Sarcoidosis with renal involvement.

Nine of ninety patients with sarcoidosis were found to have significant renal impairment. Epithelioid granulomata were present in five of eight patients who had renal biopsies and glomerular lesions were present in six. There was close correlation between hypercalcaemia, hyperuricaemia, nephrocalcinosis and creatinine clearance. In one patient, renal sarcoidosis complicated membrano-proliferative glomerulonephritis and one patient died in end-stage renal disease.     

充血性心力衰竭致肾损害的l临床分析

目的了解充血性心力衰竭致肾损害的临床特点。方法回顾性分析56例充血性心力衰竭致肾损害的临床、实验室资料。结果年龄大于40岁者占86．6％；心功能Ⅲ级者3％发生肾损害，心功能Ⅳ级者12．3％发生肾损害；肾损害的恢复及减轻时间与心力衰竭持续时间呈正相关（P〈0．01）。结论40岁以上、重度心力衰竭者易致肾损害；肾损害随心力衰竭的纠正而消失或减轻。     

38例多发性骨髓瘤肾损害临床分析

目的探讨多发性骨髓瘤肾损害患者的临床表现、诊断及其治疗效果。方法对10年间确诊的38例多发性骨髓瘤肾损害患者的临床资料进行回顾性分析。结果38例患者均有不同程度的贫血(血红蛋白41～90g/L),尿蛋白( ～ ),肾衰竭(血清肌酐442～1021μmol／L);10例(26．3％)血尿酸增高;5例(13．2％)血钙升高。除2例放弃治疗外,36例经综合治疗后29例(76．3％)完全缓解。结论多发性骨髓瘤肾损害临床表现复杂,对蛋白尿、肾衰竭病人应首先考虑该病的可能,并进行骨髓穿刺或活检术、血清蛋白电泳血清免疫球蛋白和尿本-周氏蛋白等检查,才不致于漏诊、误诊。一旦明确诊断,积极输液,利尿,促进尿酸排泄,应用血液透析和化学治疗等,可改善预后。     

充血性心力衰竭致肾损害的临床分析

目的了解充血性心力衰竭致肾损害的临床特点。方法回顾性分析56例充血性心力衰竭致肾损害的临床、实验室资料。结果年龄大于40岁者占86.6%;心功能Ⅲ级者3%发生肾损害,心功能Ⅳ级者12.3%发生肾损害;肾损害的恢复及减轻时间与心力衰竭持续时间呈正相关(P<0.01)。结论40岁以上、重度心力衰竭者易致肾损害;肾损害随心力衰竭的纠正而消失或减轻。     

Clinicopathological study of renal involvement in patients with systemic sclerosis.

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肾癌伴下腔静脉癌栓的诊断和治疗

目的：提高肾癌伴下腔静脉癌栓的诊断效果。方法：总结2例肾细胞癌伴下腔静脉癌栓的诊治情况，并复习有关文献。结果：2例均完整取出癌栓，术后接受TNFα和IL－2治疗。1例术后11个月死亡，1例已存活26个月目前尚。结论：CT、MRI和彩色多普勒超声检查是目前诊断肾癌伴下腔静脉癌栓的较好方法，对无淋巴结和和远处转移者，手术应采取积极的态度，手术方式的选择取决于癌栓手术。     

Sarcoidosis presenting with severe hypocalcaemia

Disorders of calcium metabolism, especially hypercalcemia and hypercalceuria, are common in sarcoidosis. They are caused by extra renal unsuppressed production of 1,25 dihydroxy vitamin D at the level of the sarcoid granuloma. Hormonal changes during pregnancy have a physiological synergistic effect on this mechanism, which is primarily parathyroid hormone (PTH) dependant. However, the combination of primary hypoparathyroidism with hypocalcemia and sarcoidosis is rare. Di George syndrome, is a dysmorphic disorder characterised by aplasia/hypoplasia of thymus and parathyroid glands in addition to aortic arch anamolies and facial dysmorphia. After commencing appropriate treatment this lady made excellent recovary.