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Tag: Weird medicine

  • Man’s Switch to Keto Diet Triggers Bizarre, Rare Rash

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    A 20-year-old man’s switch to the keto diet dramatically changed his body—just not in the way anyone would have expected.

    Doctors writing in this week’s New England Journal of Medicine detailed how the man developed a rare skin condition often caused by switching to keto, one that covered his neck and chest in itchy rashes. Despite the alarming symptoms, the condition is readily treatable, provided the person can be convinced to stop their diet.

    Keto rash

    This latest case was presented as a part of a regular segment in the NEJM detailing unusual or noteworthy medical images.

    According to the report, the otherwise healthy man visited a dermatology clinic four weeks after developing a peculiar rash. He told doctors that two months earlier, he had started a keto diet for weight loss.

    The skin condition is formally called prurigo pigmentosa, though it’s better known by its nickname, “keto rash.”

    Scientists aren’t really sure why the condition occurs, but it’s strongly linked to someone entering ketosis, a metabolic state in which the body breaks down stored fat as its primary source of energy instead of glucose. Keto diets induce ketosis by heavily limiting carbohydrate-rich foods, though other health conditions can trigger it as well.

    The rash develops across several phases. It usually begins as small, itchy red or purple bumps along the neck, chest, and back. These bumps then enlarge and form a distinctive net-like (reticular) pattern on the skin; they can sometimes fill with fluid and crust over, similar to blisters. The bumps may become less itchy and fade over time but can recur repeatedly, eventually leaving behind persistent darkened (hyperpigmented) spots.

    Rare and resolvable

    All this said, keto rash remains an incredibly rare complication of ketosis.

    According to a 2019 paper, only around 300 cases had been documented worldwide at the time, including just 20 cases in the U.S. The condition has been most commonly reported among women of East Asian ancestry, particularly in Japan, but not exclusively, as with this latest report.

    Rare as the rash is, its incidence could be rising with the increased popularity of keto diets. And because it’s seldom seen, doctors may mistake the rash for more common skin conditions like eczema. Once identified, however, it can be easily treated.

    The rash eventually goes away once a person leaves ketosis, though it might take a few weeks to clear. For most cases, that means ending the keto diet (cases not linked to a keto diet tend to go away on their own). Tetracycline antibiotics are commonly used to manage its symptoms, since they have anti-inflammatory effects. As for our protagonist, the report authors didn’t detail whether the man took their advice and ditched the keto diet.

    Strange rashes aren’t the only weird side effect of trendy diets. Last January, doctors described how a man’s high-fat “carnivore” diet full of cheese, butter, and meat caused his hands to literally seep out cholesterol.

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    Ed Cara

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  • Boy Swallows 100 Magnets Bought From Temu, Hospital Trip Ensues

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    It’s a macabre medical tale updated for our modern day. In a case report out today, doctors describe how a young boy in New Zealand was hospitalized and required surgery after he ingested dozens of small magnets—magnets allegedly bought off the popular, China-based marketplace Temu.

    Surgeons detailed the strange events in the New Zealand Medical Journal Friday. Though the magnets caused serious damage to his intestines, the doctors did successfully remove them, and the boy was eventually discharged from the hospital.

    Magnet mishap

    According to the report, the boy was admitted into the hospital four days into having generalized abdominal pain. He told the doctors that about a week earlier, he had eaten roughly 80 to 100 high-power neodymium magnets, measuring 5 by 2 millimeters, which were purchased from Temu.

    Medical imaging soon revealed that the magnets had bunched up into four separate straight lines throughout his guts. What’s worse, these clumps had started to cause necrosis, or dead tissue, along his intestines. Doctors operated on the boy, removing both the magnets and dead intestinal tissue. After an eight-day stay in the hospital, the boy was sent home.

    Though the surgery was successful, it may have long-term consequences, the doctors noted. In similar cases of surgical magnet removal, patients have later developed complications like bowel obstructions and abdominal hernias.

    An online danger

    These sorts of small, high-powered magnets are known to be a serious health risk for children or others who ingest them. And some countries have outright banned their sale locally in recent years, including New Zealand since 2013. The authors argue this case should be seen as an important reminder that there are still ways for children to get their hands on these potentially hazardous toys.

    “This case highlights not only the dangers of magnet ingestion but also the dangers of the online marketplace for our pediatric population,” they wrote.

    In a statement sent to Gizmodo, Temu stated it is conducting an internal review and has gotten in touch with the study’s authors. For now, though, the company isn’t quite ready to accept any blame for this specific case.

    “We are sorry to learn about the reported incident and wish the boy a full and speedy recovery,” said the Temu representative. “At this stage, we have not been able to confirm whether the magnets involved were purchased through Temu or identify the specific product listing.”

    The spokesperson added: “Nonetheless, our teams are reviewing relevant listings to ensure full compliance with local safety requirements. Any products found to be non-compliant will be removed, and we will take firm action against any sellers found to have breached our platform rules or local regulations.”

    It is worth noting that Temu isn’t the only online retailer from which these kinds of products can be easily purchased.

