A diagnostic challenge in a young woman with intractable hiccups and vomiting: a case of neuromyelitis optica
Intractable nausea and vomiting along with hiccups is a commonly encountered problem on any general medicine or gastroenterology service. These symptoms are usually not appreciated as the possible initial manifestation of neuromyelitis optica (NMO). Missing diagnosis at this early stage will lead to...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Greater Baltimore Medical Center
2015-10-01
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| Series: | Journal of Community Hospital Internal Medicine Perspectives |
| Subjects: | |
| Online Access: | http://www.jchimp.net/index.php/jchimp/article/view/28850/pdf_94 |
| _version_ | 1797966760057503744 |
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| author | Rohan Mandaliya Margot Boigon David G. Smith Suchit Bhutani Naveed Ali Cheryl Hilton John Kelly Nataliya Ternopolska |
| author_facet | Rohan Mandaliya Margot Boigon David G. Smith Suchit Bhutani Naveed Ali Cheryl Hilton John Kelly Nataliya Ternopolska |
| author_sort | Rohan Mandaliya |
| collection | DOAJ |
| description | Intractable nausea and vomiting along with hiccups is a commonly encountered problem on any general medicine or gastroenterology service. These symptoms are usually not appreciated as the possible initial manifestation of neuromyelitis optica (NMO). Missing diagnosis at this early stage will lead to a delay in the treatment, and hence, irreversible complications including blindness and paraplegia could occur. We report a case of a 22-year-old young female who presented with intractable hiccups and vomiting. After extensive evaluation, she was found to have NMO which involved the area postrema, the vomiting center of the brain. Early diagnosis from the clinical picture aided by aquaporin-4 serologic testing is extremely important to allow early initiation of immunosuppressive therapy. Immunosuppression gives an opportunity to modify the disease at an earlier stage rather than waiting for evolution of disease to fulfill the diagnostic criteria of NMO. |
| first_indexed | 2024-04-11T02:19:20Z |
| format | Article |
| id | doaj.art-5f71deeacff744d898bf84368c1372e3 |
| institution | Directory Open Access Journal |
| issn | 2000-9666 |
| language | English |
| last_indexed | 2024-04-11T02:19:20Z |
| publishDate | 2015-10-01 |
| publisher | Greater Baltimore Medical Center |
| record_format | Article |
| series | Journal of Community Hospital Internal Medicine Perspectives |
| spelling | doaj.art-5f71deeacff744d898bf84368c1372e32023-01-03T00:12:21ZengGreater Baltimore Medical CenterJournal of Community Hospital Internal Medicine Perspectives2000-96662015-10-01501510.3402/jchimp.v5.2885028850A diagnostic challenge in a young woman with intractable hiccups and vomiting: a case of neuromyelitis opticaRohan Mandaliya0Margot Boigon1David G. Smith2Suchit Bhutani3Naveed Ali4Cheryl Hilton5John Kelly6Nataliya Ternopolska7 Division of Internal Medicine, Department of Medicine, Abington Memorial Hospital, Abington, PA, USA Division of Internal Medicine, Department of Medicine, Abington Memorial Hospital, Abington, PA, USA Division of Internal Medicine, Department of Medicine, Abington Memorial Hospital, Abington, PA, USA Division of Internal Medicine, Department of Medicine, Abington Memorial Hospital, Abington, PA, USA Division of Internal Medicine, Department of Medicine, Abington Memorial Hospital, Abington, PA, USA Division of Internal Medicine, Department of Medicine, Abington Memorial Hospital, Abington, PA, USA Division of Infectious disease, Department of Medicine, Abington Memorial Hospital, Abington, PA, USA Division of Neurology, Department of Medicine, Abington Memorial Hospital, Abington, PA, USAIntractable nausea and vomiting along with hiccups is a commonly encountered problem on any general medicine or gastroenterology service. These symptoms are usually not appreciated as the possible initial manifestation of neuromyelitis optica (NMO). Missing diagnosis at this early stage will lead to a delay in the treatment, and hence, irreversible complications including blindness and paraplegia could occur. We report a case of a 22-year-old young female who presented with intractable hiccups and vomiting. After extensive evaluation, she was found to have NMO which involved the area postrema, the vomiting center of the brain. Early diagnosis from the clinical picture aided by aquaporin-4 serologic testing is extremely important to allow early initiation of immunosuppressive therapy. Immunosuppression gives an opportunity to modify the disease at an earlier stage rather than waiting for evolution of disease to fulfill the diagnostic criteria of NMO.http://www.jchimp.net/index.php/jchimp/article/view/28850/pdf_94hiccupsvomitingneuromyelitis opticaaquaporin-4 antibodyarea postrema |
| spellingShingle | Rohan Mandaliya Margot Boigon David G. Smith Suchit Bhutani Naveed Ali Cheryl Hilton John Kelly Nataliya Ternopolska A diagnostic challenge in a young woman with intractable hiccups and vomiting: a case of neuromyelitis optica Journal of Community Hospital Internal Medicine Perspectives hiccups vomiting neuromyelitis optica aquaporin-4 antibody area postrema |
| title | A diagnostic challenge in a young woman with intractable hiccups and vomiting: a case of neuromyelitis optica |
| title_full | A diagnostic challenge in a young woman with intractable hiccups and vomiting: a case of neuromyelitis optica |
| title_fullStr | A diagnostic challenge in a young woman with intractable hiccups and vomiting: a case of neuromyelitis optica |
| title_full_unstemmed | A diagnostic challenge in a young woman with intractable hiccups and vomiting: a case of neuromyelitis optica |
| title_short | A diagnostic challenge in a young woman with intractable hiccups and vomiting: a case of neuromyelitis optica |
| title_sort | diagnostic challenge in a young woman with intractable hiccups and vomiting a case of neuromyelitis optica |
| topic | hiccups vomiting neuromyelitis optica aquaporin-4 antibody area postrema |
| url | http://www.jchimp.net/index.php/jchimp/article/view/28850/pdf_94 |
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