Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0009676 (confusion)
 21,692 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pregabalin, a molecule with similar structure of GABA neurotransmitter, initially developed as an antiepileptic, is now commonly used in the treatment of painful peripheral neuropathies. We report an 82-year-old man who presented with confusion, urinary incontinence and gait instability. He was receiving pregabalin for a left L5 radicular pain. Laboratory tests at admission revealed a profound hyponatremia (117 mmol/L) that was corrected by fluid restriction and pregabalin withdrawal. According to the patient and laboratory outcome, we established the diagnosis of inappropriate antidiuretic hormone secretion due to pregabalin. The test of Naranjo demonstrated a probable imputability of pregabalin.
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PMID:[Gait instability revealing a syndrome of inappropriate antidiuretic hormone secretion associated to pregabalin]. 2301 93

Morphea consists of various variants, including nodular morphea (NM), keloidal morphea (KM) and morphea profunda (MP). NM and KM are used synonymously. We present a 67-year-old Japanese female, the first case of limited type systemic sclerosis (SSc), developing both NM and MP. The NM and MP lesions on the lower legs were partly continuous, and showed histopathological features of morphea but not of keloid or scar. Pregabalin relieved severe lesional pain. Our literature review of all NM/KM cases indicated that some cases had merely keloid or scar, and, therefore, we first propose to abandon the term KM and use only the term NM for this condition to avoid confusion. We also propose making the diagnosis of NM only in cases showing histopathological features characteristic of SSc or morphea, which should facilitate the establishment of this entity. Our literature review also indicated that NM is closely associated with SSc, while the standard classification for morphea, which does not refer to NM/KM, probably due to ambiguity of this entity, suggests that morphea is rarely associated with SSc. Therefore, NM should be included as a distinct and unique subset in the classification of morphea when the disease entity of NM is established. Establishment of the disease entity of NM may change the general consensus of the rare association of morphea with SSc.
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PMID:Nodular morphea (NM): report of a case of concurrent NM and morphea profunda associated with limited type systemic sclerosis, and overview and definition for NM. 2340 Feb 40

Pregabalin is often used for the treatment of neuropathic pain in patients with spinal cord injury (SCI). We reported a patient with C5 [S(C5/C6)] ASIA Impairment Scale C SCI due to cervical myelopathy who presented CO2 retention when taking a therapeutic dosage of pregabalin. An 88-year-old patient with cervical SCI was transferred to the department of physical medicine and rehabilitation. When he had transferred, his neuropathic pain had been treated with 150-mg pregabalin per day (75 mg twice a day); however, he still exhibited severe neuropathic pain with a Numeric Pain Rating Scale score of 7 to 8. Dosage for the pregabalin increased from 150 mg/d (75 mg twice a day) to 225 mg/d (150 mg at morning and 75 mg at dinner). That afternoon, he presented drowsiness and confusion, and arterial blood gas analysis (ABGA) demonstrated respiratory acidosis with CO2 retention; pH, 7.312; PaCO2, 62.8 mm Hg; PaO2,58.9 mm Hg; HCO3 concentration, 30.8 mmol/L; base excess, 3.2 mmol/L; and oxygen saturation, 90.4%. Finally, he required tracheal intubation and ventilation. After 6 weeks, the patient was transferred to a general ward, and the follow-up ABGA and end-tidal CO2 showed normal range with the discontinuation of pregabalin. We demonstrated CO2 retention via ABGA in a patient with SCI due to cervical myelopathy who developed hypercapnia after taking a therapeutic dose of pregabalin. Physicians should pay particular attention to CO2 retention when prescribing a therapeutic dosage of pregabalin in a patient with cervical SCI.
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PMID:Hypercapnia Caused by a Therapeutic Dosage of Pregabalin in a Tetraplegic Patient With Cervical Spinal Cord Injury. 2832 59