A Case of Normoreninemic Aldosterone-Producing Adenoma Associated with Chronic Renal Failure: Case Report and Literature Review

Endocrine ◽  
2003 ◽  
Vol 21 (3) ◽  
pp. 221-226 ◽  
Author(s):  
Hiroyuki Koshiyama ◽  
Takeshi Fujisawa ◽  
Naomitsu Kuwamura ◽  
Yoshio Nakamura ◽  
Hiroshi Kanamori ◽  
...  
2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Xin Cao ◽  
Qiang Fang ◽  
Hao Shi

The syndrome of acute bilateral basal ganglia lesions is an uncommon clinical occurrence exhibiting acute onset of movement abnormalities, which can be seen almost exclusively among patients with chronic renal failure, especially in the setting of concurrent diabetes mellitus. Symmetrical lesions located in basal ganglia demonstrated in MRI are typical manifestation of this syndrome. Our study includes routine MRI examination, MRS, 3D-ASL, and SWI findings, which have been rarely reported and will contribute to diagnosing more cases about this syndrome.


2020 ◽  
Vol 7 (S) ◽  
pp. S30-S33
Author(s):  
Chahrazed Bekhtaoui ◽  
◽  
Hichem Bouguedra ◽  
Abderrahmane Boulerial ◽  
Hassen Chadou ◽  
...  

En Algérie, le protocole thérapeutique à base d’hydroxychloroquine essentiellement fut adopté depuis le 23 mars 2020, auquel ont été soumis les patients atteints de Covid-19. Ce protocole a prouvé son efficacité "quasi totale" selon le taux de guérison de 98.2% sur un total 16000 cas traités [1]. L’hydroxychloroquine (HCQ) est préférée pour sa meilleure tolérance attendue, sur la base des publications de travaux préliminaires de plusieurs équipes que nous avons analysées précédemment avec un recul de trois mois supplémentaires. Sur le plan pharmaceutique, on s’intéresse à la pharmacologie de cette molécule et souligne l’intérêt d’études pharmacocinétiques pour définir le schéma posologique optimal pour les patients avec un statut particulier (Insuffisance Rénale - Insuffisance Hépatique - grossesse) COVID-19. Sur la base de ces travaux, on peut proposer des ajustements posologiques et optimiser la chronologie d’administration avec une surveillance thérapeutique des médicaments qui doit être pratiquée pour personnaliser le schéma posologique individuel. Donc le rôle du pharmacien hospitalier est essentiel dans le contexte de la pandémie pour optimiser et modifier les pratiques en élaborant de nouveaux protocoles d’ordonnance tout en s’assurant d’une bonne gestion des effets indésirables.


1970 ◽  
Vol 5 (3) ◽  
pp. 53-67
Author(s):  
Aline Dos Santos ◽  
Ana Caroline Balducci Scafi ◽  
Luciene Azevedo Morais ◽  
Pablo Girardelli Mendonça Mesquita

RESUMOIntrodução: A Granulomatose de Wegener (GW) é uma vasculite rara e idiopática associada à presença do anticorpo Anticitoplasma de Neutrófilo (ANCA) que acomete, preferencialmente, os pequenos vasos. As manifestações clínicas são diversas, ocorrendo em mais de 90% dos casos, sintomas do trato respiratório. O comprometimento renal é tardio e preditor de mau prognóstico.  Sua morbidade a médio e longo prazo inclui insuficiência renal crônica. A probabilidade de sucesso de manutenção da função renal depende da concentração sérica de creatinina ao início do tratamento, o que indica a importância do diagnóstico e terapêutica adequada precoces. Casuística: Relata-se o caso de uma paciente do sexo feminino, 61 anos, portadora de GW com comprometimento renal avançado à apresentação não precedido por sintomas pulmonares esperados. O tratamento imunossupressor associado a plasmaferese permitiu a melhora da função renal da paciente poupando-a de tornar-se dialítica- dependente. Discussão: A paciente iniciou a doença através de insuficiência renal assintomática, com valores de função renal compatíveis com o estágio mais avançado de doença renal crônica, ultrassonografia dos rins sem alterações compatíveis e sem os sintomas respiratórios esperados. Segundo a literatura, a combinação de imunossupressores e plasmaferese associa-se à recuperação renal em três meses com sobrevivência sem necessidade de diálise por 12 meses, no caso relatado, obteve-se tal resultado em 22 dias sem a necessidade de diálise após um ano. Conclusão: Devido ao diagnóstico precoce, o tratamento adequado foi instalado rapidamente proporcionando à paciente um aumento da expectativa e da qualidade de vida, evitando dependência de terapia renal substitutiva.Palavras-Chave: Granulomatose de Wegener, Plasmaferese, Doença renal crônica.  ABSTRACTIntroduction: The Wegener's Granulomatosis (WG) is a rare and idiopathic vasculitis associated with the presence of Antineutrophil Cytoplasmic Antibody (ANCA), that affects, preferentially, the small vessels. The clinical manifestations are diverse, occurring in over 90% of cases, symptoms in the respiratory tract. Kidney damage is a late and bad prognostic predictor. Morbidity in the medium and long term includes chronic renal failure. The probability of renal function maintenance success depends on serum creatinine concentration at the beginning of treatment that indicates the importance of early diagnosis and deployment of an appropriate therapy. Case Report: We present a case of a 61-year-old female patient, carrier of GW with advanced renal impairment presentation, not preceded by expected pulmonary symptoms. The immunosuppressive treatment associated with plasmapheresis allowed the improvement of the patient’s renal function, saving her from becoming dialysis-dependent Discussion: The patient developed the disease through asymptomatic renal failure, renal function with values that are compatible with the most advanced stage of chronic kidney disease, ultrasound of the kidneys without compatible changes and without the expected respiratory symptoms. According to the literature, the combination of immunosuppressive drugs and plasmapheresis is associated with renal recovery in three months with survival without dialysis for 12 months. In this case, a result was obtained in 22 days without the need for dialysis after one year. Conclusion: Due to the early diagnosis, appropriate treatment was quickly installed giving the patient increased life expectancy and quality, preventing dependence on renal replacement therapy.Keywords: Wegener’s granulomatosis, Plasmapheresis, Chronic renal failure.


2012 ◽  
Vol 45 (3) ◽  
pp. 170-172 ◽  
Author(s):  
Fabrício Guimarães Gonçalves ◽  
Prasad Baladev Hanagandi ◽  
Carlos Ignacio Torres ◽  
Raquel DelCarpio-O'Donovan

Disc herniation with posterior epidural migration is a rare and often symptomatic entity. Multiple are the natural barriers that prevent this pattern of migration. Enhanced magnetic resonance imaging is the diagnostic modality of choice in these cases. The diagnostic dilemma in this case was the contraindication to the use of contrast since the patient was known to have chronic renal failure.


2013 ◽  
Vol 12 (4) ◽  
Author(s):  
NM Aldemir ◽  
H Begenik ◽  
H Emre ◽  
FM Erdur ◽  
Y Soyoral

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