Common causes of gross haematuria include stones, neoplasms,tuberculosis, trauma and prostatitis. However, macroscopic haematuriacan occur in patients with IgA nephropathy. IgA nephropathyusually occurs in patients under 40 years of age, and loin painoften accompanies the haematuria [1]. Furthermore, macroscopichaematuria in IgA nephropathy often causes acute renal failurebecause of tubular obstruction by red blood cells [2–4].Obstruction or haematoma of the renal pelvis and lower urinarytract by gross haematuria in IgA nephropathy or any other diseasescausing haematuria has not been reported. Here, we report thecase of a patient with pelvic haematoma in IgA nephropathy,that was erroneously suspected for pelvic malignancy leadingto its radical resection.   A  相似文献   

2.
Acute renal failure in SARS patients: more than rhabdomyolysis.     
Vin-Cent Wu  Po-Ren Hsueh  Wei-Chou Lin  Jenq-Wen Huang  Hung-Bin Tsai  Yung-Ming Chen  Kwan-Dun Wu 《Nephrology, dialysis, transplantation》2004,19(12):3180-3182
  Severe acute respiratory syndrome (SARS)-associated coronavirus(SARS-CoV) has been identified as the causal agent of SARS.Although not common, acute renal failure (ARF) in SARS patientsusually has a catastrophic outcome, with a mortality rate of77% [1]. The causes of ARF in association with SARS are unknown.An increase in creatine kinase (CK) may play a role [2]. Wepresent two patients who met the definition of probable SARS.   A 78-year-old man  相似文献   

3.
Renal allograft failure related to a lower extremity vascular access--a case report.     
Martine C M Willems  L W Ernest van Heurn  Geert W Schurink  Frank M van der Sande  Jan H M Tordoir 《Nephrology, dialysis, transplantation》2006,21(12):3583-3584
  Early renal transplant dysfunction can be caused by acute rejection,acute tubular necrosis (ATN), infection, ciclosporin toxicity,bleeding, urethral obstruction, urinary leak, lymphocele andthrombosis [1]. Prompt treatment of early allograft dysfunctionis essential and therefore accurate diagnosis mandatory. Wedescribe a patient with an unusual cause of allograft dysfunction,which was resolved by a simple surgical intervention.   A 32-year-old man with congenital blindness, hypertension andend-stage renal disease underwent renal transplantation. Hehad been haemodialysis-dependant since the age of 24 years.Dialysis was performed through an  相似文献   

4.
A rare case of acute renal failure due to massive renal allograft infiltration with Candida glabrata.     
Nadia Wasi  Venkata Reddivari  Luis Salinas-Madrigal  Paul Garvin  Bahar Bastani 《Nephrology, dialysis, transplantation》2008,23(1):374-376
  Renal transplant patients remain at risk of graft loss due toacute rejection, calcineurin inhibitor toxicity and chronicallograft nephropathy. Less frequent causes include opportunisticinfections related to immunosuppressive therapy. However, infectionsare a major clinical issue in the field of renal transplantation,impacting on graft and patient survival. Fungal infections accountfor about 5% of infections in renal transplant recipients [1].Candida species are the most common fungal pathogen, and themost common forms of infection are oral and esophageal candidiases,vascular access device-related and urinary tract infections[2]. The incidence of candidiasis of the renal allograft israre and not very well documented.   A 50-year-old white female with a prior medical history of hypertension,  相似文献   

5.
Ticlopidine-induced lupus with renal involvement.     
Takayasu Ohtake  Shuzo Kobayashi  Koji Okamoto  Machiko Oka  Kyoko Maesato  Takeo Yasu  Hidekazu Moriya 《Nephrology, dialysis, transplantation》2006,21(7):1992-1993
  Ticlopidine hydrochloride is a platelet aggregation inhibitorthat is used for the prevention of vascular thrombosis. So far,only six cases of ticlopidine-induced lupus have been documentedin the literature [1–3]. We report here a first case ofticlopidine-induced lupus with renal involvement.   A  相似文献   

