Case 7-2006: A Man with Altered Mental Status and Acute Renal Failure

2006 ◽  
Vol 354 (25) ◽  
pp. 2727-2729 ◽  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Mental Status ◽  
Altered Mental Status

scholarly journals Antacids, Altered Mental Status, and Milk-Alkali Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Simon C. Watson ◽  
Bonnie B. Dellinger ◽  
Katie Jennings ◽  
Lancer A. Scott
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Peptic Ulcer ◽  
Mental Status ◽  
Proton Pump ◽  
Metabolic Alkalosis ◽  
Altered Mental Status ◽  
Ulcer Disease ◽  
Calcium Supplements ◽  
Patients At Risk

The frequency of milk-alkali syndrome decreased rapidly after the development of histamine-2 antagonists and proton pump inhibitors for the treatment of peptic ulcer disease; however, the availability and overconsumption of antacids and calcium supplements can still place patients at risk (D. P. Beall et al., 2006). Here we describe a patient who presented with altered mental status, hypercalcemia, metabolic alkalosis, and acute renal failure in the context of ingesting large amounts of antacids to control dyspepsia.

scholarly journals PROLONGED HYPERCALCEMIA FROM ANTIBIOTIC-ELUTING CALCIUM SULFATE BEADS

2019 ◽  
Vol 5 (6) ◽  
pp. e349-e351 ◽  
Author(s):  
Amy Vora ◽  
Sadia Ali
Keyword(s):  
Renal Failure ◽  
Mental Status ◽  
Serum Calcium ◽  
Calcium Sulfate ◽  
Volume Overload ◽  
Altered Mental Status ◽  
Caucasian Woman ◽  
Local Antibiotics ◽  
Joint Infections ◽  
Severe Hypercalcemia

Objective: Calcium sulfate beads (CSBs) are biocompatible hydrophilic crystals that are used to deliver local antibiotics in periprosthetic joint infections. Hypercalcemia after placement of CSBs is uncommon and poorly understood. Methods: We present the case of a woman who presented with symptomatic hypercalcemia after placement of antibiotic-eluting CSBs. Results: A 58-year-old, Caucasian woman presented with altered mental status, respiratory failure, and septic shock 2 days after placement of antibiotic-eluting CSBs for a left prosthetic hip infection. Laboratory analysis revealed severe hypercalcemia at presentation. She had no known history of fractures, kidney stones, parathyroid, or calcium disorders. She was not on any medications that could induce hypercalcemia. She was treated with aggressive intravenous hydration and 8 doses of calcitonin. Due to impaired renal function, bisphosphonate was contraindicated. She subsequently became anuric with worsening renal failure and volume overload and the decision was made to initiate dialysis. She received 8 days of continuous renal replacement therapy followed by 2 sessions of hemodialysis which improved her serum calcium levels, mental status, and renal failure with no long-term complications. Conclusion: Hypercalcemia secondary to the placement of antibiotic-eluting CSBs is rare. Larger volumes of CSBs may contribute to hypercalcemia. In some cases, hypercalcemia can be severe and symptomatic as in the case of our patient. Serum calcium levels should be monitored frequently after placement of CSBs and managed as appropriate.

scholarly journals Posterior Reversible Encephalopathy Syndrome: A Case of Hypercalcemia

2018 ◽  
Vol 31 (6) ◽  
pp. 338
Author(s):  
Ana Ponciano ◽  
Vera Vieira ◽  
José Leite ◽  
Célio Fernandes
Keyword(s):  
Renal Failure ◽  
Immunosuppressive Therapy ◽  
Mental Status ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Altered Mental Status ◽  
Normotensive Patient ◽  
Posterior Reversible Encephalopathy ◽  
Severe Hypercalcemia ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome is an encephalopathy that can be clinically characterized by headache, altered mental status and/or seizures. Neuroimaging demonstrates usually reversible bilateral subcortical vasogenic occipital-parietal edema. Exact pathophysiology remains unclear but is commonly associated with hypertension, renal failure, sepsis and use of immunosuppressive therapy. Its development in the setting of severe hypercalcemia is extremely rare. The authors report a case of posterior reversible encephalopathy syndrome in a normotensive patient with severe hypercalcemia as the only identifiable cause.

