摘要:

A 22-year-old woman with hemoglobin SC who was hematologically asymptomatic, developed gross hematuria associated with urinary tract infection, without any urological antecedents. Investigations revealed a unilateral hematuria due to papillary necrosis on the left kidney. Medullary sponge kidney was also discovered by radiologic investigations. Papillary cysts could play a role in the occurrence of papillary necrosis.

ISSN:0250-8095    

DOI:10.1159/000168717

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We describe a case of peritonitis due to Verticillium spp. in a 33-year-old farmer on continuous ambulatory peritoneal dialysis (CAPD) for 3 months for end-stage renal failure due to chronic pyelonephritis. The etiologic agent was a hyaline hyphomycete which we report as a new human opportunistic pathogen. The fungus was isolated from the peritoneal fluid culture and from the tip of the catheter; identification was made on the basis of macroscopic and microscopic features. The patient had previously been admitted to our hospital for peritonitis caused by mixed enteric flora and treated for 8 days with intraperitoneal broad-spectrum antibiotic therapy. Five days after discharge he was readmitted for severe abdominal pain and cloudy drainage fluid. Two days of intraperitoneal broad-spectrum antimicrobial therapy produced no clinical improvement. Intravenous fluconazole and oral flucytosine were administered upon identifying the fungus. After another 2 days without improvement, peritoneal dialysis was discontinued and the catheter removed. Antimycotic therapy was continued for 4 days with complete resolution of the peritonitis. The patient chose to start hemodialysis and was discharged in good clinical condition.

ISSN:0250-8095    

DOI:10.1159/000168718

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

A 44-year old female was admitted to our hospital for evaluation of uncontrolled hypertension. She received renal transplantation 3 months ago and suffered from a tingling sensation and weakness on both hands. Laboratory findings (low serum potassium, low plasma renin activity and elevated plasma aldosterone level) was consistent with primary aldosteronism. Through the postural study for plasma aldosterone and the adrenal CT finding we diagnosed this case as adrenal adenoma, which was confirmed by surgical removal. A retrospective review of medical records showed that characteristic findings in primary aldosteronism (hypokalemia and low plasma renin activity) were masked by renal failure and became evident after successful renal transplantation. It was suggested that impaired urinary potassium excretion and excess release of renin from the ischemic kidney masked the characteristic findings of primary aldosteronism. To our knowledge, this is the first report documenting the change of renin-angiotensin-aldosterone system after renal transplantation in a case of coexistence of primary aldosteronism and chronic renal failure.

ISSN:0250-8095    

DOI:10.1159/000168719

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Agnogenic myeloid metaplasia (AMM), a myeloproliferative disorder of clonal origin, can affect the kidneys via several mechanisms. Associated disorders include asymptomatic interstitial extramedullary hematopoiesis, obstructive uropathy and nephrolithiasis. Currently, there are no descriptions of the nephrotic syndrome associated with AMM. We present a case of AMM associated with the nephrotic syndrome, a mesangial proliferative glomerular lesion and extramedullary hematopoiesis.

ISSN:0250-8095    

DOI:10.1159/000168720

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000168721

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

A 42-year-old man with chronic renal failure and homograft transplantation developed adult T cell lymphoma in one native kidney. The role of transfusion in the acquisition of human T-lymphotropic virus type I and its role in the early development of adult T cell lymphoma, particularly on the background of chronic immunosuppression, are discussed. To our knowledge, this is the first such case.

ISSN:0250-8095    

DOI:10.1159/000168722

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

An unexpected case of nonocclusive mesenteric infarction in a patient on continuous ambulatory peritoneal dialysis is described. The common clinical finding in this entity is a low cardiac output state or even circulatory collapse. Nonocclusive mesenteric infarction has been reported very rarely during continuous ambulatory peritoneal dialysis, and only in the setting of cardiac dysfunction or prolonged hypotension. The current patient had none of the typical features commonly described in the clinical setting of nonocclusive mesenteric infarction; potential mechanisms, including the role of erythropoietin, in the genesis of this disorder are discussed.

ISSN:0250-8095    

DOI:10.1159/000168723

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Two insulin-dependent diabetic women with severe retinopathy who were referred for the management of nephrotic syndrome are presented. On the basis of clinical risk factors, such as retinopathy and severe hypertension, both patients were expected to develop progressive end-stage renal failure. One woman has shown a gradual decline in creatinine clearance over 7 years while the plasma creatinine of the other has remained normal for 11 years. The unexpectedly good outcome of both these patients may be related to maintaining a normal blood pressure despite neither patient receiving a prolonged course of an angiotensin-converting enzyme inhibitor. Because of the efficacy of current antihypertensive therapy, the outcome of diabetic nephropathy cannot be so easily predicted and needs to be formally reassessed.

ISSN:0250-8095    

DOI:10.1159/000168724

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We report the case of a 42-year-old woman with autosomal dominant polycystic kidney disease complicated by primary aldosteronism. She had a history of hypertension for 12 years and was found to have hypokalemia and polycystic renal and hepatic disease. Endocrinological tests revealed hyporeninemia and hyperaldosteronemia. Adrenal scintigraphy and venography demonstrated a left adrenal adenoma. Blood sampled from the adrenal veins confirmed hyperaldosteronemia originating from the left adrenal gland. Left adrenalectomy was performed. After surgery, plasma renin activity, plasma aldosterone titer, and serum potassium level normalized. The mechanism for the development of primary aldosteronism with autosomal dominant polycystic kidney disease may be related to the activation of the renin-angiotensin system. Four years after left adrenalectomy, hepatic but not renal cysts showed a remarkable increase; the improvement in hypokalemia may have delayed the progression of kidney cysts.

ISSN:0250-8095    

DOI:10.1159/000168725

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000168726

出版商:S. Karger AG    

年代:1994

数据来源: Karger