6.
Renal tubular injury associated with anagrelide use.     
Graham E J Rodwell  Megan L Troxell  Richard A Lafayette 《Nephrology, dialysis, transplantation》2005,20(5):988-990
  We describe the first case of biopsy-proven renal tubular injuryassociated with anagrelide.   A 60-year-old man with a 35 year history of Crohn's diseasewas diagnosed with essential thrombocytosis (ET) following aunilateral renal artery thrombosis in May 2003. His plateletcount at the time of diagnosis with ET was 1.3 million cells/mm3. He began taking 0.5 mg oral anagrelide twice daily, increasingthe dose to 1 mg each morning and 0.5 mg each evening over  相似文献   

7.
Complications of blood transfusion     
Maxwell  Melanie J; Wilson  Matthew J A 《CEACCP》2006,6(6):225-229
The first 150 words of the full text of this article appear below. Key points
  • Complications of blood transfusion are rare but canbe life-threatening.
  • Since 2005, it has been a legal requirementthat all serious adverse reactions attributable to the safetyor quality of blood are reported.
  • Most reported complicationsare because of transfusion of mismatched blood products andare avoidable through clinical vigilance.
  • Massive blood transfusionsresult in abnormalities of coagulation status, serum biochemistry,acid–base balance and temperature homeostasis.
  • Transfusion-relatedacute lung injury is the most common cause of major morbidityand death after transfusion.
  The serious hazards of transfusion (SHOT) scheme has collecteddata on significant adverse events resulting from transfusionof blood components from volunteer organizations since 1996.However, after the implementation of the European Union Directiveon Blood Safety and Quality in 2005, it is now a requirementthat all ‘Blood Establishments and Hospital Blood Banksreport to the Secretary of State for Health all serious adversereactions . . . [Full Text of this Article]
  CoagulationBiochemistryHypocalcaemiaHyperkalaemiaAcid–base abnormalitiesHypothermia   Clinical features       Immediate reactionsDelayed reactions       BacterialViralPrion      相似文献   

8.
Familial juvenile hyperuricaemic nephropathy in a Caucasian family associated with inborn malformations.     
Peter Kotanko  Eva Gebetsroither  Falko Skrabal 《Nephrology, dialysis, transplantation》2002,17(7):1333-1335
  Familial juvenile hyperuricaemic nephropathy (FJHN; OMIM 162000)is considered a rare cause of end-stage renal disease (ESRD).FJHN is characterized by hyperuricaemia and gout after adolescenceand the slow development of renal insufficiency, leading toESRD in adulthood. The disorder is characterized by a renalunder-secretion of urate, which may be detected already duringearly childhood [1]. The histological lesions in affected subjectsare characterized by unspecific tubulo-interstitial nephropathy.FJHN is inherited in an autosomal dominant pattern with a highpenetrance. Recently, the gene(s) for FJHN was localized toa candidate interval at the short arm of chromosome 16 [2,3].   We report a Caucasian four-generation family with FJHN withoutconsanguinity between spouses and a clustering of  相似文献   

9.
Anaesthesia and cognitive disturbance in the elderly     
Fines  Daniel P; Severn  Andrew M 《CEACCP》2006,6(1):37-40
The first 150 words of the full text of this article appear below. Key points Perioperative delirium and longer term cognitivedisturbance are common and disabling consequences of anaesthesiaand surgery in the elderly. Evidence is emerging that the riskof postoperative delirium can be predicted by preoperative screeningof otherwise asymptomatic patients. The risk of prolonged postoperativecognitive dysfunction (POCD) is
    Anaesthetic assessment   Possible causes of POCDEmboliPerioperative physiological disturbancesPre-existing cognitive impairmentOther factors   PremedicationConduct of anaesthesia    相似文献   

