1.Rhinocerebral Mucormycosis with Isolated Sixth Nerve Palsy in An Immunocompetent Patient
Shraddha Jain ; Sunil Kumar ; Amit Kaushal
The Medical Journal of Malaysia 2011;66(4):376-378
We report a case of rhinocerebral mucormycosis in a 31 year
old immunocompetent female presenting initially like acute
rhinosinusitis with nasal stuffiness, severe headache,
vomiting who soon developed isolated right lateral rectus
palsy. Computed tomography(CT) scan of the Post-Nasal
Spaces(PNS) showed an ill defined expansile heterogenous
density mass in the sphenoid with extension into the
ethmoids, nasal cavity, optic canal, superior orbital fissure, clivus and right temporal lobe with signal void in Magnetic Resonance Imaging(MRI). The debris and polypoid mucosa obtained on nasal endoscopy revealed mucormycosis on histopathologic examination. The patient was managed with urgent surgical debridement and medical management.
2.Telmisartan-induced sprue-like enteropathy: a case report and a review of patients using non-olmesartan angiotensin receptor blockers.
Harshal Surendra MANDAVDHARE ; Vishal SHARMA ; Kaushal K PRASAD ; Amit KUMAR ; Manish RATHI ; Surinder S RANA
Intestinal Research 2017;15(3):419-421
Recent studies have identified sprue-like illness associated with the use of the antihypertensive agent olmesartan medoxomil. However, whether this condition is specific to the use of olmesartan or is associated with the use of drugs belonging to the class of “sartans” remains to be clarified. A 45-year-old woman with chronic kidney disease along with hypothyroidism and hypertension presented with chronic diarrhea and significant weight loss. Endoscopy of the upper gastrointestinal tract showed scalloping and grooving of the duodenum, and histopathological examination showed subtotal villous atrophy. She was on telmisartan for hypertension, which was discontinued. Subsequently, diarrhea ameliorated dramatically, and she regained weight. To our knowledge, this is the first study to report telmisartan-associated sprue-like enteropathy. Further, we have reviewed the cases of patients with sprue-like enteropathy caused by valsartan, irbesartan, and eprosartan.
Angiotensin Receptor Antagonists*
;
Angiotensins*
;
Atrophy
;
Celiac Disease
;
Diarrhea
;
Duodenum
;
Endoscopy
;
Female
;
Humans
;
Hypertension
;
Hypothyroidism
;
Middle Aged
;
Olmesartan Medoxomil
;
Pectinidae
;
Renal Insufficiency, Chronic
;
Upper Gastrointestinal Tract
;
Valsartan
;
Weight Loss