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===Suicidal events===
'''Completed'''
suicide-A self-injurious behavior that resulted in fatality and
was associated with at least some intent to die as a
result of the act.
1) After a long argument with his girlfriend, which resulted in the
end of their relationship, the patient collected a rope and rode his
bike to an isolated area where he fatally hanged himself. A suicide
note was later found. 2) After four documented attempts at suicide,
the patient stole his uncle’s gun and shot himself and was fatally
injured.
'''Suicide attempt''' A potentially self-injurious behavior, associated with
at least some intent to die, as a result of the act.
Evidence that the individual intended to kill him/
herself, at least to some degree, can be explicit or
inferred from the behavior or circumstance. A suicide
attempt may or may not result in actual injury.
1) After a fight with her friends at school, in which they discontinued
speaking with her, the patient ingested approximately 16 aspirin
and eight other pills of different types on the school
grounds. She said that she deserved to die, which was why she
swallowed the pills. 2) The patient used a razor blade to lacerate
his wrists, his antecubital fossae, and his back bilaterally. He told
his therapist that the “the main objective was to stop feeling like
that,” and he knew that he could die but didn’t care. According to
the patient, he also ingested a bottle of rubbing alcohol because
in his health class he heard “that the medulla will get more suppressed
that way,” thereby increasing the chances that he would
be “successful” and die.
'''Preparatory acts
toward
imminent'''
suicidal
behavior
The individual takes steps to injure him- or herself,
but is stopped by self or others from starting the
self-injurious act before the potential for harm has
begun.
1) The patient had run away from home overnight because his father
had gone to school and retrieved a recent “bad” report card.
He was fearful of his father’s reaction. Upon his return home, a 5-
to 6-hour argument with his parents ensued, and he took a vegetable
(broad, sharp) knife and went to his room. He reported putting
the knife to his wrist but never puncturing the skin. 2) The patient
stated that he “couldn’t stand being depressed anymore”
and “wanted to die.” He decided to hang himself. He tied a telephone
cord to the door knob and placed the cord loosely around
his neck. Then, he stopped himself and did not follow through
with the attempt.
'''Suicidal ideation''' Passive thoughts about wanting to be dead or active
thoughts about killing oneself, not accompanied by preparatory behavior
by preparatory behavior.a
1) Active: The patient reported to the doctor that he was thinking
about hanging himself in the closet. He was taken to the hospital
and admitted. 2) Passive: The patient reported ideas about wanting
to be dead but denied acting on these feelings.


_NOTOC _
{{CMG}};{{AE}}{{Vbe}}


==Causes==
[[Hypogammaglobulinemia]] is caused by:


elf-injurious
Immunodeficiency secondary to:
behavior, no
*[[Uremia]]
suicidal intent
*Protein losing enteropathy
Self-injurious behavior associated with no intent to
*[[Nephrotic syndrome]]
die. The behavior is intended purely for other reasons,
*Malnutrition
either to relieve distress (often referred to as
*Cirrhosis
“self-mutilation,” e.g., superficial cuts or scratches,
*Hemodialysis
hitting/banging, or burns) or to effect change in
* Intestinal lymphangiectasia
others or the environment.
 