10.
Renal vein thrombosis as a presenting symptom of multiple genetic pro-coagulant defects.     
Talya Wolak  Boris Rogachev  David Tovbin  Yancu Hertzanu  Moshe Zlotnik  Gilles Lugassy 《Nephrology, dialysis, transplantation》2005,20(4):827-829
  Renal vein thrombosis (RVT) may present as an acute or chronicevent, the latter being more common, and patients are usuallyasymptomatic. Acute RVT is more frequent in younger patientsand is characterized by a sudden onset of severe flank painassociated with marked costovertebral angle tenderness and macroscopichaematuria. RVT is a known complication of the nephrotic syndrome. Othercauses of acute RVT include membranous nephropathy and amyloidosis,trauma, oral contraceptive drugs, dehydration (mostly in infants)and steroid administration [1].   A previously healthy 27-year-old female was admitted to thenephrology department suffering from severe pain in the leftflank. The pain had begun 3 weeks previously during a vacationin India and 24 h after fasting.  相似文献   

11.
Acute kidney injury due to deferoxamine in a renal transplant patient.     
Christian Clajus  Jan U Becker  Dirk O Stichtenoth  Jessica Wortmann  Anke Schwarz  Jan T Kielstein 《Nephrology, dialysis, transplantation》2008,23(3):1061-1064
  Deferoxamine is an iron-chelating agent, used in the treatmentof acute iron intoxication and chronic iron overload secondaryto multiple blood transfusions. Moreover it is currently recommendedby the K/DOQI clinical practice guidelines for bone metabolismand disease in chronic kidney disease (CKD) for treatment insymptomatic aluminium toxicity [1]. Deferoxamine is known tohave many adverse effects, some of them potentially fatal, especiallyinfections with siderophilic organisms like mucormycosis [2].We report a case of acute tubular injury in a renal transplantrecipient secondary to treatment with deferoxamine due to ironoverload, in the context of autoimmune haemolytic anaemia.   A 58-year-old Caucasian male, with 21-year status post-cadaverkidney transplantation due to Goodpasture's syndrome, presentedwith a sudden rise in serum creatinine from 120 µmol/Lto 250 µmol/L (Figure 1  相似文献   

12.
Thrombotic microangiopathy in a patient with Sezary syndrome treated with interferon-alpha.     
Marianna Politou  Panagiotis Tsaftarides  John Vassiliades  Marina P Siakantaris  Spyros Michail  Lydia Nakopoulou  Gerassimos A Pangalis  George Vaiopoulos 《Nephrology, dialysis, transplantation》2004,19(3):733-735
  Sezary syndrome is a cutaneous T-cell lymphoma (CTCL), characterizedby erythroderma and infiltration of the epidermis, the dermisand the bone marrow by monoclonal CD4+ T lymphocytes [1]. Renalcomplications of patients with CTCLs have rarely been reported[2–4]. In patients with other haematological malignancies,treated with interferon-   A 63-year old male, who had been diagnosed with Sezary syndrome  相似文献   

13.
Membranoproliferative glomerulonephritis associated with type 1 diabetes mellitus and Hashimoto's thyroiditis.     
Omer Dizdar  Serkan Kahraman  Gültekin Gen?toy  Dilek Ertoy  Mustafa Arici  Bülent Altun  Unal Yasavul  Cetin Turgan 《Nephrology, dialysis, transplantation》2004,19(4):988-989
  A wide spectrum of primary glomerular diseases may occur inpatients with type 1 diabetes mellitus (DM) due to autoimmunemechanisms [1,2]. We here report a patient with type 1 DM andHashimoto's thyroiditis who developed membranoproliferativeglomerulonephritis (MPGN).   A 35-year-old man with type 1 DM for 18 years and Hashimoto'sthyroiditis for 6 years was referred to  相似文献   

