scholarly journals Probable Linezolid-Induced Pancytopenia

2005 ◽  
Vol 16 (5) ◽  
pp. 286-288 ◽  
Author(s):  
Nita Lakhani ◽  
William Thompson ◽  
Anne Marie Bombassaro
Keyword(s):  
Staphylococcus Aureus ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Cardiac Disease ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Deficiency Anemia ◽  
Patients At Risk ◽  
Baseline Values ◽  
Baseline Levels ◽  
Diabetic Foot Osteomyelitis

A 75-year-old male outpatient with cardiac disease, diabetes, chronic renal insufficiency and iron deficiency anemia was prescribed linezolid 600 mg twice daily for a methicillin-resistant Staphylococcus aureus diabetic foot osteomyelitis. After one week, his blood counts were consistent with baseline values. The patient failed to return for subsequent blood work. On day 26, he was admitted to hospital with acute renal failure secondary to dehydration, and was found to be pancytopenic (erythrocytes 2.5x1012/L, leukocytes 2.9x109/L, platelets 59x109/L, hemoglobin 71 g/L). The patient was transfused, and linezolid was discontinued. His blood counts improved over the week and remained at baseline two months later. The patient's decline in blood counts from baseline levels met previously established criteria for clinical significance. Application of the Naranjo scale indicated a probable relationship between pancytopenia and linezolid. Clinicians should be aware of this rare effect with linezolid, and prospectively identify patients at risk and emphasize weekly hematological monitoring.

Effect of L-arginine on myoglobin-induced acute renal failure in the rabbit

1996 ◽  
Vol 270 (5) ◽  
pp. F784-F789
Author(s):  
Y. Wakabayashi ◽  
R. Kikawada
Keyword(s):  
Nitric Oxide ◽  
Renal Failure ◽  
Blood Flow ◽  
Acute Renal Failure ◽  
Protective Effect ◽  
Potent Inhibitor ◽  
Renal Vasoconstriction ◽  
Baseline Levels ◽  
Nitrite Nitrate ◽  
Renal Vascular

Because myoglobin is a potent inhibitor of nitric oxide (NO), we tested whether myoglobin infusion results in renal vasoconstriction and dysfunction, on which L-arginine, a source of NO, has a protective effect in sedated, nondehydrated, and nonacidotic rabbits. The infusion of myoglobin (375 mg/kg) resulted in a decrease in renal blood flow, an increase in renal vascular resistance, and a decrease in creatine clearance associated with a decrease in urinary excretory rate of nitrite/nitrate and guanosine 3',5'-cyclic monophosphate (cGMP). These values 1-2 h after the infusion were significantly different from baseline levels. Co-administration of L-arginine (150 mg/kg bolus followed by 150 mg.kg(-1).min(-1) reversed these changes significantly with attenuation of urinary excretory rate of nitrite/nitrate and cGMP. This study suggests that the myoglobin-induced renal vasoconstriction and dysfunction and protective effect of L-arginine on these outcomes could be mediated through the NO system.

Serum Cystatin C-A Useful Endogenous Marker of Renal Function in Intensive Care Unit Patients at Risk for or with Acute Renal Failure?

2007 ◽  
Vol 14 (21) ◽  
pp. 2314-2317 ◽  
Author(s):  
Annick A. Royakkers ◽  
Jeroen van Suijlen ◽  
Lieuwe Hofstra ◽  
Michael Kuiper ◽  
Catherine Bouman ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
At Risk ◽  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Intensive Care ◽  
Cystatin C ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Patients At Risk

Erythropoietin enhances recovery from cisplatin-induced acute renal failure

1994 ◽  
Vol 266 (3) ◽  
pp. F360-F366 ◽  
Author(s):  
N. D. Vaziri ◽  
X. J. Zhou ◽  
S. Y. Liao
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Functional Recovery ◽  
Deficiency Anemia ◽  
Control Group ◽  
Cortical Tissue ◽  
Sprague Dawley ◽  
Arterial Blood ◽  
Significant Difference ◽  
Epo Deficiency

Acute renal failure (ARF) is associated with erythropoietin (EPO) deficiency anemia. The present study was designed to determine whether the course of ARF can be altered by preventing EPO deficiency and the associated anemia. Sprague-Dawley rats were injected with a single dose of cisplatin (CP), 7 mg/kg intraperitoneally, and randomized into recombinant EPO-treated (EPO), placebo-treated (control), recombinant EPO-treated pair-fed (EPO-PF), and EPO-treated anemic (EPO-anemic) groups. They were then treated with daily injections of recombinant EPO, 100 U/kg, or placebo for 9 days. Animals in the EPO-anemic group received daily phlebotomies gauged to maintain hematocrits equal to those in the control group. Rats in the EPO-PF group were pair fed with the controls. The control and EPO-anemic groups showed a fall, whereas the EPO and EPO-PF groups showed a rise in hematocrit on day 9. Although blood volume on day 9 was significantly greater in the EPO group than in either the EPO-anemic group or the control group, it was comparable in the latter groups. An equally severe reduction in creatinine clearance (CCr) was found in all groups on day 4. However, measurements of CCr and inulin clearance on day 9 revealed a significantly greater functional recovery in the EPO, EPO-PF, and EPO-anemic groups than in the controls. The enhanced functional recovery with EPO administration was accompanied by an increased tubular regeneration and [3H]thymidine incorporation in the cortical tissue. No significant difference was found in either cortical tissue iron content or arterial blood pressure in the study groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Septic Parotitis: Incidence, Aetiology and Management