    Earlier this year, for instance, the U.S. Consumer Product Safety Commission issued a warning to consumers about buying small magnetic balls from the company Shenzhen Xiaoju Technology that were exclusively sold through Amazon. An investigation last year from UK consumer advocacy organization Which? (yes, that’s the name of the organization) last December also found that online retailers like eBay are still selling small magnet toys otherwise illegal in the country.

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    Ed Cara

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  • Woman’s Bruising From a Massage Gun Was a Sign of Something Far Worse: Scurvy

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    A 37-year-old woman’s bruising from a massage gun ended up having a cause stranger than anyone could have expected. In a recent report, doctors documented how the woman had developed the rare condition scurvy.

    Doctors at the University of Pennsylvania detailed the bizarre turn of events in a paper published last month in the New England Journal of Medicine as part of a regular segment highlighting medically complex cases. The woman’s bruising was the only first sign of worsening health issues that eventually landed her in the hospital. Fortunately, after several false leads, her clinicians correctly diagnosed the woman’s vitamin C deficiency, and she made a full recovery.

    The wrong culprit

    According to the report, the woman visited the emergency room four days into having acute pain, swelling, and bruising on the upper portion of her left knee—symptoms that began after she used an electric massage gun on that area. She carried a genetic mutation that increased her general risk of blood clotting, which was managed with a blood thinner, and also had a long history of heavy menstrual bleeding. Anyone can potentially bruise or hurt themselves by applying too much pressure with a massage gun, though, and since initial tests didn’t find any other underlying reason for her symptoms, she was discharged and simply told to stop using the gun.

    Several weeks later, however, she visited the ER again, now with new symptoms of lightheadedness and shortness of breath while exerting herself. She was then admitted to the hospital. The doctors suspected she had anemia caused by a lack of iron, and she was discharged with a prescription for iron pills and weekly IV infusions of iron.

    Despite her treatment, her anemia and overall health continued to worsen, however. She visited the ER once more six weeks after her hospitalization with new chest pain, night sweats, and a sudden weight loss of 15 pounds. She now also had a high heart rate and low blood oxygen level, and soon enough, she was admitted to the intensive care unit.

    Doctors determined she had developed pulmonary hypertension, a life-threatening type of high blood pressure that affects the arteries in the lungs and right side of the heart. But all of their tests continued to show no clear indication of what was causing her illness in the first place.

    Throughout all of this, her left leg continued to show bruising and swelling. And when doctors reexamined both legs, they found distinctive discolored spots and hairs curled up into a corkscrew shape. They also found she had developed “red-purple soft nodules” along her gums. Unlike her earlier, more general symptoms, these skin problems finally pointed to a very specific, if now rarely encountered, culprit: scurvy.

    When questioned, the woman admitted that she had purposefully avoided eating anything containing citrus fruits years ago, following an episode of hives that she attributed to eating citrus. Testing failed to detect any vitamin C in her system, and she was immediately started on supplementation.

    Just two days into her new therapy, she was discharged from the ICU and eventually the hospital as well. Her health continued to steadily improve over the next few months, and follow-up testing showed that her heart issues had cleared up.

    Rare but still around

    Thanks to the widespread knowledge that we need regular doses of vitamin C from our diets, scurvy is no longer the fearsome threat it was centuries ago.

    But even today, doctors do still occasionally see it. Some research has also suggested that the incidence of scurvy in the U.S. has climbed lately, particularly among vulnerable groups like children with sensory issues, elderly people, and others struggling to eat or afford healthy fruits and vegetables.

    This case was stranger than most, though, since pulmonary hypertension usually isn’t linked to scurvy. The authors note that the condition is often hard to diagnose at first because—as is with this case—the earliest signs tend to be non-specific symptoms potentially caused by many different things. So as rare as it is, the doctors hope their report can provide doctors a timely lesson that scurvy is still around.

    “The current case serves as a reminder that scurvy continues to occur in the United States and highlights its potential severity and clinical features,” they wrote.

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    Ed Cara

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  • A 36-Year-Old Woman Developed an Insatiable Craving for Bleach. Scientists Now Know Why

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    We all have our unusual food preferences, but it’s unlikely any are quite as weird as the craving experienced by a 36-year-old woman featured in a recent case report. Her doctors described how the woman developed a sudden hunger for bleach—a craving likely triggered by an autoimmune disorder.

    Doctors in Michigan detailed the strange tale in a paper published last month in the journal Case Reports in Psychiatry. The woman had developed a severe bout of anemia caused by vitamin B12 deficiency, not long after she began to enjoy smelling and eventually tasting bleach powder. Though she was treated successfully for her anemia and deficiency, it’s unknown whether her bleach craving disappeared for good.

    Mouthing bleach

    According to the case report, the woman visited a local emergency room with symptoms of severe anemia, including shortness of breath, fatigue, and pain along her lower left side. Initial tests found that she had macrocytic anemia (anemia characterized by overly large red blood cells) caused by a chronic lack of vitamin B12. The woman was soon given a blood transfusion and admitted into the intensive care unit for further treatment and evaluation.

