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==Classification of suicidal ideation==
{| class="wikitable"
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Classification
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Definition
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Examples
|-


|'''Suicidal events'''
_NOTOC _
Completed suicide
{{CMG}};{{AE}}{{Vbe}}


|A self-injurious behavior that resulted in fatality and
==Causes==
was associated with at least some intent to die as a
[[Hypogammaglobulinemia]] is caused by:
result of the act.


Immunodeficiency secondary to:
*[[Uremia]]
*Protein losing enteropathy
*[[Nephrotic syndrome]]
*Malnutrition
*Cirrhosis
*Hemodialysis
* Intestinal lymphangiectasia


|  
* Protein-losing gastroenteropathy
example:1) After a long argument with his girlfriend, which resulted in the
*[[Nephrotic syndrome]]
end of their relationship, the patient collected a rope and rode his
*[[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>
bike to an isolated area where he fatally hanged himself. A suicide
* Medications :
note was later found. 2) After four documented attempts at suicide,
** Gold
the patient stole his uncle’s gun and shot himself and was fatally injured
**D-Penicillamine
**Sulfasalazin
**Anticonvulsants
**Glucocorticoids
**Methotrexate
**Calcineurin inhibitors
** 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>


|-
* Environmental hazards:
|[[Suicide attempt]]
** Ionizing radiation
**Toxins


|A potentially self-injurious behavior, associated with
*Infections
at least some intent to die, as a result of the act.
** Viral(Herpes, Measles)
Evidence that the individual intended to kill him/
**Bacterial(Mycobacterial)
herself, at least to some degree, can be explicit or
**Parasitic(Malaria, helminthic infections)
inferred from the behavior or circumstance. A suicide
attempt may or may not result in actual injury
 
 
 
|'''Example''':fter 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 y increasing the chances that he would
be “successful” and die
 
|-
|[Preparatory acts
towards 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
 
 
|
her 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.a
|ctive: 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.
 
 
 
|[[Hypothyroidism]]
|Hypofunctioning of the thyroid gland due to multifactorial etiology ranging from congenital to [[autoimmune]] causes described below:
*[[Congenital]]
*[[Autoimmune]]
*[[Drugs]]
*[[Post surgery]]
*[[Post radiation]]
*[[Infiltrative]] e.g., amyloid
|
*[[ Fatigue]]
* [[Constipation]]
*[[ Dry skin]]
*[[ Weight gain]]
* [[Cold intolerance]]
*[[ Puffy face]]
*[[ Hoarseness]]
*[[ Muscle weakness]]
* Elevated blood [[cholesterol]] level
* [[Bradycardia]]
*[[ Myopathy]]
*[[ Depression]]
* Impaired [[memory]]
| Diagnosis of [[hypothyroidism]] is based on [[blood]] tests:
*T3(triiodothyronine)
*T4(Thyroxine) and
*TSH (thyroid stimulating hormone).
*Signs and symptoms are neither [[sensitive]] nor [[specific]] for the diagnosis.
*TSH is the most sensitive tool for screening,diagnosis and treatment follow up, when[[ pituitary]] is normal.
*The drug of choice for treatment is [[Levothyroxine]].
|-
|[[Psychogenic polydipsia]]
| Also called as[[ primary polydipsia]] is characterized by[[ polyuria]] and [[polydipsia]]. Causes are:
* Defect in the [[hypothalamus]]
*Adverse effect of a [[medication]]
*Traumatic[[ brain]] injury
*[[Psychiatric]] disorders such as [[schizophrenia]]
|
*[[Polyuria]]
*[[Polydipsia]]
*[[Confusion]]
*[[Lethargy]]
*[[Psychosis]]
*[[Seizures]] and
*Sometimes, even [[Death]].
|Evaluation of[[ psychiatric]] patients with polydipsia warrants a comprehensive evaluation for other medical causes of polydipsia, polyuria,[[ hyponatremia]], and the syndrome of inappropriate secretion of antidiuretic hormone.
*The management strategy in[[ psychiatric]] patients should include:
 
*[[Fluid]] restriction and[[ behavioral]] and [[pharmacologic]] modalities.
*The [[water deprivation test]] is the [[gold standard]] test.
|}

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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