群蜂蜇伤致急性肾小管坏死伴间质性肾炎一例

单蜂蜇伤人后多仅产生轻度的过敏反应,但群蜂蜇伤可导致多脏器功能障碍.其中急性肾损伤主要表现为急性肾小管坏死(ATN),罕见急性间质性肾炎(AIN),两者合并发生,国外仅1例报道[1].     

急性阑尾炎并发门静脉炎一例报告

病例:男,55岁,有哮喘病史50年,一直服用强的松。因脐周痛伴恶心、呕吐6h到我院急诊,予抗炎治疗,8h后腹痛加剧,拟腹痛待查收入外科。入院查体:T40℃,BP70/50m m H g,H R124次/分,R21次/分。腹稍胀,右下腹轻压痛,无反跳痛、肌紧张,肝区叩痛阳性。无明显巩膜黄染。血白细胞27.2×1     

链球菌感染后肾炎合并急性间质性肾炎一例

患者,女,24岁。1月前受凉后出现发热、咽痛,体温高达40℃。抗炎后发热消退,但又出现咳嗽、咳痰。10 d前注射克林霉素1 d后出现无尿,伴呕吐、颜面及双下肢水肿,入当地医院查Scr 897μmol／L,BUN 9．4 mmol／L。予抗感染、护肾、利尿及支持治疗,行3次血液透析,仍无尿, 后转入我科。既往有青霉素过敏史。入院体检贫血貌,面部     

A case of acute focal bacterial nephritis

Acute focal bacterial nephritis refers to a renal mass caused by acute focal infection. We report a case of acute focal bacterial nephritis, herein. The case was in a 56-year-old woman, who was hospitalized with the chief complaint of left flank pain, chills and fever. Intravenous pyelography suggested the presence of a mass in the upper pole of the left kidney. Ultrasonography showed a hypoechoic mass, CT scan revealed a round, low density mass. Antibiotic therapy resulted in resolution of symptoms, and a follow-up CT scan and ultrasonography showed complete resolution of the renal mass.     

A case of acute interstitial nephritis and nonoliguria acute renal failure induced by cimetidine]

Cimetidine is a histamine H2-receptor antagonist. Widely it is prescribed, and then various side effects have been increasingly recognized. Acute renal failure as a result of acute interstitial nephritis is one of the most important adverse effect. We report a case of biopsy-proven acute interstitial nephritis following cimetidine therapy. Farther more, we review other reported cases of cimetidine-induced acute interstitial nephritis, and discuss the clinical features and a role of immunological mechanisms of these cimetidine-induced disorders. A 52-year-old woman was admitted because of fever and protenuria. A month before admission, she developed gastric ulcer and was given cimetidine 600mg orally a day by a near physician. Laboratory data on admission included the following: white blood cell count, 14700/microliters; eosinophils, 6%; BUN, 50.7mg/dl; Cr, 7.6mg/dl; CRP, 34.0mg/dl. All drugs were discontinued because we suspected drug-induced acute renal failure, especially by cimetidine. Renal biopsy performed on day 3 showed interstitial nephritis with lymphocyte infiltration which was composed mainly of T cell. T4/T8 ratio was determined to be 1. There was neither predominance of helper nor cytotoxic cells in T cell subpopulation. We reviewed 22 cases reported and discussed the features of cimetidine-induced interstitial nephritis. The most important thing is to monitor renal function periodically with the suspicion of this disorder. On the detection of abnormality of laboratory data, cimetidine should be discontinued.     

