Letters to the Editor
- α-Gal syndrome is a recently recognized entity in which allergy to mammalian meat may be acquired by exposure to the disaccharide galactose-α-1,3-galactose (α-gal) antigen through the saliva of the Lone Star tick. Subsequent exposure to the antigen in meat may result in the delayed presentation (3 to 6 hours after ingestion) of systemic hypersensitivity reactions (eg, urticaria, angioedema), gastrointestinal symptoms, or life-threatening anaphylaxis.1,2 Anaphylaxis is potentially fatal, and identifying the cause is critical.
- Arteriovenous fistulas are a common form of autogenous access in patients requiring renal replacement therapy.1-3 Aneurysmal degeneration of segments of the outflow vein and outflow stenosis are frequently identified.4 Albeit rare, arteriovenous fistulas bleeding can be a devastating and fatal dialysis access complication. Skin thinning and ulceration are signs of increased risk for bleeding or impending rupture.5 Immediate investigation of the fistula for any concerning signs of bleeding is imperative and any issues should prompt swift referral.
- The artificial intelligence–enhanced electrocardiogram (AI-ECG) has been validated for the identification of multiple cardiac pathologies.1-3 We developed an AI-ECG algorithm that closely predicts chronologic age and demonstrated that the difference between AI-ECG age and chronologic age, or delta age (the first minus the latter), predicts long-term survival. Furthermore, AI-ECG age has been associated with cardiovascular diseases and risk factors such as hypertension and dyslipidemia.4,5 As this AI tool reflects potentially valuable information about overall fitness and cardiovascular health, we discuss an exemplary case where the AI-ECG showed a change towards youth following risk factor modification.
- Determining the clinical diagnosis underlying thrombotic microangiopathy (TMA), a pathologic entity, may be challenging, as is its effective management. This is especially true when TMA occurs in pregnancy. We report a case of a woman presenting in mid-pregnancy with severe pre-eclampsia and acute TMA who was successfully managed with eculizumab.