1/3. Aggressive systemic mastocytosis mimicking sclerosing cholangitis.A 43 year-old woman presented with fever, abdominal pain, epato-splenomegaly, ascites, cholestasis, anemia, thrombocytopenia and previous diagnosis of sclerosing cholangitis based on liver biopsy and endoscopic retrograde cholangiopancreatography(ERCP). The bone marrow biopsy and the revision of liver biopsy using antitryptase stain diagnosed systemic mastocytosis. Because of the aggressive course of the disease the patient was treated with an acute myeloid leukaemia chemotherapy regimen without success.- - - - - - - - - - ranking = 1keywords = mastocytosis (Clic here for more details about this article) |
2/3. Parmesan cheese and vegetable-induced histaminuria in a thermal flusher.flushing disorders are associated with sweating (wet flushes) or without sweating (dry flushes). When associated with systemic symptoms and histaminuria, flushing reactions may easily be confused with mastocytosis or pheochromocytoma. We report a case of a woman with significant transient histaminuria that could be dissociated from episodes of thermal wet flushing. Treatment with clonidine led to a decrease in both frequency and intensity of the flushing reactions.- - - - - - - - - - ranking = 0.2keywords = mastocytosis (Clic here for more details about this article) |
3/3. Recurrent near-syncope with flushing.Episodic vasomotor instability with flushing is an uncommon presentation that is suggestive of an endocrine etiology. This report is the case of a 42-year-old woman who presented to the ED 5 times in a 2-week period for recurrent, self-limited episodes of light-headedness associated with tachycardia, hypertension, and flushing. The patient's diagnosis eluded detection in both the outpatient and the inpatient settings for several months. The clinical diagnosis was ultimately confirmed by biochemical test samples obtained in the ED during a subsequent symptomatic event. The differential diagnosis of this patient's presentation includes pheochromocytoma, carcinoid syndrome, medullary thyroid carcinoma, systemic mastocytosis, and other endocrine and toxicologic diseases. ED management of the patient with transient yet significant vasomotor changes includes a workup for syncope, initiation of focused biochemical investigations, referral to the appropriate consultant, and consideration for admission.- - - - - - - - - - ranking = 0.2keywords = mastocytosis (Clic here for more details about this article) |