    The woman had a history of past psychological disorders, including depression and anxiety, though she had been managing well with medications. But given this history and her severe anemia, the doctors were concerned that she may have also developed pica, or the compulsive urge to eat inedible things. Pica is a complex and poorly understood condition, often linked to psychological issues as well as anemia and nutritional deficiencies.

    The woman received a psychological consultation, in which she revealed her bleach habit. She initially only enjoyed the smell and texture of bleach powder but later started to taste it. For more than a month, two to three times a day, she licked her finger, dipped it in the powder, and placed her finger on her tongue. She claimed to have never fully ingested the bleach and instead swished it around her mouth before spitting it out and rinsing her mouth out with water. She also reported that while she had no problem with her craving, her “family had expressed significant concern” and tried to get her to stop.

    Later tests showed that the woman carried harmful antibodies to a protein known as intrinsic factor, which is needed for our bodies to absorb vitamin B12 from food. In other words, the woman’s vitamin B12 deficiency and subsequent anemia—and likely her pica as well—were caused by an autoimmune disorder.

    This explanation only makes the woman’s ailment all the more unusual, however. For starters, bleach is already a rare, though not unheard of, craving seen with pica (more common cravings are dirt, chalk, or hair). Vitamin B12 deficiency is known to cause several psychological symptoms, but as far as the authors know, this is the first reported case of bleach craving linked to vitamin B12 deficiency. The case is also notable because the woman didn’t have an iron deficiency, a more common trigger for pica.

    An uncertain fate

    The woman was soon moved from the ICU to the general hospital unit and recovered significantly over the next three days. She was told to take regular vitamin B12 supplements and a medication for her gastritis. But she never followed up with doctors, so whether she continued treatment—or what her current health looks like—remains a mystery.

    Still, the doctors say, the saga does provide a timely lesson about the importance of seeking psychiatric consultations for medically complex cases like this one.

    “We suggest that nuanced presentations of pica warrant thorough psychiatric evaluation in critically anemic patients, especially since the pica can involve toxic substances like bleach,” they wrote.

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    Ed Cara

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  • What Seemed Like a Pregnancy Was Actually Something Far More Dangerous

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    A woman’s supposed pregnancy turned out to be something much stranger. In a recent report from her doctors, they detail how the woman had developed an incredibly rare form of ovarian cancer that mimicked the symptoms of pregnancy, even causing a positive pregnancy test.

    Doctors in India described the case of mistaken identity earlier this July in the journal Oncoscience. After first suspecting the woman had an ectopic pregnancy, the doctors instead discovered a large and rare type of tumor in her right ovary. Thankfully, the cancer was removed before it spread elsewhere, and the woman seems to have responded well to treatment.

    A pregnancy that wasn’t

    According to the report, the 36-year-old woman visited doctors three months into having intermittent bouts of heavy menstrual bleeding. She tested positive for a pregnancy on a urine test, and when doctors performed a physical examination, they felt a solid mass along her abdomen consistent with having a 20-week-old fetus. An initial ultrasound appeared to show that the woman was experiencing an ectopic pregnancy, a condition where the embryo forms outside of the uterus, usually in the fallopian tube (ectopic pregnancies are inherently non-viable). After conducting more extensive imaging, they found that she actually had cancer in her right ovary, most likely a choriocarcinoma.

    Choriocarcinomas are tumors mainly formed from the cells that become the placenta during a pregnancy. It’s an especially dangerous cancer since the tumors tend to grow quickly and spread to other parts of the body. The woman’s doctors soon performed surgery to assess the progression of her cancer and to treat it if possible.

    They successfully removed the tumor, along with the woman’s uterus, ovaries, and surrounding lymph nodes. Though relatively large, the tumor was still in an early stage of development and hadn’t metastasized. When the doctors looked closer, though, they found her cancer was even weirder than first thought.

    ‘Exceedingly rare’

    Choriocarcinomas are usually gestational, meaning they’re linked to pregnancy; oftentimes, the tumor will even arise from an abnormal and non-viable pregnancy. But the woman’s cancer was a non-gestational ovarian choriocarcinoma (NGOC), which only accounts for 0.6% of all reported ovarian germ cell tumors (a germ cell being the actual egg). What’s more, the cancer was a pure NGOC, an “exceedingly rare” subtype made completely out of germ cells and not any other kinds of tissues.

    An image of the woman’s tumor, as well as her uterus and a benign ovarian cyst, can be seen here, but be warned, it’s not for the faint of heart.

    While these cancers aren’t tied to pregnancy, they do cause the body to produce high levels of the hormone human chorionic gonadotropin (hCG). Women also produce high levels of hCG during pregnancy, and some tests detect pregnancy through measuring hCG, explaining the woman’s positive result.

    “NGOC is a rare, distinct, and highly aggressive tumor that predominantly affects young, reproductive-aged women,” the authors wrote.

    Fortunately, in this case, the cancer appears to have been caught early enough in time. Following surgery, the woman was placed on chemotherapy. And her most recent tests showed that her hCG level had returned to normal, indicating a complete treatment response, according to the doctors. She will need to have regular follow-up tests, including CT imaging, to make sure the cancer isn’t staging an unwelcome comeback.

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    Ed Cara

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