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Hyperhomocysteinemia and Evan's syndrome with uncal herniation for emergency splenectomy

Hyperhomocysteinemia is a genetic disorder of metabolism and transport of amino acid, commonly present as a pro-coagulant state. Evan's syndrome is an autoimmune disorder with pancytopenia, a diagnosis of exclusion. The present report highlights the anesthetic management of a rare case, where b...

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Autores principales: Shivalingaiah, Savitha Keelara, Arpana, J., Jain, M. Karthik, Varghese, Vineesh K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383129/
https://www.ncbi.nlm.nih.gov/pubmed/25886436
http://dx.doi.org/10.4103/0259-1162.150186
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author Shivalingaiah, Savitha Keelara
Arpana, J.
Jain, M. Karthik
Varghese, Vineesh K.
author_facet Shivalingaiah, Savitha Keelara
Arpana, J.
Jain, M. Karthik
Varghese, Vineesh K.
author_sort Shivalingaiah, Savitha Keelara
collection PubMed
description Hyperhomocysteinemia is a genetic disorder of metabolism and transport of amino acid, commonly present as a pro-coagulant state. Evan's syndrome is an autoimmune disorder with pancytopenia, a diagnosis of exclusion. The present report highlights the anesthetic management of a rare case, where both these clinical entities coexist. A 26-year-old male, a known case of hyperhomocyteinemia on medication for 4 years, came with a history of severe headache, blurring of vision and bleeding gums. Computerized tomography brain report showed subdural hematoma (SDH) of 16 mm with 9 mm right midline shift and on investigation had thrombocytopenia (5000 cells/cumm). Patient was diagnosed to have Evan's syndrome. Because he was refractory to the medical management, taken up for emergency splenectomy, followed by burr hole evacuation of SDH. Successful anesthetic management of the case is presented in this report.
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spelling pubmed-43831292015-04-13 Hyperhomocysteinemia and Evan's syndrome with uncal herniation for emergency splenectomy Shivalingaiah, Savitha Keelara Arpana, J. Jain, M. Karthik Varghese, Vineesh K. Anesth Essays Res Case Report Hyperhomocysteinemia is a genetic disorder of metabolism and transport of amino acid, commonly present as a pro-coagulant state. Evan's syndrome is an autoimmune disorder with pancytopenia, a diagnosis of exclusion. The present report highlights the anesthetic management of a rare case, where both these clinical entities coexist. A 26-year-old male, a known case of hyperhomocyteinemia on medication for 4 years, came with a history of severe headache, blurring of vision and bleeding gums. Computerized tomography brain report showed subdural hematoma (SDH) of 16 mm with 9 mm right midline shift and on investigation had thrombocytopenia (5000 cells/cumm). Patient was diagnosed to have Evan's syndrome. Because he was refractory to the medical management, taken up for emergency splenectomy, followed by burr hole evacuation of SDH. Successful anesthetic management of the case is presented in this report. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4383129/ /pubmed/25886436 http://dx.doi.org/10.4103/0259-1162.150186 Text en Copyright: © Anesthesia: Essays and Researches http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Shivalingaiah, Savitha Keelara
Arpana, J.
Jain, M. Karthik
Varghese, Vineesh K.
Hyperhomocysteinemia and Evan's syndrome with uncal herniation for emergency splenectomy
title Hyperhomocysteinemia and Evan's syndrome with uncal herniation for emergency splenectomy
title_full Hyperhomocysteinemia and Evan's syndrome with uncal herniation for emergency splenectomy
title_fullStr Hyperhomocysteinemia and Evan's syndrome with uncal herniation for emergency splenectomy
title_full_unstemmed Hyperhomocysteinemia and Evan's syndrome with uncal herniation for emergency splenectomy
title_short Hyperhomocysteinemia and Evan's syndrome with uncal herniation for emergency splenectomy
title_sort hyperhomocysteinemia and evan's syndrome with uncal herniation for emergency splenectomy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383129/
https://www.ncbi.nlm.nih.gov/pubmed/25886436
http://dx.doi.org/10.4103/0259-1162.150186
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