Browsing by Author "Quintana Ospina, Jhon Herney"
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Item Autoimmune Hemolytic Anemia Caused by Cold Agglutinin Antibodies in Systemic Lupus erythematosus—a Rare Association: Case Report(Dove Medical Press Ltd, 2023-09-04) Osorio Toro, Luis Miguel; Quintana Ospina, Jhon Herney; Melo Burbano, Luis Álvaro; Ruiz Jiménez, Paola Andrea; Daza Arana, Jorge Enrique; Rivas Tafurt, Giovanna Patricia; Izquierdo Loaiza, Jorge HernánAutoimmune hemolytic anemias (AIHAs) are rare and heterogeneous disorders characterized by the destruction of redblood cells by warm or cold antibodies. Hemolytic anemia associated with warm antibodies is the most common, whereas coldantibodies are rare and infrequent in cases published in the scientific literature. Herein, we present the case of a young patient withsystemic lupus erythematosus (SLE) and autoimmune hemolytic anemia caused by cold antibodies. Initially, infectious etiology andhematological malignancy were considered, which were ruled out. She required management in the intensive care unit due to severehematological involvement and responded well to immunomodulatory therapy. This case illustrates the importance of a strong clinicalsuspicion of AIHA due to cold agglutinins associated with SLE when faced with similar clinical symptoms in order to achieve a timelydiagnosis and provide optimal therapy.Item Late-onset Sheehan’s syndrome: a major diagnostic challenge—a case report(BioMed Central Ltd, 2025-02-26) Osorio Toro, Luis Miguel; Ordoñez Guzman, Yessica Alejandra; Montenegro Palacios, Jhon Fernando; Quintana Ospina, Jhon Herney; Pacichana Abadia, Julian Andres; Daza Arana, Jorge Enrique; Escobar Vargas, Hector Fabio; Restrepo Erazo, Katherine; García Ramos, Andrés FelipeBackground Sheehan’s syndrome is a form of maternal hypopituitarism resulting from excessive blood loss during or after childbirth. This extensive bleeding may reduce blood flow to the pituitary gland, causing pituitary cell damage and death (necrosis). The incidence of Sheehan’s syndrome has decreased in developed countries, whereas in developing countries, it remains a substantial cause of morbidity and mortality among at-risk populations. Case presentation We describe the case of a 59-year-old patient of mestizo ethnicity, with an unusual presentation of Sheehan’s syndrome 38 years after postpartum hemorrhage that affected hormone secretion at the adenohypophysis. During hospitalization, central adrenal insufficiency, low free thyroxine levels, decreased pituitary gland size, hypogonadotropic hypogonadism, and growth hormone deficiency were noted. The patient was treated with hydrocortisone and levothyroxine, with satisfactory clinical progress and improvement in her quality of life.Item Oxaliplatin-Associated Takotsubo Cardiomyopathy in a Patient with Metastatic Gastric Cancer: A Case Report(2023-08-14) Osorio Toro, Luis Miguel; Bonilla Bonilla, Diana Marcela; Escobar Dávila, Santiago Leandro; Quintana Ospina, Jhon Herney; Melo Burbano, Luis Alvaro; Benitez Escobar, Edith Norela; Galindes Casanova, Duván Arley; Daza Arana, Jorge Enrique; Rivas Tafurt, Giovanna PatriciaWe present the case of a 64-year-old female with stage IV gastric adenocarcinoma, pulmonary, and abdominal wall metastases, and no history of cardiovascular disease. In palliative care, she received systemic cytotoxic treatment with fluorouracil, leucovorin, oxaliplatin, and docetaxel protocol, which was well tolerated over five cycles. During cycle 6, she presented with cardiovascular symptoms with hemodynamic consequences while receiving oxaliplatin injection without docetaxel or 5-fluorouracil. She was transferred to the emergency department and then to the intensive care unit. She developed no complications during the hospital stay and was discharged after 10 days with preserved systolic function and no structural changes at the myocardial level. The electrocardiogram, echocardiogram, cardiac catheterization, and magnetic resonance imaging findings indicated an oxaliplatin-associated Takotsubo syndrome. The immunochemistry analysis showed PD-L1 expression level TPS: 40% and the foundation one genomic profiling revealed high mutation load, microsatellite instability, and HER2 not found. The patient is currently asymptomatic and on pembrolizumab monotherapy with good tolerance and partial treatment response.