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ABSTRACT: A 58-year-old white woman on continuous ambulatory peritoneal dialysis for 2 years developed calciphylaxis-induced necrotic skin lesions over both lower extremities. Despite subtotal parathyroidectomy and other conventional measures, skin lesions continued to worsen. Mapping of transcutaneous oxygen pressure showed markedly low values in involved areas. Skin ulcers completely healed after 38 sessions of hyperbaric oxygen therapy. The results in our case indicate that hyperbaric oxygen therapy may be useful in the treatment of skin ulcers secondary to calciphylaxis.
American Journal of Kidney Diseases 07/1994; 23(6):878-81. · 5.43 Impact Factor
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ABSTRACT: The primary antiphospholipid antibody syndrome (PAPS) and systemic lupus erythematosus (SLE) may occur in women of reproductive age, and both syndromes have been reported to exacerbate during periods of hormonal flux such as oral contraceptive administration, pregnancy, or the puerperium. These disorders have features which cause them to resemble other multisystem diseases. PAPS and SLE must be differentiated from preeclampsia with HELLP syndrome and thrombotic thrombocytopenic purpura occurring during pregnancy. These four disorders differ in prognosis and required therapies. We report an instructive case of PAPS in a patient who developed microscopic polyarteritis with significant glomerulonephritis following prostaglandin-induced delivery of a stillborn fetus. We compare the manifestations of PAPs, SLE, HELLP, and thrombocytopenic purpura, and discuss the possible role of hormonal imbalance as a precipitating event.
International Archives of Allergy and Immunology 02/1994; 103(3):311-6. · 2.40 Impact Factor
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Peritoneal dialysis international: journal of the International Society for Peritoneal Dialysis 02/1992; 12(3):323-5. · 2.10 Impact Factor
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ABSTRACT: Dialysate and blood leukocyte counts were measured during 130 episodes of peritonitis in 91 hospitalized patients on long-term peritoneal dialysis (CPD). The authors found that the blood/dialysate leukocyte count can be less than 1.0, and this is usually the case when dialysate leukocyte count exceeds 20,000/mm3. Dialysate leukocyte removal in a single 2 L drain bag can approach the leukocyte number in the entire circulating blood volume. Daily drainage can remove leukocytes in amounts exceeding the blood leukocyte pool 2 to 3 fold. The observed blood leukocyte counts throughout a range of 2,700 to 10,000 at dialysate leukocyte counts greater than 20,000 per mm3 may reflect: 1) leukocyte removal approaching maximum bone marrow output of leukocytes, and/or 2) increasing microcirculatory margination of leukocytes in those episodes of peritonitis associated with very high dialysate leukocyte counts.
ASAIO Journal 41(2):194-7. · 1.39 Impact Factor
