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Case report: Therapeutic approach to secondary polycythemia vera in an adult with eisenmenger syndrome Lil Alamin, Rahmatan; Raharjo, Fajar; Gunawan, Michelle; Wardhani, Shinta
Deka in Medicine Vol. 1 No. 3 (2024): December 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2024.e433

Abstract

BACKGROUND: Secondary Polycythemia Vera due to Eisenmenger Syndrome remains a big challenge, and the reported cases regarding this condition are still scanty. CASE: This was a case of a 22-year-old girl who, since childhood, had complaints of fatigue most of the time and thus showed more intolerance to heavy physical work. She had a history of a congenital heart defect, with lip and finger cyanosis that increased upon fatigue, and she had undergone Bi-directional Cavo-pulmonary Shunt. Physical examination showed cyanosis with clubbing of fingers with low oxygen saturation. Further diagnosis testing revealed this was a case of Eisenmenger Syndrome due to congenital heart abnormalities, with Polycythemia Vera: Secondary to the diagnosis. The patient also had a hemoglobin level of 21.1g/dL and a hematocrit level of 64.2%. Based on the diagnosis, treatment was given in the form of hydration therapy along with medications. Additionally, phlebotomy was performed. Because the patient improved clinically from the applied treatment, the patient was discharged after 5 days. CONCLUSION: Early diagnosis, a multidisciplinary approach, and proper interventions are important in the management of Eisenmenger Syndrome and associated Polycythemia Vera to avoid complications and hence improve outcomes.
The Outcome of Primary Hyperaldosteronism in Resistant Hypertension with Efficiency Cost in Clinical Practices A Case Report Raharjo, Fajar Maulana; Lil Alamin, Rahmatan; Gunawan, Michelle; Nur Samsu
Clinical and Research Journal in Internal Medicine Vol. 6 No. 1 (2025): Volume 6 No 1, May 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.01.13

Abstract

Aldosterone as a major mineralocorticoid has an important role in regulating circulating volume and potassium homeostasis, especially in the kidney. Manifestation of hypertension and hypokalemia in the young age population must be considered about the role of Aldosterone. This case report will discuss a patient with uncontrolled hypertension with severe hypokalemia who was treated with 3 kinds of antihypertensive drugs but the blood pressure is still high. After performing several diagnostic tests, the Aldosterone level was significantly high and left an adrenal tumor from an abdominal MRI. The patient treated with mineralocorticoid receptor antagonists or Spironolactone 25mg daily and show controlled blood pressure.