14.
Atrial fibrillation     
Bajpai  Abhay; Rowland  Edward 《CEACCP》2006,6(6):219-224
The first 150 words of the full text of this article appear below. Key points
  • Atrial fibrillation (AF) is the commonest cardiacarrhythmia; its incidence increases with age.
  • Diabetes mellitus,hypertension and ventricular hypertrophy are commonly associatedwith non-valvular atrial fibrillation.
  • Primary aims of managementof AF are conversion to sinus rhythm, maintenance of sinus rhythmand prevention of thromboembolic complications.
  • In elderlypatients who are asymptomatic, adequate rate control of AF appearsto offer the same benefits as rhythm control.
  • Chronic AF carriesa high risk of ischaemic stroke from thromboembolism; all patientsat risk must receive adequate anticoagulation.
  • Anticoagulationshould be continued in patients with risk factors despite successfulconversion to sinus rhythm.
  Atrial fibrillation (AF) is the commonest cardiac arrhythmia.The incidence increases with age and affects 5% of UK populationabove the age of 65 yr and 10% above 75 yr.1 2 In the UnitedStates, AF accounts for more than 35% of all admissions forcardiac arrhythmias.3 Men are . . . [Full Text of this Article]
            Direct current cardioversionPharmacological restoration of sinus rhythm       Non-pharmacological management   Cardiac surgeryAcute myocardial infarctionPregnancyVentricular pre-excitationHyperthyroidismPulmonary disease  相似文献   

15.
Sirolimus-based immunosuppression for transplant-associated thrombotic microangiopathy.   总被引：2，自引：1，他引：1  
Cedric Edwards  Andrew House  Vahakn Shahinian  Greg Knoll 《Nephrology, dialysis, transplantation》2002,17(8):1524-1526
  Thrombotic microangiopathy (TMA) is a well-recognized complicationof solid organ transplantation. Both calcineurin inhibitorscyclosporine [1] and tacrolimus [2] have been associated withTMA. Treatment strategies for TMA have included plasmapheresis[1,2], calcineurin inhibitor dose reduction [1,2], calcineurininhibitor withdrawal [1,2], and conversion from one calcineurininhibitor to the other [3]. However, calcineurin inhibitor dosereduction or discontinuation increases the risk of acute allograftrejection and recurrent TMA has been described in patients thatwere converted from cyclosporine to tacrolimus [4,5]. We presenttwo cases of biopsy-proven transplant-associated TMA that weresuccessfully treated by discontinuation of tacrolimus followedby the use of sirolimus, mycophenolate mofetil (MMF) and prednisonefor the prevention of allograft rejection.   A 42-year-old white male with end-stage  相似文献   

16.
Reversible posterior leukoencephalopathy in a patient with systemic sclerosis/systemic lupus erythematosus overlap syndrome.   总被引：3，自引：0，他引：3  
Patrick F K Yong  Sally M A Hamour  Aine Burns 《Nephrology, dialysis, transplantation》2003,18(12):2660-2662
  Reversible posterior leukoencephalopathy is a recently recognizedneurological syndrome, first characterized 7 years ago [1].In this article, we present such a case with images typicalof the syndrome. This is followed by discussion of the typicalpresentation, its associations, hypothetical aetiology and treatmentmodalities.   A 39-year-old woman with systemic sclerosis/systemic lupus erythematosusoverlap syndrome was admitted with fever. This followed a secondcourse of pulsed intravenous cyclophosphamide for relapse oflupus nephritis  相似文献   

17.
Biopsy-proven anuric acute tubular necrosis associated with vancomycin and one dose of aminoside.     
Harry Sokol  Cécile Vigneau  Eric Maury  Bertrand Guidet  Georges Offenstadt 《Nephrology, dialysis, transplantation》2004,19(7):1921-1922
  We present the first report of a biopsy-proven acute tubularnecrosis (ATN) secondary to vancomycin and a single dose ofaminoside.   A 71-year-old woman with a history of hypertension and restrictivechronic respiratory failure was admitted to our intensive careunit (ICU) for dyspnoea. She had been on levofloxacin for 3weeks for pneumonia, and had purulent expectoration, fever (38.5°C)and pulmonary  相似文献   

