Background: Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) offers the possibility of cure for hematological malignancies, various complications have been described. Capillary leak syndrome (CLS) has been previously observed in HSCT patients. CLS is a rare disease characterized by recurrent episodes of generalized edema and severe hypotension along with hypoproteinemia. ...

Most of the patients with star fruit intoxication are uremic patient on dialysis and few of them are advanced renal failure patient not yet beginning dialysis. We reported a case of less advanced renal insufficiency (Cr: 2.3 mg/dL) who present vomiting, hiccup and lower limbs numbness after ingesting star fruit and rapid progressed to seizure six hours later. Status epilepticus was noted refrac...

Intra-operative hypotension is generally responsive to decreasing anesthetic depth and/or intravenous fluid boluses. We present a 20-year-old male with multiple refractory intra-anesthetic hypotensive episodes, determined to have multifactorial etiology. Using propranolol to treat anxiety and Asperger’s syndrome, an indication likely to increase due to recent research efforts, was identified as...

Autosomal-recessive renal tubular dysgenesis (AR-RTD) is a rare disorder caused by a genetic defect in the renin-angiotensin system. Although AR-RTD has typically been known as a lethal disease due to refractory hypotension and renal failure immediately after birth, few cases have reported survival of the neonatal period. We report here an additional case of AR-RTD, who had novel ACE mutations ...

Perioperative echocardiography, especially transesophageal echocardiography, is of paramount importance in evaluating and managing refractory hypotension, a potential cause of which is systolic anterior motion (SAM) of anterior mitral leaflet. Dynamically moving anterior mitral valve leaflet towards the left ventricular outflow tract (LVOT) is described as SAM. Although SAM was initially observ...

Severe sepsis and septic shock, which are among the most common causes of death in intensive care units worldwide, cause high morbidity, mortality, and social and economic costs. Therefore, developing successful therapies against sepsis is one of the most important challenges in critical care medicine. Death from septic shock is caused by refractory hypotension and multiple organ failure (MOF)....

Two Japanese cases of streptococcal toxic shock syndrome (STSS) are reported. The first patient was a 45-year-old male who developed necrotizing fasciitis and myositis of the left thigh, refractory hypotension, hepatic dysfunction and acute renal failure; the patient died despite treatment. Streptococcus pyogenes was isolated from the inflamed fascia. The second patient was a 69-year-old female...

Two children with severe septic shock are reported. One had meningococcal septicaemia and the other Escherichia coli septicaemia. They remained hypotensive despite high concentrations of conventional inotropes and vasopressors. In one child, using a pulmonary artery catheter, extended haemodynamic variables were measured. To restore blood pressure, in both cases, an infusion of angiotensin II w...

Cortisol production by the human fetal adrenal cortex has been shown to be not adequate at early gestation. This is due to an inefficient expression of 3b-hydroxysteroid dehydrogenase, the enzyme that catalyzes the synthesis of progesterone from pregnenolone, before about 23 weeks of gestation. Whereas, the fetal adrenal cortex it is able to produce dehydroepiandrosterone sulphate for placental...

Abstract Background Diffuse coronary artery spasm after bypass grafting may cause disastrous circulatory collapse and death if not detected managed promptly. Case presentation Four out of 387 patients who underwent uneventful off-pump between January 2019 December 2021 at our centre developed unexplained arrhythmias hypotension within 2 to 6 h the postoperative period. Coronary angiogram showed...