Asian Journal of Case Reports in Medicine and Health

Starvation Induced Euglycaemic Diabetic Ketoacidosis in a Postoperative Diabetic Patient

Ashish Bangaari — 2021-07-16

Peri-operative euglycaemic diabetic ketoacidosis is under-recognized and difficult to diagnose due to variable triggers and absence of hyperglycaemia. We report a case of a 58 years old type -2 diabetic female who developed refractory post-operative metabolic acidosis caused by starvation and euglycaemic diabetic ketoacidosis. Recent surgery, major illness, carbohydrate restriction, and a relative insulin deficiency were the contributing factors leading to it. This report highlights the importance of nutrition and appropriate insulin usage in sick peri-operative diabetic patients presenting with unexplained keto acidosis.

Abdominal Migraine as a Differential Diagnosis of Abdominal Pain in Children: A Case Report

Anush Vahanyan — 2021-06-26

Aims: To illustrate abdominal migraine as a possible and often unrecognized cause of recurrent abdominal pain in children.

Study design: Case report.

Place and duration of study: Department of Propaedeutics of internal diseases, “Heratsi” N1 University Hospital Complex, Yerevan, Armenia, August 2017.

Methodology: The differential diagnosis of abdominal pain in children can be difficult. We present a case of a 12 years old girl who was complaining of recurrent abdominal pain and nausea during the last year, which was affecting her regular activity. After many diagnostic procedures, every possible somatic disease was ruled out, and a diagnosis of abdominal migraine was made. As of now, four years after the initial diagnosis, the abdominal migraine transitioned into migraine headaches, as often occurs in patients with this diagnosis.

Successful Treatment of Clonal Eosinophilia with FIP1L1-PDGFRA Rearrangement with Low Dose IMATINIB – A Case Report

Kuranage Hiranthi Bernadene Perera Fernandopulle — 2021-07-06

Clonal eosinophilia with FIP1L1-PDGFRA rearrangement is a rare disorder which is almost exclusively seen in males. Targeted therapy with Imatinib has led to successful achievement of molecular remission of this disorder but no evidence exists for continuous or maintenance therapy or treatment free remission yet. This is a case of clonal eosinophilia with FIP1L1-PDGFRA rearrangement in a young man, who presented with very high eosinophil and neutrophil counts, moderate thrombocytopenia, hepatosplenomegaly and skin and lung involvement. Imatinib at 100mg daily was started after initial treatment with cytoreductive therapy and steroids. He responded well to low dose Imatinib with complete absence of symptoms and normalization of counts within 3 months and disappearance of molecular evidence of the disease following 2 years of therapy. Imatinib was then tailed off and he remains asymptomatic on a weekly dose of 100mg Imatinib. Workup towards a diagnosis of eosinophilia has been made easy with the new classification and inclusion of molecular evaluation. The high eosinophil count, presence of organomegaly and thrombocytopenia favoured a clonal aetiology .Low dose Imatinib gives excellent clinical, haematological and molecular remission and can be safely reduced thereafter to weekly maintenance.