18.
Massive haemorrhage in pregnancy     
Banks  Amelia; Norris  Andrew 《CEACCP》2005,5(6):195-198
The first 150 words of the full text of this article appear below. Key points Massive haemorrhage remains a significant causeof maternal mortality and morbidity. Clear and timely communicationbetween surgical, anaesthetic and haematology services is vitalto ensure optimal maternal and fetal outcome. Signs of hypovolaemiaoccur relatively late because of physiological changes in pregnancy. Theextent of intravascular volume deficit is not reflected by visualestimates of vaginal bleeding. The decision to perform a hysterectomyshould be made when other methods of haemostasis have failedand not delayed until control of maternal haemostasis and cardiovascularstability has been lost.   Massive haemorrhage is a major cause of maternal mortality.Life-threatening haemorrhage may occur as frequently as 6.7per 1000 deliveries.1 This equates to 1400 cases yr –1in the UK or 33.5 yr –1 in an obstetric unit with 5000deliveries annually. Pregnancy-related conditions and complicationsaccount for 0.8% of intensive care admissions; 35% of thesearise from massive haemorrhage.1 2 Management of massive . . . [Full Text of this Article]
      Antepartum haemorrhagePostpartum haemorrhageCoagulopathies   GeneralSpecific treatmentsPhysicalPharmacologicalSurgicalRadiologicalBlood and blood productsAnaesthesia for obstetric haemorrhageAutologous transfusion        相似文献   

19.
A rare cause of fever associated with leukopenia in a renal transplant patient.     
Hayet Kaaroud  Soumaya Beji  Amel Jebali  Karima Boubaker  Sami Turki  Ezzeddine Abderrahim  Ta?eb Ben Abdallah  Fatma Ben Moussa  Khaled Ayed  Hédi Ben Maiz 《Nephrology, dialysis, transplantation》2004,19(8):2140-2141
  The occurrence of fever in association with leukopenia in renaltransplanted patients is related to viral infection in the majorityof cases. We report a rare cause of such an association in a renal transplantwoman.   A 24-year-old woman was referred to our unit for end-stage renalfailure secondary to reflux nephropathy. She had mild proteinuria(0.45 g/24 h) without haematuria. Routine immunology tests performedbefore the diagnosis of reflux nephropathy showed  相似文献   

20.
Diffuse alveolar haemorrhage in a systemic lupus erythematosus patient successfully treated with rituximab: a case report.     
Cordula M Nellessen  Uwe P?ge  Karl A Brensing  Tilman Sauerbruch  Hans-Ulrich Klehr  Christian Rabe 《Nephrology, dialysis, transplantation》2008,23(1):385-386
  Diffuse alveolar haemorrhage (DAH) often mimics, clinicallyand radiologically, severe pneumonia or ARDS [1]. The causesof DAH include a variety of non-infectious diseases, e.g. collagenvascular disease. In DAH associated with SLE, a regimen of corticosteroidscombined with cyclophosphamide and plasma exchange is generallyrecommended [2]. We describe here a ventilated SLE patient withDAH refractory to standard therapies. To our knowledge, thisrepresents the first successful application of rituximab inDAH.   A 29-year-old North African female presented to our institution  相似文献   

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   Introduction    Case    Introduction    Case 1    Introduction    Case report    Introduction    Case report    Introduction    Case    Introduction    Case    Massive transfusion    Transfusion-related acute lung injury    Pathogenesis    Incidence    Haemolytic transfusion reactions    Non-haemolytic febrile reactions    Allergic reactions    Transfusion-related infections    Transfusion-associated graft-vs-host disease    Immunomodulation    Introduction    Case    Delirium    Dementia    Postoperative cognitive dysfunction    Anaesthetic technique and postoperative cognitive impairment    Future developments    Introduction    Case    Introduction    Case report    Introduction    Case    Introduction    Case    Definition and electrocardiographic patterns    Classification    Pathophysiology and mechanisms    Causes and risk factors    Principles of management    Restoration of sinus rhythm    Maintenance of sinus rhythm    Rate control of atrial fibrillation    Prevention of thromboembolism    Management in special situations    Introduction    Case 1    Introduction    Case    Introduction    Case    Definitions    Physiology    Causes of haemorrhage    Management of haemorrhage    Protocols and fire drills    Problems in early pregnancy    Web resources    Introduction    Case    Introduction    Case report
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