Severe Respiratory Alkalosis in Acute Ischemic Stroke: A Rare Presentation

Muppidi, Vijayadershan; Kolli, Sashank; Dandu, Vasuki; Pathireddy, Samata; Meegada, Sreenath

doi:10.7759/cureus.7747

Cited by 7 publications

(4 citation statements)

References 13 publications

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“…In secondary hyperparathyroidism, the parathyroid glands become overactive in an attempt to maintain normal calcium levels in the blood. The conditions that can lead to secondary hyperparathyroidism include chronic kidney disease, vitamin D deficiency, and malabsorption disorders, and pseudohyperparathyroid disease (Hoshi et al, 2008;Muppidi et al, 2024) Brown's tumor is characterized by elevated levels of parathyroid hormone (PTH) secreted by the parathyroid glands, leads to hypercalcemia. The parathyroid glands function to regulate serum calcium levels.…”

Section: Discussionmentioning

confidence: 99%

Brown Tumor in Parathyroid Adenoma Mimicking Malignant Bone Tumor: A Case Report

Asri Dhea Pratiwi,

Setiawati

2024

Jember Medical Journal

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Brown tumors, also recognized as osteitis fibrosa cystica or osteoclastoma, represent a unique pathological entity intricately linked to hyperparathyroidism. Although benign in nature, brown tumor can manifest as focal bone abnormalities, presenting diagnostic challenges due to their striking resemblance to malignant bone tumors, particularly bone metastases. A 24-year-old woman presented with a lump on her left knee and right lower leg pain. Imaging unveiled multiple osteolytic lesions resembling aggressive bone tumors. Subsequent investigations, including abdominal USG, thyroid USG, bloodwork, and parathyroid hormone assessment, confirmed hyperparathyroidism with elevated PTH levels and nephrocalcinosis. HistoPA examination shows a brown tumor diagnosis, prompting parathyroidectomy. Brown tumor can mimic aggressive bone tumors both in clinical and radiological findings. Besides PTH level, thyroid and abdominal USG should be performed to find both parathyroid mass and nephrocalcinosis as the result of hypercalcemia. A HistoPA examination shoud be performed to diagnose the main cause of hyperparathyroidism, that is mostly parathyroid adenoma. As for the treatment, medical and surgical intervention can be done to treat hyperparathyroidism and brown tumor itself. Brown tumors pose a diagnostic challenge due to their association with hyperparathyroidism and their resemblance to aggressive bone tumors. Further research is needed to enhance diagnostic and therapeutic strategies for brown tumors associated with hyperparathyroidism.

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Section: Discussionmentioning

confidence: 99%

Brown Tumor in Parathyroid Adenoma Mimicking Malignant Bone Tumor: A Case Report

Asri Dhea Pratiwi,

Setiawati

2024

Jember Medical Journal

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“…6 CRA is characterized by a primary decrease in PCO 2 in response to sustained hyperventilation. 7,8 In CRA, the renal alkalization effect of the depressed PCO 2 results in a decrement of serum bicarbonate, which can be predictable, depending on whether the duration of hyperventilation, is acute (<48 h) or chronic (>48 h). As a rule, for each 10 mm Hg drop in the PCO 2 below 40 mm Hg, the plasma bicarbonate concentration decreases by 4-5 mEq/L.…”

Section: Discussionmentioning

confidence: 99%

Urine anion gap can differentiate respiratory alkalosis from metabolic acidosis in the absence of blood gas results

Assadi

2023

Pediatric Pulmonology

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Introduction: Low plasma bicarbonate concentration due to chronic respiratory alkalosis may be misdiagnosed as metabolic acidosis and mistreated with administration of alkali therapy, particularly when arterial blood gas is not available. Methods:We measured urine anion gap [urine (Na + + K + ) -(Cl − )], as a surrogate of renal ammonium excretion in 15 patients presenting with hyperventilation and low serum bicarbonate concentration to distinguish chronic respiratory alkalosis (CRA) from metabolic acidosis (MA) when blood gas was unavailable.Results: Hyperventilation and low serum bicarbonate concentrations were associated with urine pH above 5.5 and positive urine anion gap in all, suggesting CRA. The diagnosis was later confirmed by obtaining capillary blood gas, which showed a decrease in PCO 2 and high normal pH values. Conclusion:The use of urine anion gap can help to differentiate between chronic respiratory alkalosis and metabolic acidosis, especially when arterial blood gas is not obtained.

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“…Y por último los misceláneos como puede ser el embarazo, un hipertiroidismo, fiebre, insuficiencia hepática o una sepsis. (Hopper, 2017;Muppidi et al, 2020;Saínz Menéndez, 2018)…”

Section: Etiologíaunclassified

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2023

RevInvCon

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En el primer número de Investigación Contemporánea, presentamos trabajos destacados en el campo de educación y salud. La editorial describe la crisis que la Pandemia de la COVID-19 causó y las consecuencias que aún afectan los diferentes sectores de la sociedad ecuatoriana, presentando las implicaciones socio- económicas, educativas y de salud. El primer artículo de Educación, trata sobre una revisión teórica de la gestión educativa y el involucramiento de Padres de Familia en los procesos educativos del subnivel inicial a bachillerato. Luego se presentan cuatro artículos en el ámbito médico. El primero es un artículo original que aborda el papel de la radiocirugía con gamma knife en el control del crecimiento tumoral en pacientes con tumor de hipófisis. El segundo artículo refiere conceptos fundamentales de la alcalosis respiratoria, su etiología, diagnóstico y tratamiento:, temática abordada mediante una revisión sistemática. El tercer manuscrito se basa en una revisión integrada de la literatura acerca de Utilización de escalas Clínicas para severidad de Covid 19; y, el cuarto artículo es una caso clínico interesante de un paciente pediátrico con diagnóstico de Enteritis por salmonella, cuyo tratamiento fue conservador.

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Severe Respiratory Alkalosis in Acute Ischemic Stroke: A Rare Presentation

Cited by 7 publications

References 13 publications

Brown Tumor in Parathyroid Adenoma Mimicking Malignant Bone Tumor: A Case Report

Brown Tumor in Parathyroid Adenoma Mimicking Malignant Bone Tumor: A Case Report

Urine anion gap can differentiate respiratory alkalosis from metabolic acidosis in the absence of blood gas results

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