Department of Endocrinology, Diabetes, Metabolic Diseases and Nutrition, Mohammed VI University Hospital, Marrakech, Morocco.
Case Study
World Journal of Advanced Research and Reviews, 2023, 18(02), 564-566
Article DOI: 10.30574/wjarr.2023.18.2.0685
Received on 08 March 2023; revised on 09 May 2023; accepted on 11 May 2023
Stroke disease can result from traditional cardiovascular risk factors and by cancer, especially adrenocortical corticosteroids by hypercoagulability and megaloblastic anemia would be possibly though hyperhomocysteinemia. We report the case of a patient aged 65 years, without significant pathological , diagnosed with a left adrenocortical retained in front of a mass at the level of the left adrenal compartment, irregular shape, fairly well limited, isodense to spontaneous contrast (33UH), enhanced by the PDC in a heterogeneous way delimiting areas of necrosis measuring 9cm, with an absolute Wash out of 25% and relative to 11%. Associated with an attack of the general condition evolving rapidly gradually is a weight loss of 16 kilogram over 2 months. With the biological Assessment a cortisol cycle broken with cortisolemia from midnight to 12, braking at 1.7 and CLU at 4 times normal. The patient presented during hospitalization megaloblastic anemia and thrombocytopenia with vitamin B12 deficiency confirmed by myelogram and anti-intrinsic positive antibody treated with courses of hydroxocobalamin in intramuscular, after 4 days the patient presented upon waking left hemiplegia, left facial paralysis with dysarthria on Cerebral CT scan showed ischemic stroke of the right middle cerebral artery. The patient was put on anticoagulant therapy. The evolution was marked in a context of improvement of anemia and thrombocytopenia and the resumption of motor skills of the left hemibody. The patient is put out before the criterion of non-operability to predict a tumor excision after a good medical preparation for surgery. There is a relationship between Biermer anemia and neoplastic pathologies in stroke disease.
Adrenocortical corticosteroids; Megaloblastic anemia; Ischemic stroke; Homocysteinemia; Hydroxocobalamin
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Hassan Aden Neima, H Boualam, S RAFI, G El MGHARI and N El ANSARI. Adrenocortical corticosteroids and megaloblastic anemia responsible ischemic stroke: A case report. World Journal of Advanced Research and Reviews, 2023, 18(2), 564-566. Article DOI: https://doi.org/10.30574/wjarr.2023.18.2.0685