A case of acute tubulo-interstitial nephritis and uveitis syndrome

We report herein the case of a 14-year-old female who has acute tubulo-interstitial nephritis (AIN) associated with bilateral diffuse uveitis. She was admitted for the evaluation of "proteinuria", following general fatigue and weight loss about 2 weeks ago. Her laboratory data showed mild anemia, hyper gamma-globulinemia, mild proteinuria, and the reduced glomerular filtration rate with the increased urinary excretion of beta 2-microglobulin. The histological examination obtained by renal biopsy showed mild edema and diffuse infiltration of mononuclear cells in interstitium without any glomerular or vascular abnormalities, which were compatible with AIN. As for the etiology of AIN, clinical investigations could not reveal any specific causes, such as bacterial and viral infections, drugs and systemic diseases. About 4 months after the onset of nephritis, she also became to suffer from bilateral diffuse uveitis. Therefore, the diagnosis of the acute tubulo-interstitial nephritis and uveitis syndrome (TINU syndrome) (Vanhaesebrouck et al., 1985) could be confirmed. In her clinical course, it was noteworthy that uveitis relapsed frequently in spite of systemic administration of prednisolone, and it took two years until uveitis cured, whereas the AIN subsided spontaneously prior to the specific treatment. In this case, characteristic findings of granulomatous uveitis was closely similar to those of sarcoidosis, which has been rarely reported in TINU syndrome. In this respect, the involvement of immune processes, especially cell-mediated, was suggested as the possible pathogenesis in this case.     

A coronary aneurysm complicated by acute myocardial infarction. A case report

Coronary artery aneurysm (CAA) is a relatively rare disease that may cause angina, myocardial infarction, sudden death due to thrombosis, embolisation, or rupture. This report describes the case of a man aged 65 years old who had an anterior myocardial infarction due to left anterior descending artery (LAD) aneurysm. We attempted early percutaneous transluminal coronary angioplasty (PTCA) for treatment of acute myocardial infarction, but were not successful. He was then treated with intracoronary streptokinase. Serial coronary angiographies showed recanalisation and aneurysm on the LAD. The patient was operated on with coronary bypass surgery, and treated with an oral anticoagulant, nitrate, and blocker. He was well after one year of follow-up.     

紫癜性肾炎合并膜性肾病一例

紫癜性肾炎合并膜性肾病十分罕见,我们发现1例,报告如下. 患者,女,19岁,囚四肢皮肤出血点伴腹痛5年,双下肢水肿15 d,于2008年10月19日入院.5年前患者接触甲醛后四肢皮肤出现出血点,伴腹痛、黑便,当时血压160/120 mm Hg,眼睑水肿.尿检蛋白3+,潜血l+;大便潜血+.BUN 9.1 mmol/L,Scr 53.9 μmol/L.余无异常,诊断为过敏性紫癜,紫癜性肾炎.     

A case of acute diffuse interstitial nephritis due to sulpyrine

Sulpyrine is commonly used in Japan. We report a case of acute renal failure due to acute tubulointerstitial nephritis (ATIN), which we believe was associated with the use of sulpyrine.     

纤维样肾小球病并发过敏性间质性肾炎一例

患者,女性,58岁.2006年7月感冒后眼睑及双下肢水肿,尿蛋白3+,11月水肿加重,乏力纳差.住本市某医院查尿蛋白量(24 h)4.3 g,Alb 28.8 g/L,Scr 162.6 μmol/L,接受泼尼松40 mg/d及对症治疗2个月无效;又接受红花注射液静滴,5 d后,全身出现出血性皮疹伴瘙痒,肾功能恶化出院.     

Acute interstitial nephritis secondary to infectious mononucleosis

Renal involvement in infectious mononucleosis (IM) is infrequent. In most cases it is self-limited and is rarely associated with loss of renal function. The purpose of this case report is to document a case of acute interstitial nephritis (AIN) leading to acute renal failure (ARF) in a patient with Epstein-Barr virus (EBV) infection and to review literature of EBV infection and its renal manifestation. The patient was managed with hemodialysis and steroids and made an uneventful recovery. Renal involvement in IM may be more common than generally appreciated and may occasionally lead to ARF. Therapy with corticosteroids may have role in the management of IM-induced ARF and may shorten the duration of renal failure.     

A case of cimetidine-induced acute tubulointerstitial nephritis associated with antineutrophil cytoplasmic antibody

We present a case of acute tubulointerstitial nephritis (ATIN) that developed in a 63-year-old man who had been taking cimetidine for treatment of a gastric ulcer. The constellation of clinical, laboratory, and histopathologic findings suggested drug-induced ATIN. Of interest, the patient had antineutrophil cytoplasmic antibody (ANCA) in his sera, reactive with myeloperoxidase, elastase, and lactoferrin. Prominent renal histological features included marked plasmacyte infiltration into the renal interstitium. Withdrawal of cimetidine resulted in complete resolution of renal findings, and the titers of ANCA concomitantly declined. Thus, cimetidine may have played a causative role in the development of ANCA-associated ATIN.     