1) The patient was feeling ignored. She went into the family kitchen
* Protein-losing gastroenteropathy
where her mother and sister were talking. She took a knife out of
*[[Nephrotic syndrome]]
the drawer and made a cut on her arm. She denied that she
*[[Thymoma]] <ref name="pmid29881497">{{cite journal |vauthors=Aouadi S, Ghrairi N, Braham E, Kaabi M, Maâlej S, Elgharbi LD |title=[Acquired hypogammaglobulinemia associated with thymoma: Good syndrome] |language=French |journal=Pan Afr Med J |volume=28 |issue= |pages=253 |date=2017 |pmid=29881497 |pmc=5989270 |doi=10.11604/pamj.2017.28.253.11352 |url=}}</ref>
wanted to die at all (“not even a little”), but she just wanted them
* Medications :
to pay attention to her. 2) The patient reported feeling agitated
** Gold
and anxious after a fight with her parents. She went into her
**D-Penicillamine
room, locked the door, and made several superficial cuts on the
**Sulfasalazin
inside of her arms. She stated that she felt relieved after cutting
**Anticonvulsants
herself and that she did not want to die. She reported that she
**Glucocorticoids
had done this before at times of distress and that it usually helped
**Methotrexate
her feel better. 3) The patient was in class, where a test was about
**Calcineurin inhibitors
to begin, and stabbed himself with a pencil in order to be taken
** Rituximab<ref name="pmid29755528">{{cite journal |vauthors=Shoukat BA, Ali O, Kumar D, Bilal Gilani M, Zahid A, Aslam Joiya S, Anwar Malik M |title=Hypogammaglobulinemia Observed One Year after Rituximab Treatment for Idiopathic Thrombocytopenic Purpura |journal=Case Rep Med |volume=2018 |issue= |pages=2096186 |date=2018 |pmid=29755528 |pmc=5884289 |doi=10.1155/2018/2096186 |url=}}</ref><ref name="pmid29752554">{{cite journal |vauthors=Farhat L, Dara J, Duberstein S, De A |title=Secondary Hypogammaglobulinemia After Rituximab for Neuromyelitis Optica: A Case Report |journal=Drug Saf Case Rep |volume=5 |issue=1 |pages=22 |date=May 2018 |pmid=29752554 |pmc=5948191 |doi=10.1007/s40800-018-0087-y |url=}}</ref><ref name="pmid29627491">{{cite journal |vauthors=Thorlacius H, Jerkeman A, Marginean FE, Toth E |title=Colorectal malakoplakia in a patient with hypogammaglobulinemia |journal=Gastrointest. Endosc. |volume= |issue= |pages= |date=April 2018 |pmid=29627491 |doi=10.1016/j.gie.2018.04.001 |url=}}</ref>
to the nurse’s office. 4) A 14-year-old girl wrote her name on her
 
arm with a penknife and said that she often does so in order to reduce
* Environmental hazards:
her anxiety. 5) The patient was noted to have multiple superficial
** Ionizing radiation
burns on his arms. Upon questioning, he denied trying to
**Toxins
kill himself.
 
Other, no
*Infections
deliberate
** Viral(Herpes, Measles)
self-harm
**Bacterial(Mycobacterial)
No evidence of any suicidality or deliberate self-injurious
**Parasitic(Malaria, helminthic infections)
behavior associated with the event. The
event is characterized as an accidental injury, psychiatric
or behavioral symptoms only, or medical
symptoms or procedure only.
1) The patient had a cut on the neck from shaving. 2) The patient
was hospitalized for worsening of OCD or depressive symptoms
with no suicidal thoughts or actions or 3) aggressive behavior.
4) Hospitalization was becaus

Latest revision as of 14:23, 3 August 2018


_NOTOC _ Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]

Causes

Hypogammaglobulinemia is caused by:

Immunodeficiency secondary to:

  • Protein-losing gastroenteropathy
  • Nephrotic syndrome
  • Thymoma [1]
  • Medications :
    • Gold
    • D-Penicillamine
    • Sulfasalazin
    • Anticonvulsants
    • Glucocorticoids
    • Methotrexate
    • Calcineurin inhibitors
    • Rituximab[2][3][4]
  • Environmental hazards:
    • Ionizing radiation
    • Toxins
  • Infections
    • Viral(Herpes, Measles)
    • Bacterial(Mycobacterial)
    • Parasitic(Malaria, helminthic infections)
  1. ↑ Aouadi S, Ghrairi N, Braham E, Kaabi M, Maâlej S, Elgharbi LD (2017). "[Acquired hypogammaglobulinemia associated with thymoma: Good syndrome]". Pan Afr Med J (in French). 28: 253. doi:10.11604/pamj.2017.28.253.11352. PMC 5989270. PMID 29881497.
  2. ↑ Shoukat BA, Ali O, Kumar D, Bilal Gilani M, Zahid A, Aslam Joiya S, Anwar Malik M (2018). "Hypogammaglobulinemia Observed One Year after Rituximab Treatment for Idiopathic Thrombocytopenic Purpura". Case Rep Med. 2018: 2096186. doi:10.1155/2018/2096186. PMC 5884289. PMID 29755528.
  3. ↑ Farhat L, Dara J, Duberstein S, De A (May 2018). "Secondary Hypogammaglobulinemia After Rituximab for Neuromyelitis Optica: A Case Report". Drug Saf Case Rep. 5 (1): 22. doi:10.1007/s40800-018-0087-y. PMC 5948191. PMID 29752554.
  4. ↑ Thorlacius H, Jerkeman A, Marginean FE, Toth E (April 2018). "Colorectal malakoplakia in a patient with hypogammaglobulinemia". Gastrointest. Endosc. doi:10.1016/j.gie.2018.04.001. PMID 29627491.
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