scholarly journals Altered Mental Status and Renal Failure in a 58-Year-Old Woman

2010 ◽  
Vol 41 (9) ◽  
pp. 517-521
Author(s):  
Sara Taylor ◽  
Jonathan Yau
Keyword(s):  
Renal Failure ◽  
Mental Status ◽  
Altered Mental Status

Acute Renal Failure and Neurotoxicity following Oral Acyclovir

1994 ◽  
Vol 28 (4) ◽  
pp. 460-463 ◽  
Author(s):  
Gretchen L. Johnson ◽  
Lynn Limon ◽  
Gita Trikha ◽  
Hillary Wall
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Serum Creatinine ◽  
Mental Status ◽  
Case Reports ◽  
Signs And Symptoms ◽  
Published Data ◽  
Oral Acyclovir ◽  
Increased Risk ◽  
Intravenous Acyclovir

OBJECTIVE: To report a case of acute renal failureand neurotoxicity following administration of oral acyclovir. DATA SOURCES: Medical record of the patient, case reports identified by MEDLINE. DATA EXTRACTION: Data were abstracted from relevant published data by Johnson and reviewed by the remaining authors. CASE SUMMARY: A 69-year-oldwoman was diagnosed with herpes zoster and oral acyclovir was prescribed by her local physician. After approximately two days the patient was taken to the emergency department of a local hospital with signs of acute confusion and acute renal failure. Medications included oxycodone/acetaminophen, al prazolam, prazepam, and digoxin. Pertinent laboratory abnormalities included serum digoxin 4.1 μmol/L, white blood cell count 17.6 × 109/L, blood urea nitrogen (BUN) 24 mmol/L of urea, and serum creatinine 305 μmol/L (patient baseline is 11 mmol/L of urea and 91.5 serum creatinine μmol/L, respectively). Because of increasing lethargy and a focal seizure, she was transferred to our institution. Despitean extensive workup, no organiccause of her altered mental status and acute renal failure was identified. Four days after discontinuation of the acyclovir, without specific intervention, the patient's mental status improved and her BUN and serum creatinine concentrations had decreased to 21 mmol/L of urea and 190.6 μmol/L, respectively. On day 5, the patient was alert and oriented to name, place, year, and month, On day 9, her renal function and mental status had returned to baseline and she was discharged. CONCLUSIONS: Acute renal failure and neurotoxicity are usually associated with intravenous acyclovir. The temporal relationship between the initiation of oral acyclovir therapy and the onset of adverse events, supported by published data of a few similar cases, strongly implicateoral acycloviras the cause of this patient's acute renal failure and neurotoxicity. This case suggests that elderly patients with mild increased serum creatinine concentrations may be at increased risk and should be monitored closely for signs and symptoms of acute renal failure and neurotoxicity.

scholarly journals Hemodynamically significant atrial fibrillation in a previously healthy man with ethylene glycol toxicity

2014 ◽  
Vol 1 (1) ◽  
pp. 21
Author(s):  
Ryan Thompson ◽  
Allan R. Mottram
Keyword(s):  
Atrial Fibrillation ◽  
Renal Failure ◽  
Metabolic Acidosis ◽  
Ethylene Glycol ◽  
Mental Status ◽  
Altered Mental Status ◽  
Late Presentation ◽  
Electrical Cardioversion ◽  
Anion Gap ◽  
Healthy Man

Ethylene glycol ingestion is a well-described phenomenon that results in altered mental status, anion gap metabolic acidosis, and renal failure. Cardiac sequelae of ethylene glycol ingestion have not been well described in the literature. We report a case of a young, previously healthy man who developed atrial fibrillation successfully treated with electrical cardioversion in the setting of a large ethylene glycol ingestion with a late presentation.

A 37-Year-Old Woman with Altered Mental Status, Fever, and Renal Failure

1993 ◽  
Vol 8 (6) ◽  
pp. 298-309
Author(s):  
Nicholas A. Smyrnios ◽  
Mark C. Nitzberg ◽  
Richard S. Irwin
Keyword(s):  
Renal Failure ◽  
Mental Status ◽  
Altered Mental Status
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