Try a new search

Format these results:

Searched for:

person:vassas01

in-biosketch:true

Total Results:

19


Case Report: Analytically Confirmed Severe Albenzadole Overdose Presenting with Alopecia and Pancytopenia

Alexina Riggan, Morgan Anne; Perreault, Gabriel; Wen, Anita; Raco, Veronica; Vassallo, Susi; Gerona, Roy; Hoffman, Robert S
Internet-facilitated self-diagnosis and treatment is becoming more prevalent, putting individuals at risk of toxicity when drugs are acquired without medical oversight. We report a patient with delusional parasitosis who consumed veterinary albendazole purchased on the Internet, leading to pancytopenia, transaminase elevation, and alopecia. A 53-year-old man was sent to the emergency department (ED) by his gastroenterologist because of abnormal laboratory results. The patient had chronic abdominal pain and believed he was infected with parasites. He purchased two bottles of veterinary-grade albendazole on the Internet, and over the 3 weeks before his ED visit, he consumed 113.6 g of albendazole (a normal maximal daily dose is 800 mg). Five days before admission, he noticed hair loss and a rash on his face. His examination was notable for significant scalp hair loss and hyperpigmentation along the jaw line. Laboratory studies were remarkable for pancytopenia (most notably a WBC of 0.4 × 103 cells/mm3, with an absolute neutrophil count (ANC) of 0 × 103 cells/mm3) and transaminase elevation (AST 268 IU/L, ALT 89 IU/L). He developed a fever and was treated with antibiotics and colony-stimulating factors for presumed neutropenic bacteremia. Over the course of 1 week, his hepatic function normalized and his ANC increased to 3,000 × 103 cells/mm3. Serial albendazole and albendazole sulfoxide concentrations were measured in serum and urine by liquid chromatography-quadruple time-of-flight mass spectrometry. On day 2, his serum concentrations were 20.7 ng/mL and 4,257.7 ng/mL for albendazole and albendazole sulfoxide, respectively. A typical peak therapeutic concentration for albendazole sulfoxide occuring at 2-5 hours post-ingestion is 220-1,580 ng/mL. Known adverse effects of albendazole include alopecia, transaminase elevation, and neutropenia. Pancytopenia leading to death from septic shock is reported. In our patient, prolonged use of high-dose albendazole resulted in a significant body burden of albendazole and albendazole sulfoxide, leading to pancytopenia, transaminase elevation, and alopecia. He recovered with supportive therapy.
PMID: 31701853
ISSN: 1476-1645
CID: 4179552

Thermoregulatory principles

Chapter by: Vassallo, Susi U; Delaney, Kathleen A
in: Goldfrank's toxicologic emergencies by Nelson, Lewis; et al (Ed)
New York : McGraw-Hill Education, [2019]
pp. ?-?
ISBN: 1259859614
CID: 3698052

Athletic performance enhancers

Chapter by: Vassallo, Susi U
in: Goldfrank's toxicologic emergencies by Nelson, Lewis; et al (Ed)
New York : McGraw-Hill Education, [2019]
pp. ?-?
ISBN: 1259859614
CID: 3699832

Clinical Reasoning: A 27-year-old man with unsteady gait

Fernandez, Denise; Fara, Michael G; Biary, Rana; Hoffman, Robert S; Vassallo, Susi; Balcer, Laura; Torres, Daniel
PMID: 28871069
ISSN: 1526-632x
CID: 2687762

Analytically confirmed severe albenzadole overdose presenting with alopecia and pancytopenia [Meeting Abstract]

Riggan, Morgan; Raco, Veronica; Vassallo, Susi U; Perreault, Gabriel; Wen, Anita; Gerona, Roy; Hoffman, Robert S
ISI:000406384000116
ISSN: 1556-9519
CID: 2666912

Letter in response to: "Stimulant-induced hyperthermia and ice-water submersion: practical considerations", by John R. Richards et al., DOI -10.3109/15563650.2015.1104536 [Letter]

Laskowski, Larissa K; Landry, Adaira; Vassallo, Susi U; Hoffman, Robert S
PMID: 26574142
ISSN: 1556-9519
CID: 1848462

Ice water submersion for rapid cooling in severe drug-induced hyperthermia

Laskowski, Larissa K; Landry, Adaira; Vassallo, Susi U; Hoffman, Robert S
Abstract Context. The optimal method of cooling hyperthermic patients is controversial. Although controlled data support ice water submersion, many authorities recommend a mist and fan technique. We report two patients with drug-induced hyperthermia, to demonstrate the rapid cooling rates of ice water submersion. Case details. Case 1. A 27-year-old man presented with a sympathomimetic toxic syndrome and a core temperature of 41.4 degrees C after ingesting 4-fluoroamphetamine. He was submerged in ice water and his core temperature fell to 38 degrees C within 18 minutes (a mean cooling rate of 0.18 degrees C/min). His vital signs stabilized, his mental status improved and he left on hospital day 2. Case 2. A 32-year-old man with a sympathomimetic toxic syndrome after cocaine use was transported in a body bag and arrived with a core temperature of 44.4 degrees C. He was intubated, sedated with IV benzodiazepines, and submerged in ice water. After 20 mins his temperature fell to 38.8 degrees C (a cooling rate of 0.28 degrees C/min). He was extubated the following day, and discharged on day 10. Discussion. In these two cases, cooling rates exceeded those reported for mist and fan technique. Since the priority in hyperthermia is rapid cooling, clinical data need to be collected to reaffirm the optimal approach.
PMCID:4684641
PMID: 25695144
ISSN: 1556-3650
CID: 1474652

Thermoregulatory principles

Chapter by: Vassallo, Susi U; Delaney, Kathleen A
in: Goldfrank's toxicologic emergencies by Hoffman, Robert S; Howland, Mary Ann; Lewin, Neal A; Nelson, Lewis; Goldfrank, Lewis R; Flomenbaum, Neal [Eds]
New York : McGraw-Hill Education, [2015]
pp. ?-?
ISBN: 0071801847
CID: 2505712

A case series of cationic detergent ingestions in a large correctional facility [Meeting Abstract]

Connors, Nicholas J.; Shawn, Lauren K.; Vassallo, Susi U.; Mercurio-Zappala, Maria; Nelson, Lewis S.; Hoffman, Robert S.; Smith, Silas W.
ISI:000322204400082
ISSN: 1556-3650
CID: 509202

Stress Cardiomyopathy Induced by Acute Cocaine Toxicity [Meeting Abstract]

Chen, B. C.; Vassallo, S. U.; Nelson, L. S.; Hoffman, R. S.; Smith, S. W.
ISI:000302024600360
ISSN: 1556-3650
CID: 164382