Massive Eosinophilic Reaction to Desipramine in Conjunction with Pneumonia*

1984 ◽  
Vol 29 (2) ◽  
pp. 142-144 ◽  
Author(s):  
R.P. Kraus ◽  
R.J. Clarke ◽  
R.A. Remick
Keyword(s):  
Affective Disorder ◽  
Female Patient ◽  
Blood Count ◽  
Bipolar Affective Disorder ◽  
Dry Mouth ◽  
White Blood Count ◽  
Medication Change ◽  
Supportive Management

The authors report on a female patient with bipolar affective disorder who presented with marked eosinophilia in conjunction with pneumonia five days after a medication change from amitriptyline to desipramine (for intolerable dry mouth). She improved with discontinuance of medications and supportive management, and her eosinophilia normalized. Reinstitution of desipramine was followed by prompt appearance of asymptomatic eosinophilia, which resolved with discontinuation of desipramine. A subsequent depression managed with amitriptyline was followed by no abnormal white blood count findings. Eosinophilia is occasionally encountered in imipramine or desipramine therapy and, although usually asymptomatic, appears to be manageable by switching to amitriptyline or nortriptyline.

scholarly journals Thyrotoxicosis followed by hypothyroidism in a patient on lithium

2014 ◽  
Vol 6 (2) ◽  
pp. 38-39 ◽  
Author(s):  
Nilamadhab Kar ◽  
Surabhi R. Hullumane ◽  
Carol Williams
Keyword(s):  
Maintenance Therapy ◽  
Affective Disorder ◽  
Female Patient ◽  
Thyroid Dysfunction ◽  
Bipolar Affective Disorder ◽  
Clinical Impact

While hypothyroidism is common in lithium-treated patients, thyrotoxicosis is rarely reported. We present a female patient on lithium for maintenance therapy of bipolar affective disorder, who developed thyrotoxicosis for few months which was followed by hypothyroidism which continued. There was no further thyrotoxicosis episode during a five year follow up period. While she was treated for thyroid dysfunction, lithium was continued. There was no clinical impact on the maintenance of the bipolar affective disorder during the follow up period; she was maintained well in the community.

scholarly journals Thyrotoxicosis followed by hypothyroidism in a patient on lithium

2014 ◽  
Vol 6 (2) ◽  
Author(s):  
Nilamadhab Kar ◽  
Surabhi R. Hullumane ◽  
Carol Williams
Keyword(s):  
Maintenance Therapy ◽  
Affective Disorder ◽  
Female Patient ◽  
Thyroid Dysfunction ◽  
Bipolar Affective Disorder ◽  
Clinical Impact

While hypothyroidism is common in lithium-treated patients, thyrotoxicosis is rarely reported. We present a female patient on lithium for maintenance therapy of bipolar affective disorder, who developed thyrotoxicosis for few months which was followed by hypothyroidism which continued. There was no further thyrotoxicosis episode during a five year follow up period. While she was treated for thyroid dysfunction, lithium was continued. There was no clinical impact on the maintenance of the bipolar affective disorder during the follow up period; she was maintained well in the community.

Identifying Targets for the Prevention of Childhood Undernutrition in a Resource-Limited Peri-Urban Ecuadorian Community

2021 ◽  
pp. 037957212098250
Author(s):  
Suzanna L. Attia ◽  
Wolf-Peter Schmidt ◽  
Janeth Ceballos Osorio ◽  
Thomas Young ◽  
Aric Schadler ◽  
...  
Keyword(s):  
Vitamin A ◽  
Blood Count ◽  
Complete Blood Count ◽  
Dietary Diversity ◽  
Demographic Data ◽  
Serum Zinc ◽  
White Blood Count ◽  
Monthly Income ◽  
Vitamin Deficiencies ◽  
Dietary Diversity Score

Background: In middle-income countries, malnutrition concentrates in marginalized populations with a lack of effective preventive strategies. Objective: Identify risk factors for undernutrition in a peri-urban Ecuadorian community of children aged 12 to 59 months. Methods: Data from a cross-sectional survey in 2011 of children 1 to 5 years were analyzed including demographic data, medical history and examination, food frequency questionnaire (FFQ), anthropometric measurements, and blood for complete blood count, C-reactive protein, vitamin A, iron, and zinc levels. Dietary Diversity Score (DDS) was calculated from FFQ. Bivariate and multivariate analysis assessed effects on primary outcome of undernutrition by DDS, vitamin deficiencies, and demographic and nutritional data. Results: N = 67, 52.2% undernourished: 49.3% stunted, 25.4% underweight, and 3% wasted; 74.6% (n = 50) were anemic and 95.1% (n = 39) had low serum zinc. Dietary Diversity Score was universally low (mean 4.91 ± 1.36, max 12). Undernutrition was associated with lower vitamin A levels (20 306, IQR: 16605.25-23973.75 vs 23665, IQR: 19292-26474 ng/mL, P = .04); underweight was associated with less parental report of illness (43.8%, n = 7 vs 80% n = 40, P = .005) and higher white blood count (13.7, IQR: 11.95-15.8 vs 10.9, IQR: 7.8-14.23 × 109/L, P = .02). In multiple regression, risk of undernutrition decreased by 4% for every $10 monthly income increase (95 CI%: 0.5%-7.4%, P = .02, n = 23); risk of underweight decreased by 0.06 for every increased DDS point (adjusted odds ratio: 0.06; 95 CI%: 0.004-0.91, P = .04, n = 23). Conclusions: In this peri-urban limited resource, mostly Indigenous Ecuadorian community, stunting exceeds national prevalence, lower monthly income is the strongest predictor of undernutrition, lower DDS can predict some forms of undernutrition, and vitamin deficiencies are associated with but not predictive of undernutrition.

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