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Vardesh DL, Pandey S, Chen H. An uncommon cause of hypophosphataemia. Aust J Gen Pract 2022; 51:347-349. [PMID: 35491459 DOI: 10.31128/ajgp-06-21-6033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Deepak L Vardesh
- MBBS, FRACP, Consultant Nephrologist and General Physician, Logan General Hospital, Meadowbrook, Qld; Griffith University, Gold Coast, Qld
| | - Sunil Pandey
- MD, Medical Registrar, Logan General Hospital, Meadowbrook, Qld
| | - Hayley Chen
- MD, BPharm, Medical Registrar, Logan General Hospital, Meadowbrook, Qld; University of Queensland, Brisbane, Qld
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Vardesh DL, Frazier JE, Tan KS. A spurious decline in kidney function: A reality check. Aust J Gen Pract 2020; 49:681-682. [PMID: 33015687 DOI: 10.31128/ajgp-01-20-5204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Deepak L Vardesh
- FRACP, Consultant Nephrologist, Department of Nephrology, Logan Hospital, Meadowbrook, Qld; Senior Lecturer, Griffith University, Qld
| | - Jeremy Elton Frazier
- FRACP, Consultant Nephrologist, Department of Nephrology, Logan Hospital, Meadowbrook, Qld; Senior Lecturer, Griffith University, Qld
| | - Ken-Soon Tan
- FRACP, Consultant Nephrologist, Department of Nephrology, Logan Hospital, Meadowbrook, Qld; Senior Lecturer, University of Queensland, Qld; Associate Professor, Griffith University, Qld
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Tabone R, Burstow MJ, Vardesh DL, Yuide PJ, Gundara J, Chua TC. Anti-lipid therapy and risk factor management for triglyceridaemia-induced acute pancreatitis. ANZ J Surg 2020; 90:1997-2003. [PMID: 32190973 DOI: 10.1111/ans.15829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/08/2020] [Accepted: 03/01/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Pancreatitis secondary to hypertriglyceridaemia is rare, accounting for less than 5% of pancreatitis presentations. We reviewed our institutional experience with triglyceridaemia induced acute pancreatitis to report the clinical presentation, patient demographics and clinical management. METHODS The Acute Surgical Unit database at a high-volume general surgical referral centre was queried to identify cases of acute pancreatitis secondary to hypertriglyceridaemia between 2016 and 2019. Patient demographics, clinical manifestations, biochemical derangements and treatment regimens were analysed. Current related literature was reviewed. RESULTS There were 496 presentations for acute pancreatitis of which 14 presentations (2.8%), amongst 12 patients were due to hypertriglyceridaemia. The mean triglyceride level at presentation was 92.46 (standard deviation 46.9) mmol/L. Ten patients (83%) had poorly controlled type 2 diabetes. All patients were managed using conservative therapy combined with a restricted fat diet and commenced on long-term anti-lipid therapy to manage associated risk factors. In addition, 10 patients received an insulin infusion and one patient received insulin infusion, plasmapheresis and heparin infusion in combination. The median length of hospital stay was 5.5 (range 3-13) days. Two patients (16%) developed a recurrent episode related to non-compliance to medical therapy. CONCLUSION Hypertriglyceridaemia is a rare cause of acute pancreatitis. Successful management involves the treatment of acute pancreatitis in conjunction with long-term anti-lipid therapy and optimisation of associated risk factors.
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Affiliation(s)
- Renee Tabone
- Department of Surgery, Logan Hospital, Metro South Health, Logan City, Queensland, Australia
| | - Matthew J Burstow
- Department of Surgery, Logan Hospital, Metro South Health, Logan City, Queensland, Australia.,Division of Medicine, Logan Hospital, Metro South Health, Logan City, Queensland, Australia
| | - Deepak L Vardesh
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Peter J Yuide
- Department of Surgery, Logan Hospital, Metro South Health, Logan City, Queensland, Australia.,Division of Medicine, Logan Hospital, Metro South Health, Logan City, Queensland, Australia
| | - Justin Gundara
- Department of Surgery, Logan Hospital, Metro South Health, Logan City, Queensland, Australia.,Division of Medicine, Logan Hospital, Metro South Health, Logan City, Queensland, Australia
| | - Terence C Chua
- Department of Surgery, Logan Hospital, Metro South Health, Logan City, Queensland, Australia.,Division of Medicine, Logan Hospital, Metro South Health, Logan City, Queensland, Australia
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Abstract
We report a case of severe lupus myocarditis with rapid, acute deterioration to cardiogenic shock and multiorgan failure, highlighting the importance of early identification and treatment of acute presentations in patients with systemic lupus erythematosus. A 31-year-old woman with previously diagnosed subacute cutaneous lupus erythematosus initially presented with abdominal pain and frank per-rectal bleeding. She deteriorated rapidly with type 1 respiratory failure and acute kidney injury requiring dialysis secondary to acute cardiac failure with a prolonged intensive care unit admission, over a month. A significantly elevated troponin, global hypokinesia on echocardiogram and normal coronary artery angiogram and cardiac MRI lead to the diagnosis of acute lupus myocarditis as the cause for the cardiogenic shock. She was treated with high-dose corticosteroids and eventually made a full recovery, with cardiac function returning to normal.
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Affiliation(s)
- Aaron M Hawkins
- Department of Medicine, Logan Hospital, Meadowbrook, Queensland, Australia.,School of Medicine, Griffith University, Southport, Queensland, Australia
| | | | - Deepak L Vardesh
- Department of Medicine, Logan Hospital, Meadowbrook, Queensland, Australia.,School of Medicine, Griffith University, Southport, Queensland, Australia
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Lin H, Peel NM, Scott IA, Vardesh DL, Sivalingam P, McBride RL, Morong JJ, Nelson MJ, Hubbard RE. In reply to Liu. Anaesth Intensive Care 2018; 46:343. [PMID: 29716500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- H Lin
- Centre for Research in Geriatric Medicine
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