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Critical COVID-19 in a pregnant patient who presented in starvation ketoacidosis with a background history of acrorenal syndrome

A primiparous woman in her late 30s at 28+1 weeks’ gestation presented with a 3-day history of abdominal pain, loss of appetite, nausea and vomiting and was diagnosed with starvation ketoacidosis. A routine admission swab returned positive for COVID-19. She had been diagnosed with acrorenal syndrome...

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Detalles Bibliográficos
Autores principales: Brady, Aoife, Aglan, Ahmed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8565554/
https://www.ncbi.nlm.nih.gov/pubmed/34728503
http://dx.doi.org/10.1136/bcr-2021-244117
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author Brady, Aoife
Aglan, Ahmed
author_facet Brady, Aoife
Aglan, Ahmed
author_sort Brady, Aoife
collection PubMed
description A primiparous woman in her late 30s at 28+1 weeks’ gestation presented with a 3-day history of abdominal pain, loss of appetite, nausea and vomiting and was diagnosed with starvation ketoacidosis. A routine admission swab returned positive for COVID-19. She had been diagnosed with acrorenal syndrome from birth. Three days post admission, she deteriorated rapidly into respiratory failure requiring intubation and ventilation. She was treated with dexamethasone, prophylactic enoxaparin, a course of piperacillin/tazobactam followed by meropenem and fluconazole and 8 cycles of proning. An emergency caesarean section was performed on day 12 of hospital admission at 29+5 weeks’ gestation to improve maternal oxygenation and ventilation. The baby had deformities consistent with acrorenal syndrome but no evidence of COVID-19. She spent 23 days in the intensive care unit. Our case describes an unusual presentation of COVID-19, the challenges in managing critically ill pregnant patients along with a rare background history of acrorenal syndrome.
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spelling pubmed-85655542021-11-16 Critical COVID-19 in a pregnant patient who presented in starvation ketoacidosis with a background history of acrorenal syndrome Brady, Aoife Aglan, Ahmed BMJ Case Rep Case Report A primiparous woman in her late 30s at 28+1 weeks’ gestation presented with a 3-day history of abdominal pain, loss of appetite, nausea and vomiting and was diagnosed with starvation ketoacidosis. A routine admission swab returned positive for COVID-19. She had been diagnosed with acrorenal syndrome from birth. Three days post admission, she deteriorated rapidly into respiratory failure requiring intubation and ventilation. She was treated with dexamethasone, prophylactic enoxaparin, a course of piperacillin/tazobactam followed by meropenem and fluconazole and 8 cycles of proning. An emergency caesarean section was performed on day 12 of hospital admission at 29+5 weeks’ gestation to improve maternal oxygenation and ventilation. The baby had deformities consistent with acrorenal syndrome but no evidence of COVID-19. She spent 23 days in the intensive care unit. Our case describes an unusual presentation of COVID-19, the challenges in managing critically ill pregnant patients along with a rare background history of acrorenal syndrome. BMJ Publishing Group 2021-11-02 /pmc/articles/PMC8565554/ /pubmed/34728503 http://dx.doi.org/10.1136/bcr-2021-244117 Text en © BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ. https://bmj.com/coronavirus/usageThis article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.
spellingShingle Case Report
Brady, Aoife
Aglan, Ahmed
Critical COVID-19 in a pregnant patient who presented in starvation ketoacidosis with a background history of acrorenal syndrome
title Critical COVID-19 in a pregnant patient who presented in starvation ketoacidosis with a background history of acrorenal syndrome
title_full Critical COVID-19 in a pregnant patient who presented in starvation ketoacidosis with a background history of acrorenal syndrome
title_fullStr Critical COVID-19 in a pregnant patient who presented in starvation ketoacidosis with a background history of acrorenal syndrome
title_full_unstemmed Critical COVID-19 in a pregnant patient who presented in starvation ketoacidosis with a background history of acrorenal syndrome
title_short Critical COVID-19 in a pregnant patient who presented in starvation ketoacidosis with a background history of acrorenal syndrome
title_sort critical covid-19 in a pregnant patient who presented in starvation ketoacidosis with a background history of acrorenal syndrome
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8565554/
https://www.ncbi.nlm.nih.gov/pubmed/34728503
http://dx.doi.org/10.1136/bcr-2021-244117
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