Successful treatment of idiopathic Harlequin Syndrome with oxybutynin and propranolol
We present the case of a patient with idiopathic HS successfully treated with oxybutynin and propranolol. In this patient, a marked improvement in both hyperhidrosis and facial erythema was noted with this combined therapy. We consider it of interest to highlight the response of our patient to the treatment employed, which may be advantageous in future cases of this rare disorder.PMID:34314021 | DOI:10.1111/ajd.13665 (Source: The Australasian Journal of Dermatology)
Source: The Australasian Journal of Dermatology - July 27, 2021 Category: Dermatology Authors: Cristina Naharro-Fern ández Adri án de Quintana-Sancho Ana Elizabet L ópez-Sundh Leandra Reguero-Del Cura Marcos A G ónzalez-López Source Type: research
Harlequin syndrome after surgery for aortic dissection
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - July 20, 2021 Category: Intensive Care Source Type: research
Managing Harlequin Syndrome in VA-ECMO - do not forget the right ventricle
Perfusion. 2021 May 31:2676591211020895. doi: 10.1177/02676591211020895. Online ahead of print.ABSTRACTHarlequin Syndrome (also known as North-South Syndrome) is a complication of veno-arterial extracorporeal membrane oxygenation (V-A ECMO) that can occur when left ventricular function starts to recover. While most commonly due to continued impaired gas exchange in the lungs, we present a case caused by right ventricular dysfunction, successfully managed by conversion of the ECMO circuit to a veno-veno-arterial (VV-A) configuration.PMID:34053349 | DOI:10.1177/02676591211020895 (Source: Perfusion)
Source: Perfusion - May 31, 2021 Category: Cardiovascular & Thoracic Surgery Authors: James Wilson Richard Fisher Francisca Caetano Hatem Soliman-Aboumarie Brijesh Patel Stephane Ledot Susanna Price Christophe Vandenbriele Source Type: research
Managing Harlequin Syndrome in VA-ECMO - do not forget the right ventricle
Perfusion. 2021 May 31:2676591211020895. doi: 10.1177/02676591211020895. Online ahead of print.ABSTRACTHarlequin Syndrome (also known as North-South Syndrome) is a complication of veno-arterial extracorporeal membrane oxygenation (V-A ECMO) that can occur when left ventricular function starts to recover. While most commonly due to continued impaired gas exchange in the lungs, we present a case caused by right ventricular dysfunction, successfully managed by conversion of the ECMO circuit to a veno-veno-arterial (VV-A) configuration.PMID:34053349 | DOI:10.1177/02676591211020895 (Source: Perfusion)
Source: Perfusion - May 31, 2021 Category: Cardiovascular & Thoracic Surgery Authors: James Wilson Richard Fisher Francisca Caetano Hatem Soliman-Aboumarie Brijesh Patel Stephane Ledot Susanna Price Christophe Vandenbriele Source Type: research
Envenomation by the Spotted Harlequin Snake, Homoroselaps lacteus (Linnaeus) 1754 (Serpentes: Atractaspidinae)
Toxicon. 2021 May 4:S0041-0101(21)00130-6. doi: 10.1016/j.toxicon.2021.04.020. Online ahead of print.ABSTRACTTwo cases of envenomation from the small, semi-fossorial, front-fanged colubrid Homoroselaps lacteus are presented and the recent literature reviewed. In addition to local oedema and lymphadenopathy, the development of significant subcutaneous loco-regional bruising suggest that damage to capillary basement membrane and possibly other underlying anti-haemostatic effects may pertain to the clinical syndrome. Although local clinical effects may appear dramatic, due to the small volumes of venom that can be injected, i...
Source: Toxicon - May 7, 2021 Category: Toxicology Authors: Colin R Tilbury Faansie Peacock James Harvey Source Type: research
Envenomation by the Spotted Harlequin Snake, Homoroselaps lacteus (Linnaeus) 1754 (Serpentes: Atractaspidinae)
Toxicon. 2021 May 4:S0041-0101(21)00130-6. doi: 10.1016/j.toxicon.2021.04.020. Online ahead of print.ABSTRACTTwo cases of envenomation from the small, semi-fossorial, front-fanged colubrid Homoroselaps lacteus are presented and the recent literature reviewed. In addition to local oedema and lymphadenopathy, the development of significant subcutaneous loco-regional bruising suggest that damage to capillary basement membrane and possibly other underlying anti-haemostatic effects may pertain to the clinical syndrome. Although local clinical effects may appear dramatic, due to the small volumes of venom that can be injected, i...
Source: Toxicon - May 7, 2021 Category: Toxicology Authors: Colin R Tilbury Faansie Peacock James Harvey Source Type: research
Envenomation by the Spotted Harlequin Snake, Homoroselaps lacteus (Linnaeus) 1754 (Serpentes: Atractaspidinae)
Toxicon. 2021 May 4:S0041-0101(21)00130-6. doi: 10.1016/j.toxicon.2021.04.020. Online ahead of print.ABSTRACTTwo cases of envenomation from the small, semi-fossorial, front-fanged colubrid Homoroselaps lacteus are presented and the recent literature reviewed. In addition to local oedema and lymphadenopathy, the development of significant subcutaneous loco-regional bruising suggest that damage to capillary basement membrane and possibly other underlying anti-haemostatic effects may pertain to the clinical syndrome. Although local clinical effects may appear dramatic, due to the small volumes of venom that can be injected, i...
