Causa inusual de dolor abdominal e ictericia en emergencia: reporte de caso : Unusual cause of abdominal pain and jaundice in emergency: case report

Jessica Milagros Calcino-Cuela; Ricardo Jonathan  Ayala-García; Loyda Jocabed  Miranda-Chávez

doi:10.25176/RFMH.v24i4.6531

Authors

Jessica Milagros Calcino-Cuela Servicio de Emergencia Hospital Edgardo Rebagliati Martins
Ricardo Jonathan Ayala-García Edgardo Rebagliati Martins Hospital, Emergency Service
Loyda Jocabed Miranda-Chávez Edgardo Rebagliati Martins Hospital, Emergency Service

DOI:

https://doi.org/10.25176/RFMH.v24i4.6531

Keywords:

bdominal pain, jaundice, spherocytosis , spherocytosis, hereditary, dengue

Abstract

We analyzed a young man with a history of jaundice since childhood and cholelithiasis, who presented with abdominal pain, jaundice and splenomegaly. Initially, a diagnosis of dengue was considered, given the prevalence of this disease in the patient's geographic region. However, additional testing identified hereditary spherocytosis, a genetic hemolytic disorder. The importance of considering alternative diagnoses in the face of common symptoms in emergencies is emphasized. Initial dengue-oriented management was followed by targeted treatment for hereditary spherocytosis after the diagnosis was confirmed, resulting in significant improvement in the patient. This case emphasizes the need for thorough anamnesis and meticulous diagnostic evaluation to prevent diagnostic errors and inappropriate treatment, highlighting how inherited diseases can mimic infectious conditions in complex clinical scenarios.

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Author Biographies

Jessica Milagros Calcino-Cuela, Servicio de Emergencia Hospital Edgardo Rebagliati Martins

Medical Specialist in Emergency and Disaster Medicine

Ricardo Jonathan Ayala-García, Edgardo Rebagliati Martins Hospital, Emergency Service

Medical Specialist in Emergency and Disaster Medicine

Loyda Jocabed Miranda-Chávez, Edgardo Rebagliati Martins Hospital, Emergency Service

Medical Specialist in Emergency and Disaster Medicine

References

Broder JS, Oliveira J. E Silva L, Bellolio F, Freiermuth CE, Griffey RT, Hooker E, et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department 2 ( GRACE‐2 ): Low‐risk, recurrent abdominal pain in the emergency department. Acad Emerg Med 2022;29:526–60. https://doi.org/10.1111/acem.14495.

Ayala-García R, Rodríguez-Malaver C. Visitas al servicio de emergencia, características de los pacientes atendidos. Interciencia Médica 2023;13:26–32. https://doi.org/10.56838/icmed.v13i4.178.

Brenner DM, Brandt LJ, Fenster M, Hamilton MJ, Kamboj AK, Oxentenko AS, et al. Rare, Overlooked, or Underappreciated Causes of Recurrent Abdominal Pain: A Primer for Gastroenterologists. Clin Gastroenterol Hepatol 2023;21:264–79. https://doi.org/10.1016/j.cgh.2022.09.022.

Wu Y, Liao L, Lin F. The diagnostic protocol for hereditary spherocytosis‐2021 update. J Clin Lab Anal 2021;35:e24034. https://doi.org/10.1002/jcla.24034.

Christensen RD, Yaish HM, Gallagher PG. A Pediatrician’s Practical Guide to Diagnosing and Treating Hereditary Spherocytosis in Neonates. Pediatrics 2015;135:1107–14. https://doi.org/10.1542/peds.2014-3516.

Güngör A, Yaralı N, Fettah A, Ok-Bozkaya İ, Özbek N, Kara A. Hereditary spherocytosis: Retrospective evaluation of 65 children. Turk J Pediatr 2018;60:264–9. https://doi.org/10.24953/turkjped.2018.03.005.

Bolton‐Maggs PHB, Langer JC, Iolascon A, Tittensor P, King M. Guidelines for the diagnosis and management of hereditary spherocytosis – 2011 update. Br J Haematol 2012;156:37–49. https://doi.org/10.1111/j.1365-2141.2011.08921.x.

Liao L, Xu Y, Wei H, Qiu Y, Chen W, Huang J, et al. Blood cell parameters for screening and diagnosis of hereditary spherocytosis. J Clin Lab Anal 2019;33:e22844. https://doi.org/10.1002/jcla.22844.

Ciepiela O. Old and new insights into the diagnosis of hereditary spherocytosis. Ann Transl Med 2018;6:339–339. https://doi.org/10.21037/atm.2018.07.35.

Current Year Data (2024). Centers for Disease Control and Prevention; 2024.

Tayal A, Kabra SK, Lodha R. Management of Dengue: An Updated Review. Indian J Pediatr 2023;90:168–77. https://doi.org/10.1007/s12098-022-04394-8.

Tejo AM, Hamasaki DT, Menezes LM, Ho Y-L. Severe dengue in the intensive care unit. J Intensive Med 2024;4:16–33. https://doi.org/10.1016/j.jointm.2023.07.007.

Wilson Salazar E. Dengue: hallazgos hematologicos y de imagen. Rev Medica Sinerg 2018;3:8–12. https://doi.org/10.31434/rms.v3i12.160.

Kularatne SA, Dalugama C. Dengue infection: Global importance, immunopathology and management. Clin Med 2022;22:9–13. https://doi.org/10.7861/clinmed.2021-0791.

Tejo AM, Hamasaki DT, Menezes LM, Ho Y-L. Severe dengue in the intensive care unit. J Intensive Med 2024;4:16–33. https://doi.org/10.1016/j.jointm.2023.07.007.

Rubio-Tapia, A., Hujoel, I. A., Smyrk, T. C., & Poterucha, J. J. (2017). Sífilis secundaria emergente que se presenta como hepatitis sifilítica. Hepatología (Baltimore, Maryland), 65(6), 2113–2115. https://doi.org/10.1002/hep.28974

Tolia, S., Kassem, H., & Capatina-Rata, A. (2017). El gran impostor: La transaminitis enmascara la coinfección de sífilis y el Virus de la Inmunodeficiencia Humana. Informes de casos en medicina, 2017, 1–5. https://doi.org/10.1155/2017/2481961.

Huang, J., Lin, S., Wan, B., & Zhu, Y. (2018). Una revisión sistemática de la literatura sobre la hepatitis sifilítica en adultos. Revista de Hepatología Clínica y Traslacional, 6(3), 1–4. https://doi.org/10.14218/jcth.2018.00003.

Huang, J., Lin, S., Wang, M., Wan, B., & Zhu, Y. (2019). Hepatitis sifilítica: reporte de un caso y revisión de la literatura. BMC Gastroenterología, 19(1). https://doi.org/10.1186/s12876-019-1112-z.

Lam J and Sze Bing Christopher Sim. Left hypochondrium pain in a dengue in a patient with hereditary spherocytosis, 2019. https://api.semanticscholar.org/Corpus ID:216616279.

Tateno Y, Suzuki R, Kitamura Y. Previously undiagnosed hereditary spherocytosis in a patient with jaundice and pyelonephritis: a case report. J Med Case Reports 2016;10:337. https://doi.org/10.1186/s13256-016-1144-8.