A case of neurogenic bladder complicated by an acute rash syndrome (measles?)

A 24-year-old female patient was was admitted because of urinary retention, four days after the development of rash with fever to be diagnosed as measles by a doctor. Neurological examinations showed hyperesthesia in lower thoracic regions and increased deep tendon reflexes in lower extremities. Cystometric findings revealed an areflexic bladder with normal sensation. Cerebrospinal fluid examination showed mononuclear pleocytosis and slightly elevated levels of protein. There was no significant increase in serum measles antibody titer. She regained normal voiding by conservative treatment with an indwelling catheter for four days. The bladder motor paralysis was probably due to non-transverse myelitis in sacral spinal region. Neurological complications of measles are briefly discussed.     

依那普利引起急性间质性肾炎一例

男,65岁,因上腹部疼痛,恶心呕吐5 d,尿少3 d于2008年1月13日入院.患者入院前5 d服依那普利10mg,次日又服2次,每次10 mg,血压由平时140/90 mm Hg降至120/60 mm Hg,当天晚上出现消化道症状.     

Multifocal streptococcal pyomyositis complicated by acute compartment syndrome: case report

A 5-year-old girl sought treatment for pyrexia of unknown origin. Despite prompt surgical drainage of a streptococcal septic arthritis of the ankle joint, her condition deteriorated. Multifocal pyomyositis was subsequently diagnosed. This was complicated by acute compartment syndrome in three extremities. With aggressive surgical and medical management, the child made a complete recovery. Orthopaedic clinicians in nontropical areas must familiarize themselves with this rare, potentially life-threatening, but eminently curable disease.     

多中心浆细胞型淋巴结增生症并发间质性肾炎一例

淋巴结增生症(Castleman病)是一种少见的慢性淋巴组织增生性疾病.本病临床表现缺乏特异性,易误诊和漏诊,无特异的治疗方法.现报道1例多中心浆细胞型Castleman病并发间质性肾炎患者,其病程迁延两年后在我院确诊,经肾上腺皮质激素治疗,目前已存活39个月.     

多中心浆细胞型淋巴结增生症并发间质性肾炎一例

淋巴结增生症(Castleman病)是一种少见的慢性淋巴组织增生性疾病.本病临床表现缺乏特异性,易误诊和漏诊,无特异的治疗方法.现报道1例多中心浆细胞型Castleman病并发间质性肾炎患者,其病程迁延两年后在我院确诊,经肾上腺皮质激素治疗,目前已存活39个月.     

多中心浆细胞型淋巴结增生症并发间质性肾炎一例

淋巴结增生症(Castleman病)是一种少见的慢性淋巴组织增生性疾病.本病临床表现缺乏特异性,易误诊和漏诊,无特异的治疗方法.现报道1例多中心浆细胞型Castleman病并发间质性肾炎患者,其病程迁延两年后在我院确诊,经肾上腺皮质激素治疗,目前已存活39个月.     

Emergency valve surgery for infective endocarditis complicated by acute intracranial hemorrhage: A case report

IntroductionOptimal timing of surgical treatment for infective endocarditis (IE) complicated by intracranial hemorrhage remains controversial.Presentation of caseA 43-year-old man with IE received appropriate antibiotic therapy but had recurrence of cerebral infarction and intracranial hemorrhage (ICH). Emergency valve surgery was performed 2 days after ICH onset because of heart failure and recurrence of cerebral complications. Postoperatively, he showed no neurologic symptoms; neuroimaging showed no enlargement of ICH.DiscussionPostoperative risk of neurologic deterioration may be relatively lower than previously thought in patients with IE who undergo surgery within 1 month after ICH onset.ConclusionsEmergency surgery in patients with ICH is justified in cases of multiple indications for such small ICH. Further evaluation regarding the risk of subsequent hemorrhage in patients with ICH who require emergency valve surgery is warranted.