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Biomedical subjects

R C Eckert

Publications and source records attributed to R C Eckert.

4 recordsLinked to original sources

Psychopathology masquerading as food allergy.

Three patients who presented with vague symptoms previously diagnosed as food allergy are reviewed. No evidence for allergy to foods was found in any of the patients. Two were depressed with psychotic thinking and the third had moderately severe anxiety with depression. All three improved following psychiatric diagnosis and intervention. One was treated with antidepressant and one with antidepressant-antipsychotic medication. All three maintained improvement two years later. The diagnosis of food allergy must be based on showing a direct relationship between the inciting food and the immunologically mediated reaction. Anxiety and depression may masquerade as food allergy. Evidence of psychopathology should be present to make such a diagnosis.

Adult

Functional versus organic vocal cord paralysis: rapid diagnosis and decannulation.

Functional versus organic vocal cord paralysis can be difficult to differentiate at times. If a tracheostomy has already been performed, the distinction can be made by the use of intratracheal pressure monitoring while the patient is being sedated. If the problem is functional then rapid decannulation can be accomplished as described in this report.

Adult

Vocal-cord dysfunction presenting as asthma.

We identified five patients with a functional disorder of the vocal cords that mimicked attacks of bronchial asthma. Paroxysms of wheezing and dyspnea were refractory to standard therapy for asthma. During episodes of wheezing, the maximal expiratory and inspiratory flow-volume relationship was consistent with a variable extrathoracic obstruction. Laryngoscopy confirmed that wheezing was due to adduction of the true and false vocal cords throughout the respiratory cycle. During asymptomatic periods the maximal flow-volume relationship and laryngoscopic examination were normal. Provocation tests for bronchial asthma were negative. A variety of personality styles and psychiatric diagnoses were represented; patients were not aware of the vocal-cord dysfunction, which uniformly and dramatically responded to speech therapy and psychotherapy. This syndrome may be a form of conversion reaction.

Adolescent