1972 ◽  
Vol 17 (2) ◽  
pp. 62-66 ◽  
Author(s):  
C. F. Speirs ◽  
D. K. Mason
Keyword(s):  
Staphylococcus Aureus ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
20Th Century ◽  
Clinical Features ◽  
Hospital Admissions ◽  
Present Survey ◽  
Factors Influencing ◽  
Incidence And Mortality ◽  
Future Management

The clinical details, management and bacteriology of acute septic parotitis in 36 patients occurring during the period 1956–67 are reviewed. The incidence of acute septic parotitis increased from 0.009 per cent of hospital admissions during 1956–61 to 0.016 per cent in the period 1962–67. In the period 1956–61, the organism most commonly isolated was Streptococcus viridans; during the period 1962–67 it was Staphylococcus aureus and more than 50 per cent of the latter were penicillin-resistant. During the period 1962–67, 4 patients with acute septic parotitis died during the course of their hospitalisation. All had acute renal failure as well as the clinical features of bacteraemic shock. The factors influencing the incidence and mortality of acute septic parotitis during the 20th century are considered. A regime for the future management of this condition, based upon an analysis of the present survey is suggested.

Hemolysis and Methemoglobinemia Secondary to Rasburicase Administration

2005 ◽  
Vol 39 (11) ◽  
pp. 1932-1935 ◽  
Author(s):  
Linda A Browning ◽  
James A Kruse
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Hemolytic Anemia ◽  
G6pd Deficiency ◽  
Tumor Lysis Syndrome ◽  
Simultaneous Occurrence ◽  
Arterial Blood Gas ◽  
Chemotherapy Administration ◽  
Arterial Blood ◽  
Patients At Risk

OBJECTIVE To report a case of hemolytic anemia and methemoglobinemia developing after rasburicase administration to a patient with glucose-6-phosphate dehydrogenase (G6PD) deficiency. CASE SUMMARY A 50-year-old African American man was hospitalized with new onset seizure, diabetic ketoacidosis, respiratory failure, and acute renal failure. Serum uric acid concentrations were elevated, and the patient was treated with one dose of intravenous rasburicase 22.5 mg for acute renal failure secondary to hyperuricemia. Routine arterial blood gas analyses performed after rasburicase was administered revealed elevated methemoglobin concentrations, which peaked at 14.7%. Hemolytic anemia developed as evidenced by a fall in blood hemoglobin from 14.8 to 5.3 g/dL. The patient made a full recovery following aggressive fluid therapy, blood transfusions, and respiratory support. G6PD deficiency was subsequently confirmed. The Naranjo probability scale indicated that rasburicase was a probable cause of hemolytic anemia and methemoglobinemia. DISCUSSION Rasburicase is contraindicated in patients with G6PD deficiency as it may cause hemolytic anemia and methemoglobinemia. As of September 26, 2005, simultaneous occurrence of hemolytic anemia and methemoglobinemia has not been reported in patients receiving rasburicase. CONCLUSIONS As of September 26, 2005, screening for G6PD deficiency should be performed whenever possible prior to chemotherapy administration in patients at risk of developing tumor lysis syndrome.

scholarly journals Mannitol-induced acute renal failure.

1997 ◽  
Vol 8 (6) ◽  
pp. 1028-1033
Author(s):  
P Visweswaran ◽  
E K Massin ◽  
T D Dubose
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
High Dose ◽  
Clinical Settings ◽  
Renal Protection ◽  
Intravenous Contrast ◽  
Cyclosporine Therapy ◽  
Patients At Risk ◽  
Tubular Toxicity

The osmotic diuretic mannitol may be used in diverse clinical settings, such as providing "renal protection" in patients at risk for acute renal failure, decreasing intracranial pressure in patients with intracranial trauma, and preventing the dialysis-disequilibrium syndrome. Mannitol is commonly used after cardiac catheterization, cardiovascular surgery, and exposure to intravenous contrast dyes. This study presents a case in which a long-term renal transplant recipient receiving cyclosporine therapy concomitantly developed acute renal failure after the administration of high-dose mannitol in an attempt to induce an osmotic diuresis. The diagnosis of "osmotic nephrosis" was confirmed by renal biopsy, and the condition was reversed by cessation of the agent. Studies in experimental animals indicate that cyclosporin A can potentiate the tubular toxicity of mannitol, but such an association has not been verified in humans. Numerous studies confirm the nephrotoxic potential of high-dose mannitol, especially in patients with renal insufficiency. The clinical utility of the osmolar gap in preventing mannitol nephrotoxicity is emphasized.

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