficial to the left frontal bone. During excision biopsy, the mass was found to be invading the frontal bone. Histopathology showed a metastatic trophoblastic tumor with mixed features of choriocarcinoma and placental site trophoblastic tumor. A pregnancy test was positive, the beta HCG level was elevated but USG did not show intrauterine pregnancy. CT head demonstrated an intracranial, dural-based mass that extended against the brain but did not breach the pial membrane. CT chest, abdomen, pelvis, and PET scan showed no evidence of metastatic disease. She was successfully treated with resection of the transcranial lesion followed by aggressive chemotherapy - Etoposide, Methotrexate, Actinomycin-D, Vincristine, and Cyclophosphamide. CONCLUSIONS This was an unusual case of GTN due to its primary presentation as skin metastasis, without any lung metastasis and no identifiable primary lesion. It is also very unusual to see a combination of choriocarcinoma and placental site trophoblastic tumor cells in the same tumor mass.
MeSH term(s)	Adult ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Choriocarcinoma/pathology ; Cyclophosphamide/therapeutic use ; Etoposide ; Female ; Gestational Trophoblastic Disease/drug therapy ; Humans ; Methotrexate/therapeutic use ; Pain ; Placenta/pathology ; Pregnancy ; Trophoblastic Tumor, Placental Site/drug therapy ; Trophoblastic Tumor, Placental Site/surgery ; Uterine Neoplasms/pathology ; Vincristine/therapeutic use
Chemical Substances	Vincristine (5J49Q6B70F) ; Etoposide (6PLQ3CP4P3) ; Cyclophosphamide (8N3DW7272P) ; Methotrexate (YL5FZ2Y5U1)
Language	English
Publishing date	2022-06-18
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2517183-5
ISSN	1941-5923 ; 1941-5923
ISSN (online)	1941-5923
ISSN	1941-5923
DOI	10.12659/AJCR.936451
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Article: Isolated Unilateral Abducens Nerve Palsy Manifesting as a Rare Complication of Idiopathic Pituitary Apoplexy: A Case Report.

Syed, Salman B / Mourra, Ahmad A / Chatterjee, Tulika

Cureus

2022 Volume 14, Issue 2, Page(s) e22408

Abstract: Pituitary apoplexy (PA) is an expansion of a pituitary adenoma due to infarction or hemorrhage of the gland. The term apoplexy usually describes larger bleeds leading to a sudden onset of symptoms. Although it is a rare condition, it can be a life- ... ...

Abstract	Pituitary apoplexy (PA) is an expansion of a pituitary adenoma due to infarction or hemorrhage of the gland. The term apoplexy usually describes larger bleeds leading to a sudden onset of symptoms. Although it is a rare condition, it can be a life-threatening emergency. PA usually presents with severe headache, nausea, vomiting, visual acuity, and field defects, frequently involving the cranial nerves directly adjacent to the pituitary gland, including third (oculomotor) cranial nerve, fourth (trochlear) cranial nerve, ophthalmic and maxillary branches of the fifth (trigeminal) cranial nerve, and, less commonly, the sixth (abducens) cranial nerve. Here, we present the case of a 36-year-old male who presented with a one-week history of worsening headache associated with double vision. On physical examination, the patient was noted to have left abducens nerve palsy. MRI brain showed anterior right T1 hyperintensity in the pituitary representing blood products. The patient was treated with analgesics and hormonal therapy with improvement in symptoms and eventual resolution of PA without the need for surgical intervention. PA is an unusual cause of acute isolated abducens nerve palsy which should be identified promptly as it is a life-threatening emergency that can be treated immediately with hormonal replacement followed by a decision to manage conservatively or surgically. The long-term follow-up includes endocrine assessment, visual assessment, and imaging surveillance.
Language	English
Publishing date	2022-02-20
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.22408
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Treatment of Extra-Intestinal

Chatterjee, Tulika / Roy, Moni / Ahmad, Sharjeel

European journal of case reports in internal medicine

2022 Volume 9, Issue 9, Page(s) 3489

Abstract: Clostridioides difficile: Learning points: Clostridioides ... ...

Abstract	Clostridioides difficile Learning points: Clostridioides difficile
Language	English
Publishing date	2022-09-14
Publishing country	Italy
Document type	Journal Article
ISSN	2284-2594
ISSN (online)	2284-2594
DOI	10.12890/2022_003489
Database	MEDical Literature Analysis and Retrieval System OnLINE

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