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   

2.
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   

3.
Kidney biopsies taken before and after oral sodium phosphate bowel cleansing.     
Willy Aaseb?  Helge Scott  Rüdiger Ganss 《Nephrology, dialysis, transplantation》2007,22(3):920-922
  Acute renal failure due to phosphate nephropathy following bowelcleansing with an oral sodium phosphate solution is a rare,but well-known, complication [1]. Several authors have reporteddiffuse tubular injury and tubular deposition of calcium phosphatein biopsies taken from such patients [1–4]. In these patients,the term acute phosphate nephropathy more aptly describes thisentity than the previously used term acute nephrocalcinosis[1]. It has been a matter of debate whether these changes aredirectly induced by the phosphate load or whether they werebeing present before the procedure [3]. We, therefore, reporta patient with acute phosphate nephropathy who had kidney biopsiestaken before and after bowel cleansing with sodium phosphate.   In 2002, a 69-year-old woman was  相似文献   

4.
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   

5.
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   

6.
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   

7.
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   

8.
Two different glomerular diseases in the same patient at an interval of 7 years.   总被引：1，自引：0，他引：1  
Giovanni M Frascà  Letizia Soverini  Paola Preda  Gianandrea Pasquinelli  Claudio Orsi  Rita Prandini  Alba Vangelista  Sergio Stefoni 《Nephrology, dialysis, transplantation》2002,17(11):2014-2016
  Overlapping of different glomerulopathies has already been observedin renal biopsies from diabetic as well as non-diabetic patients[1]. Unlike other reports, the present paper describes a patientwhere two distinct forms of immunological glomerulonephritiswith a different histological and clinical picture occurredseparately at some years’ interval from each other. Thisfinding suggests an individual susceptibility of the patientto immunological renal injury and gives food for speculationon the pathogenesis of glomerulonephritis.   The patient here described was born in Southern Italy in 1966.Family investigation proved negative for glomerular diseases,renal failure, arterial hypertension and diabetes mellitus.In 1991, when he was 25 years old, he had an episode of macroscopichaematuria during an upper airways infection, and this recurredin November 1994, at the age of 28. At that time, urinalysisrevealed haematuria  相似文献   

9.
Renal artery dissection secondary to medial hyperplasia presenting as loin pain haematuria syndrome.     
Nitin Kolhe  Mark Downes  Patrick O'Donnell  Susan Szackas  Paul Stevens 《Nephrology, dialysis, transplantation》2004,19(2):495-497
  Fibromuscular dysplasia (FMD) accounts for 5–10% of renalartery stenosis. The majority of cases (90%) involve the media.Loin pain haematuria syndrome is characterized by loin pain,which is often severe and unrelenting, in association with haematuriaof glomerular origin. We report a case of medial hyperplasiawith dissection of the renal artery, where the patient presentedwith loin pain haematuria syndrome without hypertension.   A 42-year-old heavy goods vehicle driver presented with bilateral,non-radiating loin pain associated with microscopic haematuria.He underwent normal urological investigation including intravenousurography and cystourethroscopy, renal function was normal asjudged by a serum creatinine of 98 mmol/l and he was normotensive.Despite negative investigations he remained symptomatic butwas not readmitted until 10 years later when he had a furtherepisode of severe  相似文献   

10.
Multifocal transitional cell carcinoma associated with renal cell carcinoma in a patient on long-term haemodialysis.     
Kousuke Takehara  Masaharu Nishikido  Shigehiko Koga  Yasuyoshi Miyata  Takashi Harada  Naoe Tamaru  Hiroshi Kanetake 《Nephrology, dialysis, transplantation》2002,17(9):1692-1694
  Patients with end-stage renal disease who require chronic dialysisare at high risk of developing malignancy. There are many reportedcases of the development of renal or urothelial cancer in suchpatients [1–8]. We report the first case, to our knowledge,of multifocal, invasive transitional cell carcinoma (TCC) andunilateral renal cell carcinoma (RCC) with acquired cystic disease,occurring simultaneously in a patient on haemodialysis treatedby complete urinary tract exenteration. Our patient was managedsuccessfully with an aggressive treatment.   A 69-year-old man was referred to our institution  相似文献   

