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ABSTRACT: Diffuse alveolar hemorrhage (DAH) is rarely seen in patients with systemic lupus erythematosus (SLE), often associated with a poor outcome. It almost affects young women and it is an unusual initial manifestation of SLE. We report a case of SLE presenting with DAH. The patient was a male. He had no history of photosensitivity, malar rash, discoid rash, arthritis, and oral ulcer. Antinuclear antibody, and anti-double stranded DNA (dsDNA) were positive with very high titers, and serum complement levels (C3, C4) were low. He also had renal dysfunction and pericardial effusion. He was diagnosed as DAH due to SLE. He had to undergo hemodialysis for several weeks. DAH and renal dysfunction were improved with intensive treatment including corticosteroid, cyclophosphamide, and mycophenolate mophetil.
Rheumatology International 10/2009; 31(8):1085-7. · 1.88 Impact Factor
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ABSTRACT: To investigate antiproteinuric effect of spironolactone in patients with chronic kidney disease (CKD) treated with angiotensin-converting enzyme (ACE) inhibitors and/or angiotensin II type 1 receptor blockers (ARBs).
This study was performed in 33 CKD patients with proteinuria. 24 h urinary protein excretion and biochemical parameters were obtained before the therapy. Then, spironolactone (25 mg/d) was added to the therapy. The antiproteinuric effect of spironolactone was examined for eight weeks.
At eight weeks, there was a significant decrease in proteinuria (p < 0.001, 47.9% decrease). Systolic and diastolic blood pressures were significantly decreased (p < 0.004, p < 0.001, respectively). However, no correlation was detected between the reductions in systolic and diastolic BP and the reduction in proteinuria (p = 0.464, p = 0.239, respectively). Serum potassium level increased significantly (p < 0.001).
Our study suggests that spironolactone significantly reduces urinary protein excretion. This strategy may be useful to slow the progression of CKD. However, hyperkalemia is the most important side effect of treatment, and it is necessary to monitor potassium level. Further studies are needed to determine the efficacy of spironolactone on proteinuria.
Renal Failure 01/2009; 31(10):928-32. · 0.82 Impact Factor
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ABSTRACT: Acute renal failure is a well-recognized complication of acute leukaemias. Howevcr, serious renal failure caused by leukaemic infiltration as a primary manifestation is unusual. Here we report two patients with acute lymphoblastic leukaemia presenting with acute renal failure due to leukaemic infiltration. The first patient died before the administration of specific therapy for leukaemia, whereas the second case recovered after chemotherapy. She was discharged without necessitating dialysis therapy.
Journal of the Pakistan Medical Association 10/2008; 58(9):512-4.
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ABSTRACT: A 49-year-old female patient on continuous ambulatory peritoneal dialysis presented with fever, abdominal pain and loss of appetite. While peritoneal fluid bacterial cultures remained negative, she had no relief after 3 weeks of broad-spectrum antibiotics for possible bacterial peritonitis. In a peritoneal fluid sample, Mycobacterium tuberculosis DNA was detected by nucleic acid amplification using real-time PCR testing. The initiation of antituberculous therapy (isoniazid, rifampicin, ethambutol and pyrazinamide) was followed by resolution of fever and abdominal pain within one week. Nucleic acid amplification tests can play an important role in the species-specific diagnosis of tuberculous peritonitis.
Apmis 10/2006; 114(9):656-8. · 1.99 Impact Factor
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ABSTRACT: Patients receiving dialysis therapy are known to be at increased risk of tuberculosis (TB). The aim of this study was to evaluate the frequency, clinical characteristics and course of TB disease in dialysis patients treated at our institution. Medical records of 330 regular haemodialysis (n=219) and continuous ambulatory peritoneal dialysis (n=111) patients (172 male, 158 female; mean age 55+/-16 y) who were cared for at our tertiary university hospital between December 2002 and January 2006 were retrospectively evaluated. Nine cases of TB (2.7%) occurred, in the following locations: vertebra (n=3), miliary (n=3), lymph nodes (n=1), peritoneum (n=2; one as peritionitis, 1 as an abscess). Four of these 9 patients died during the follow-up (mean time from diagnosis to death, 7 months); none of the deaths appeared to be caused by the disease itself. The incidence of TB disease in patients receiving renal replacement therapy is high, and occurs primarily in extrapulmonary sites.
Scandinavian Journal of Infectious Diseases 02/2006; 38(11-12):1040-4. · 1.72 Impact Factor
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Peritoneal dialysis international: journal of the International Society for Peritoneal Dialysis 27(5):593-5. · 2.10 Impact Factor
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Peritoneal dialysis international: journal of the International Society for Peritoneal Dialysis 28(5):547-50. · 2.10 Impact Factor
