Qatar Medical Journal - Volume 2006, Issue 1

A young male was treated for right-sided pneumonia with cloxacillin and piperacillin/tazobactam. As he was recovering from the pneumonia he developed left-sided pleuritic pain and pleural effusion. At thoracocentesis an exudative pleural effusion contained 16% eosinophils with a simultaneous 28% peripheral eosinophilia. An allergic reaction to penicllins was thought to be the cause. After withdrawal of those medications and institution of pred-nisolone a rapid resolution was seen of symptoms, signs, peripheral eosinophilia and radiological abnormalities.

In a 45-year-old female with chronic uncontrolled hy-pertension complicated by hypokalemia, laboratory and radiological findings were consistent with an aldosterone producing adenoma (APA). Diagnosis of Conn's syndrome was confirmed by histopathology. The hypokalemia re-solved and her hypertension improved after laparoscopic adrenalectomy. Discussion of the case, diagnosis and treat-ment are presented.

We report two patients with pachydermoperiostosis. Both patients presented with pain and swelling of the large joints, characteristic facial features, clubbing and enlargement of distal parts of the extremities.

Diagnostic procedures performed on patients with multiple myeloma typically reveal lytic bone lesions, osteopenia or osteoporosis, bone marrow infiltration by plasma cells as well as overproduction of immunoglobulin or light chains in the serum or urine. Skeletal manifestations are extremely variable and the unusual forms have been described extensively. Extramedullar plasma-cell tumours (plasmocytoma) are found in about 5% of newly diagnosed patients with multiple myelomas. In this paper we present eight patients with atypical forms of multiple myeloma.

Background: A consensus has emerged that angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-II receptor blockers (ARBs) have specific renoprotective effects. Guidelines specify that these are the drugs of choice for the treatment of hypertension in patients with renal disease. We sought to determine to what extent this consensus is supported by the available evidence.