11.
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   

12.
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   

13.
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   

14.
Anaesthesia for lower limb revascularization     
Tovey  Gail; Thompson  Jonathan P 《CEACCP》2005,5(3):89-92
The first 150 words of the full text of this article appear below. Key points Surgery for lower limb revascularization is associatedwith a high risk of cardiac morbidity and mortality. Preoperativecardiac risk assessment is important and risk-reducing measuresshould be started appropriately. Perioperative ß-blockadedecreases perioperative cardiac complications in the highestrisk patients. The quality of anaesthetic practice rather thanspecific technique per se has the most important influence onpatient outcome. Acute limb ischaemia is an emergency thatprecludes prolonged preoperative cardiac evaluation.  
  Critical limb ischaemia (CLI) is defined as chronic ischaemicrest pain, ulcers or gangrene attributable to objectively provenarterial occlusive disease. Peripheral vascular disease (PVD)is a marker for severe multi-system atherosclerosis and patientswith critical limb ischaemia presenting for lower limb revascularizationpresent a significant challenge to the anaesthetist. They areusually elderly with a high prevalence of hypertension, diabetesmellitus, cerebrovascular and renal vascular disease, and smoking-relatedrespiratory disease. Only 8% of patients with PVD . . . [Full Text of this Article]Treatment strategies       MonitoringGeneral anaesthesiaRegional anaesthesia      相似文献   

15.
Intracapillary proliferative glomerulonephritis due to heavy chain deposition disease.   总被引：1，自引：1，他引：0  
Anouk C Vedder  Jan J Weening  Raymond T Krediet 《Nephrology, dialysis, transplantation》2004,19(5):1302-1304
  Heavy chain deposition disease (HCDD) is a rare manifestationof plasma cell dyscrasia. Only 11 cases have been describedin the literature [1]. The clinical picture is variable, butin all patients renal biopsy showed a nodular sclerosing glomerulopathy[1–5]. We report a patient with rapidly progressive glomerulonephritisin whom the renal biopsy showed mainly intracapillary proliferativeglomerulonephritis due to HCDD.   The patient is a 55-year-old musician with an uneventful medicalhistory except ankylosing spondylitis diagnosed at the age of47. Six weeks before admission he noticed foamy urine, at 2weeks he developed generalized swelling, dyspnoea and a severeheadache. Upon admission  相似文献   

16.
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   

17.
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   

18.
Influenza vaccine-induced rhabdomyolysis leading to acute renal transplant dysfunction.     
K S Raman  T Chandrasekar  R S Reeve  M E Roberts  P A Kalra 《Nephrology, dialysis, transplantation》2006,21(2):530-531
  Rhabdomyolysis is a well-known cause of renal failure and iscommonly associated with drugs, toxins and infections. Therehas been one reported case of rhabdomyolysis attributed to influenzavaccine causing renal failure in native kidneys.   A 57-year-old Caucasian man was diagnosed to have focal segmentalglomerlosclerosis (FSGS) in 1995. He eventually underwent acadaveric renal transplantation in February 2002 and becausethis was complicated by delayed graft function, his creatinineplateaued at a  相似文献   

19.
Jaccoud's nephritis.     
Andreas L Birkenfeld  Ute Kettritz  Jan-Hinrich Br?sen  Wolfgang Schneider  Alexander Natusch  Ursula G?bel 《Nephrology, dialysis, transplantation》2005,20(3):654-656
  Jaccoud was a French clinician from the 19th century who reporteda peculiar joint deformity in patients with rheumatic fever[1]. He observed the development of an ulnar deviation thatwas reducible, which indicated that the joint spaces were notdestroyed. We have no evidence that Jaccoud was interested inthe kidney or that he ever saw a patient with nephritis. Perhapsthe patient reported here would have raised his interest inour specialty.   A 69-year-old woman was admitted because of generalized weaknessand decreasing renal function. Two months earlier, her  相似文献   

20.
Iatrogenic fistula between prosthetic haemodialysis access graft and autogenous vein: unusual cause of graft thrombosis.     
Seung Kee Min  Yeon Ho Park  Hyun Hee Lee  Joon Seung Lee  Woo Kyung Chung  Jong Ho Lee  Young Hwan Koh  Tae-Seok Seo 《Nephrology, dialysis, transplantation》2004,19(10):2647-2649
  Haemodialysis access graft is so important as to be called alifeline for the patient on maintenance haemodialysis. The vascularaccess problem is the leading cause of admission in patientswith end-stage renal disease. Many complications of the prostheticvascular access graft are reported, such as graft thrombosis,infection, aneurysm or pseudoaneurysm, and arterial steal syndrome[1]. We recently experienced two cases of graft thrombosis relatedto the iatrogenic fistula between haemodialysis access graftand autogenous vein at the needling site during haemodialysis.We report our cases with their clinical manifestation and thetreatment outcome and possible methods of prevention [2].   A 76-year-old female on long-term haemodialysis  相似文献   

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   Introduction    Case    Introduction    Case report    Introduction    Case report    Introduction    Case    Introduction    Case    Introduction    Case 1    Delirium    Dementia    Postoperative cognitive dysfunction    Anaesthetic technique and postoperative cognitive impairment    Future developments    Introduction    Case    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    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 report    Critical limb ischaemia    Preoperative assessment    Preoperative management    Perioperative management    Postoperative management    Acute limb ischaemia    Introduction    Case    Introduction    Case    Introduction    Case    Introduction    Case Report    Introduction    Case    Introduction    Case 1
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