Abstract
Introduction: Extrarenal angiomyolipomas are rare and tend to become clinically relevant only when hemorrhagic complications occur. case report: We report the case of an 81-year-old woman with a right extrarenal retroperitoneal mass initially misdiagnosed as acute cholecystitis. A definitive diagnosis of angiomyolipoma is typically made after histopathologic examination of the operative specimen, which was not possible in this case. However, modern imaging modalities, particularly ct scan and MrI scan, have made it possible to identify these lesions in vivo. conclusion: this case highlights that the preoperative diagnosis of extrarenal angiomyolipoma can be challenging. Awareness of their clinicopathological and radiological features is essential. 4
Highlights
Hypereosinophilic syndrome (HES) can be a multisystem disorder due to direct end-organ damage by eosinophilia, and can rarely present with life-threatening features
We present a case of multi-organ failure secondary to eosinophilia related to medications
Case report: A 66-year-old woman with a recent diagnosis of asthma on montelukast, presented with excruciating pains of sudden onset in her lower limbs, and on admission, she was found to be in multi-organ failure
Summary
Eosinophilia refers to an absolute count of eosinophils >500/ml in the peripheral blood [1]. The patient described excruciating shooting pains in all muscle groups in her right leg, to the point that on presentation she was unable to weight bear, and had to be wheeled into the department. The patient was on montelukast 10 mg once daily and lansoprazole 30 mg once daily On further questioning, she admitted to having had recurrent chest infections and asthma exacerbations over the last few months prior to her current presentation, requiring steroids and antibiotics every 2–3 weeks. On further follow-up post-montelukast cessation and steroid withdraw, patient remained well and asymptomatic, with repeated bloods with normal blood count and eosinophilic values, having not required further treatment and in particular immunosuppression, making montelukast the main differential diagnosis for the patient’s life threatening presentation
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