Browsing by Author "George, Kiran"

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    Hypodipsic-hypernatremia syndrome in an adult with polycythemia : a case report
    (BMC (part of Springer Nature), 2018-12-27) Chothia, Mogamat-Yazied; George, Kiran; Sheik, Muhammed; Davids, Mogamat Razeen
    Background: Hypernatremia is a very common electrolyte disorder and is frequently encountered in out-patient as well as in-hospital settings. We describe an adult who was found to have unexplained relative polycythemia and episodic hypernatremia. A diagnosis of idiopathic hypodipsic-hypernatremia syndrome was made and the patient was managed with a water-drinking schedule. Case presentation: A 24-year-old South African-Indian man was found to have polycythemia in association with episodes of hypernatremia. Investigations indicated that he had relative polycythemia. He experienced no thirst at a time when his serum sodium concentration was found to be 151 mmol/L. Further testing indicated that his renal response to arginine vasopressin was intact and magnetic resonance imaging of his brain revealed no hypothalamic lesions. A diagnosis of idiopathic hypodipsic-hypernatremia syndrome was made and he was managed with a water-drinking schedule that corrected his hypernatremia. Conclusion: Hypodipsia should always be considered when a patient without physical or cognitive disability presents with unexplained episodic hypernatremia or with relative polycythemia.
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    A massive pericardial effusion in South Africa is not always due to tuberculosis
    (South African Heart Association, 2020) Ntshalintshali, Sipho; Mhlana, Nontembiso; Moosajee, Farzana; Abousriwiel, Riyad; George, Kiran; Du Toit, Riette
    South Africa (SA) has a high incidence of tuberculosis. Medical conditions mimicking tuberculosis often result in erroneous treatment with antitubercular therapy (ATT) before a definitive diagnosis is made. We report on 2 cases presenting with massive pericardial effusions secondary to Still’s disease (sJIA) and Adult onset Still’s disease (AOSD). Both cases were treated with ATT, with an alternative diagnosis only considered upon poor response to therapy and the development of ATT associated side effects. Our objective is to remind clinicians of other potential differential diagnoses in the clinical scenario of massive effusive pericarditis in a tuberculosis endemic region.