Lymphoma case study one: Difference between revisions

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==Case #1==
==Case #1==


===Case presentation===
===Case Presentation===


A 77-year-old woman with past medical history of [[hypertension]], [[diabetes mellitus]], [[autoimmune hepatitis]], [[liver transplant]] who presented to the [[Emergency Department]] for symptoms of worsening [[dyspnea]] on exertion progressing to shortness of breath at rest and [[pleuritic chest pain]] over the course of three months. Review of systems was otherwise negative.
A 77-year-old woman with past medical history of [[hypertension]], [[diabetes mellitus]], [[autoimmune hepatitis]], [[liver transplant]] who presented to the [[Emergency Department]] for symptoms of worsening [[dyspnea]] on exertion progressing to shortness of breath at rest and [[pleuritic chest pain]] over the course of three months. Review of systems was otherwise negative.
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Her home medications included [[tacrolimus]], [[mycophenolate]], [[amlodipine]], [[valsartan]], [[metoprolol]], [[atorvastatin]], [[metformin]], [[glipizide]] and [[levothyroxine]].
Her home medications included [[tacrolimus]], [[mycophenolate]], [[amlodipine]], [[valsartan]], [[metoprolol]], [[atorvastatin]], [[metformin]], [[glipizide]] and [[levothyroxine]].


===Past medical history===
===Past Medical History===


Other than what is mentioned above, her [[autoimmune hepatitis]] was complicated by liver [[cirrhosis]] for which she had an orthotopic liver transplant four years prior to this presentation. [[Hepatocellular carcinoma]] and [[mixed cholangiocarcinoma]] were found on the explant with no evidence of spread. Post-transplant course was otherwise uncomplicated on stable doses of [[immunosuppresants]], [[tacrolimus]] and [[mycophenolate]].
Other than what is mentioned above, her [[autoimmune hepatitis]] was complicated by liver [[cirrhosis]] for which she had an orthotopic liver transplant four years prior to this presentation. [[Hepatocellular carcinoma]] and [[mixed cholangiocarcinoma]] were found on the explant with no evidence of spread. Post-transplant course was otherwise uncomplicated on stable doses of [[immunosuppresants]], [[tacrolimus]] and [[mycophenolate]].
===Physical Examination===
Vitals were stable with [[blood pressure]] of 155/100 mmHg, [[heart rate]] of 87 /min, mild [[tachypnea]] and [[oxygen saturation]] of 98% on room air. No [[pallor]], [[icterus]] or [[palpable lymph nodes]]. Lung, abdominal and neurologic exam was normal. No [[pedal edema]] or [[jugular venous distension]]. Heart sounds [[S1]] and [[S2]] were normal without any [[murmurs]], added sounds, [[rubs]] or [[gallops]].
===Laboratory and Imaging Findings===





Revision as of 22:19, 4 January 2013

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Case #1

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In Chief: Apranta Deka Patel, M.B.B.S, M.D.

Case #1

Case Presentation

A 77-year-old woman with past medical history of hypertension, diabetes mellitus, autoimmune hepatitis, liver transplant who presented to the Emergency Department for symptoms of worsening dyspnea on exertion progressing to shortness of breath at rest and pleuritic chest pain over the course of three months. Review of systems was otherwise negative.

Her home medications included tacrolimus, mycophenolate, amlodipine, valsartan, metoprolol, atorvastatin, metformin, glipizide and levothyroxine.

Past Medical History

Other than what is mentioned above, her autoimmune hepatitis was complicated by liver cirrhosis for which she had an orthotopic liver transplant four years prior to this presentation. Hepatocellular carcinoma and mixed cholangiocarcinoma were found on the explant with no evidence of spread. Post-transplant course was otherwise uncomplicated on stable doses of immunosuppresants, tacrolimus and mycophenolate.

Physical Examination

Vitals were stable with blood pressure of 155/100 mmHg, heart rate of 87 /min, mild tachypnea and oxygen saturation of 98% on room air. No pallor, icterus or palpable lymph nodes. Lung, abdominal and neurologic exam was normal. No pedal edema or jugular venous distension. Heart sounds S1 and S2 were normal without any murmurs, added sounds, rubs or gallops.

Laboratory and Imaging Findings

References