Source: Toxicon - May 7, 2021 Category: Toxicology Authors: Colin R Tilbury Faansie Peacock James Harvey Source Type: research
Harlequin syndrome in a pediatric population: a case series
We present three pediatric cases of this uncommon syndrome, each of them of different origin and displaying distinct associated (neurological) symptoms, and review medical literature. Insight into the anatomical structure of the thoracocervical and facial sympathetic nervous system is pivotal as it dictates symptomatology. About half of Harlequin syndrome cases are complicated with ocular symptoms and a minority may be part of more extensive partial dysautonomias affecting facial sudomotor, vasomotor and pupillary responses, such as Holmes –Adie syndrome and Ross syndrome. Etiology is generally idiopathic, however, cases...
Source: Acta Neurologica Belgica - January 30, 2021 Category: Neurology Source Type: research
Must be sympathetic nervous system with unilateral facial flushing in harlequin syndrome
Publication date: 23–29 January 2021Source: The Lancet, Volume 397, Issue 10271Author(s): Lizhang Chen, Muke Zhou (Source: The Lancet)
Source: The Lancet - January 22, 2021 Category: General Medicine Source Type: research
Central Versus Peripheral Arterial Cannulation for Veno-Arterial Extracorporeal Membrane Oxygenation in Post-Cardiotomy Patients
Different arterial cannulation strategies are feasible for veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in postcardiotomy shock. We aimed to analyze potential benefits and safety of different arterial cannulation strategies. We identified 158 patients with postcardiotomy cardiogenic shock requiring VA-ECMO between 01/10 and 01/19. Eighty-eight patients were cannulated via axillary or femoral artery (group P), and 70 centrally via the ascending aorta directly or through an 8 mm vascular graft anastomosed to the ascending aorta (group C). Demographics and operative parameters were similar. Change of cannulat...
Source: ASAIO Journal - December 23, 2020 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research
A case of Harlequin syndrome following bilateral neck dissection for malignant oral squamous cell carcinoma
Background: Harlequin syndrome is a rare, frequently idiopathic, autonomic disorder. It typically presents with unilateral sweating and flushing of the face, often triggered by exercise and warm environments. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 1, 2020 Category: ENT & OMF Authors: Holly Haria, Andrew Douglas, Sajid Sainuddin Tags: P46 Source Type: research
Peripheral cardiopulmonary bypass in 2 patients with symptomatic tracheal masses: Perioperative challenges
We report two cases of tracheal masses, where awake peripheral cardiopulmonary bypass was instituted. The first case was an obese boy weighing 102 kg with tracheal rhinoscleroma who developed Harlequin or north-south syndrome after institution of femoro-femoral veno-arterial partial cardiopulmonary bypass. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 24, 2020 Category: Anesthesiology Authors: Satyajeet Misra, Bikram Kishore Behera, Chappity Preetam, Satyapriya Mohanty, Rudra Pratap Mahapatra, Priyank Tapuria, Anirudh Elayat, Anindiya Nayak, Kunal Kotkar, John S. McNeil, Randal S. Blank Tags: Case Conference Source Type: research
Peripheral Cardiopulmonary Bypass in Two Patients With Symptomatic Tracheal Masses: Perioperative Challenges
Tracheal tumors or masses causing critical airway obstruction require resection for symptom relief. However, the location and extent of these tumors or masses often preclude conventional general anesthesia and tracheal intubation. Peripheral cardiopulmonary bypass often is required before anesthetizing these patients. Herein, two cases of patients with tracheal masses, in whom awake peripheral cardiopulmonary bypass was instituted, are reported. The first case was that of an obese male child weighing 102 kg, with tracheal rhinoscleroma, who developed Harlequin, or north-south, syndrome after institution of femorofemoral ve...
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 24, 2020 Category: Anesthesiology Authors: Satyajeet Misra, Bikram Kishore Behera, Chappity Preetam, Satyapriya Mohanty, Rudra Pratap Mahapatra, Priyank Tapuria, Anirudh Elayat, Anindya Nayak, Kunal Kotkar, John S. McNeil, Randal S. Blank Tags: Case Conference Source Type: research
Risk of harlequin syndrome during bi-femoral peripheral VA-ECMO: should we pay more attention to the watershed or try to change the venous cannulation site?
(Source: Critical Care)
Source: Critical Care - July 20, 2020 Category: Intensive Care Authors: Patrick M. Honore, Leonel Barreto Gutierrez, Luc Kugener, Sebastien Redant, Rachid Attou, Andrea Gallerani and David De Bels Tags: Letter Source Type: research
Patient with Cluster Headache and Harlequin Sign - Related or Not?
CONCLUSION: This case reports a rare combination of cluster headache and harlequin sign that warrants further testing to exclude pathology in the brain, neck or mediastinum. It also illustrates the underlying anatomy and physiology of the autonomic nervous system.
PMID: 32654114 [PubMed - as supplied by publisher] (Source: Headache)
Source: Headache - July 10, 2020 Category: Neurology Authors: Van Oosterhout WPJ Tags: Headache Source Type: research
