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_NO TOC_
_NOTOC _
{{CMG}};{{AE}}{{Vbe}}
{{CMG}};{{AE}}{{Vbe}}
== Hyperventilation ==
{| class="wikitable"
! rowspan="3" |Organ system
! rowspan="3" |Diseases
! colspan="9" |Clinical manifestations
! colspan="5" rowspan="2" |Diagnosis
! rowspan="3" |Other features
|-
! colspan="4" |Symptoms
! colspan="5" |Physical exam
|-
!Chest pain
!Dyspnea
!Fever
!Palpitations
!Cyanosis
!Tachypnea
!JVD
!Peripheral edema
!Auscultation
!ABGs
!Lab findings
!Imaging
!PFT
!Gold standard
|-
! rowspan="8" |Pulmonary system
!Pneumothorax
!+
!+
!+
!+
!+
!+
!_
!_
!
*Decreased breath sounds
!
!
!X- ray -
*Mediastinal shift,
*Deep sulcus sign,
*Hydropneumothorax
*CT-scan- Bullae
!
! CT-scan
!
*Hypoxia,
*Hypercapnia
* Hyperesonance to percussion,
* Vocal resonance
*Tactile fremitus decreased
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!Pulmonary embolism
!+
!+
!+
!+
!+
!+
!
!
!
!
!
!
!
!
!
|-
!Pneumonia
!+
!+
!+
!+
!+
!+
!-
!-
!
*Bronchial breath sounds
* Crepitations
*Bronchophony
*Egophony
*Whispering pectoroloqy
!
!
*CBC
*Blood culture
*Mantoux test
*Serology (mycoplasma, viruses)
*Sputum: Gram stain and culture
!
*CXR- Lobar consolidation, Air bronchogram;
*Atypical pneumonia: Diffuse interstitial infiltrates
!
!
!
!
!
|-
!Exacerbation of asthma/COPD
!-
!+
!-
!+
!+
!+
!-
!-
!
*Decreased breath sounds
*Wheezing
*Coarse crackles


!
==Causes==
*Increased PaCo2
[[Hypogammaglobulinemia]] is caused by:
*Decreased PaO2
 
!
Immunodeficiency secondary to:
*CBC- Increased hematocrit from chronic hypoxia
*[[Uremia]]
*Sputum evaluation, BNP( to rule out heart failure)
*Protein losing enteropathy
!
*[[Nephrotic syndrome]]
*X- ray:
*Malnutrition
*Hyperinflated lungs
*Cirrhosis
*Flattening of the diaphragm
*Hemodialysis
*Narrow heart shadow
* Intestinal lymphangiectasia
*Cardiomegaly
 
!
* Protein-losing gastroenteropathy
*Increased TLC
*[[Nephrotic syndrome]]
*Increased RV
*[[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>
*Decreased Vital capacity
* Medications :
*Decreased DLco ( Emphysema)
** Gold
*Normal DLco ( Chronic bronchitis)
**D-Penicillamine
!
**Sulfasalazin
*HRCT ( High resolution computed tomography of the lung)
**Anticonvulsants
!
**Glucocorticoids
*Productive cough
**Methotrexate
*Exercise intolerance
**Calcineurin inhibitors
*Altered mental status
** 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>
*Cor-pulmonale
 
*Hyperresonance on percussion
* Environmental hazards:
|-
** Ionizing radiation
!Interstitial lung disease
**Toxins
!
 
!
*Infections
!
** Viral(Herpes, Measles)
!
**Bacterial(Mycobacterial)
!
**Parasitic(Malaria, helminthic infections)
!
!
!
!
!
!
!
!
!
!
|-
!Intrapulmonary shunt
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Upper airway obstruction
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!High altitude sickness
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
! rowspan="4" |Cardiovascular system
!Acute coronary syndrome
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Heart failure
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Dysrhythmias
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Shock
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
! rowspan="3" |Metabolic/Systemic disorders
!Diabetic ketoacidosis
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Hypocalcemia
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Hypoglycemia
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
! rowspan="2" |Endocrine system
!Hyperthyroidism
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Pheochromocytoma
!
!
!
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!
!
!
!
!
!
!
!
!
!
!
|-
! rowspan="2" |CNS
!Central nervous system tumor
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Anxiety/panic attacks
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
! rowspan="3" |Others
!Pregnancy
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Hepatic failure
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Sepsis
!
!
!
!
!
!
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!
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!
!
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!
!
|}

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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