摘要:

We report the case of a uremic dialysis patient with severe secondary hyperparathyroidism, proximal muscle weakness and impaired respiratory muscle strength, the latter being assessed by maximal inspiratory pressure. After subtotal parathyroidectomy, we observed a marked improvement in respiratory muscle strength (27 vs. 87 cm H2O) and disappearance of proximal muscle weakness.

ISSN:0250-8095    

DOI:10.1159/000167524

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

A mother developed hematuria during the fourth month of pregnancy, and her nursing infant son from this otherwise uncomplicated pregnancy developed hematuria at 3.5 months of age. Both had a mild glomerulonephritis characterized by mesangial prominence, focal thickening and mottling of the glomerular basement membrane and electron-dense deposits, predominantly in the intramembranous and subendothelial positions. Immunofluores-cence studies revealed striking accumulations of C3 and other complement components associated with alternative complement pathway activation within glomeruli, and the presence of small or equivocal amounts of immunoglob-ulin. C1q, C4, and factor B were not detectable. The glomerular lesion was accompanied by hypocomplementemia. Sera of both mother and infant displayed half normal levels of C3 and factor B, increased levels of C4, and normal levels of 12 other complement proteins. High normal or slight elevation in nephritic factor-like activity was observed in serial serum samples. Studies suggested that this mother and son represent the second kindred having an abnormal form of C3 which produces an alternative complement pathway C3 convertase, C3b, Bb, resistant to control by factor H. No additional affected family members were identified. The course of the nephritis over 7 years without drug therapy has been mild with resolving hematuria and no abnormal proteinuria or decrease in creatinine clearance.

ISSN:0250-8095    

DOI:10.1159/000167525

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Subdural hematoma is an infrequent occurrence in association with hemodialysis. Because of its rarity, there is no widely accepted method of continuing dialysis in such patients. We describe a case of an interhemispheric subdural hematoma with apparent onset during hemodialysis, after which the patient was successfully managed with peritoneal dialysis for 7 weeks. Following this, hemodialysis was reinstated without recurrent intracranial hemorrhage. The strategy of prompt institution of peritoneal dialysis appears to be useful, and deserves serious consideration for long-term use in patients with subdural hematomas in light of the past record of high mortality with continued hemodialysis. However, it also appears that hemodialysis may be cautiously resumed after an appropriate interval of avoiding anticoagulation.

ISSN:0250-8095    

DOI:10.1159/000167526

出版商:S. Karger AG    

年代:1987

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000167527

出版商:S. Karger AG    

年代:1987

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000167528

出版商:S. Karger AG    

年代:1987

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000167529

出版商:S. Karger AG    

年代:1987

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000167530

出版商:S. Karger AG    

年代:1987

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000167531

出版商:S. Karger AG    

年代:1987

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000167532

出版商:S. Karger AG    

年代:1987

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000167513

出版商:S. Karger AG    

年代:1987

数据来源: Karger