Journal of Clinical Case Reports

A 22-year-old female with no previous morbidities presented with acute onset neurological symptoms in the form of hemi sensory phenomenon. On evaluation she had fever and routine COVID-19 RT-PCR testing turned out to be positive. During the course of hospital stay she developed classical features of acquired TTP. Her ADAMTS 13 level was 36% of normal activity suggestive of direct viral mediated thrombotic microangiopathy. High vWF levels and low ADAMTS 13 activity is reported in COVID-19 Infection. In rare cases like ours this can mimic classical TTP.

This case report depicts about an uncommon presentation of a commonly used drug. Ondansetron a commonly used antiemetic for various reasons and indications is implicated this. This is of importance because to the best of our knowledge this is the first case of nephritis reported with ondansetron. This clinical scenario is of immense clinical importance because this is one of the commonly used drugs and such rare adverse events should be kept in mind for early identification and prompt management of patient.

We report the case of a seven year old male child who presented with regression of cognitive function and loss of speech over a 12 month period. Physical neurological examination was normal with no KF ring. Differential diagnoses considered were Wilson’s disease, autoimmune encephalitis and SSPE. CSF analysis was normal. EEG was non-contributory. Serum ceruloplasmin was within normal limits. Serum autoimmune panel had tested positive for CASPR2. Child was treated with pulse methylprednisolone followed by oral steroids. Child‘s cognitive function and speech have improved to a great extent.

Peripheral intravenous cannulation is a routine simple procedure. However, it is associated with complications if not done properly. Ultrasonography is one of the imaging modality to asses and confirm the broken fragment of IV cannula in setting of developing country.