ABSTRACT
4 liters of polyethylene glycol (PEG) solution is commonly used to evacuate the colon before colonoscopy. This substance, however, is known to cause electrolyte abnormalities such as hyponatremia. Seizures caused by hyponatremia associated with bowel preparation have only rarely been reported. We report the case that a 75-year-old woman with no prior history of seizures was developed severe hyponatremia (112 mEq/L) with generalized tonic-clonic seizure and mental change after ingestion of 4L of PEG solution. Past medical history was notable for thiazide diuretics. Her symptoms are improved during intravenous administration of hypertonic saline for the correction of hyponatremia. Patients with impaired ability to excrete free water those with renal insufficiency, hypothyroidism, mineralocorticoid deficiency, liver cirrhosis, or heart failure as well as those taking drugs which including thiazide diuretics, NASIDs, and ACE inhibitors have risk of hyponatremia following bowel preparation for colonoscopy. We conclude that physicians should check patient's condition and electrolyte abnormalities before colonoscopy procedures.
Subject(s)
Female , Humans , Administration, Intravenous , Angiotensin-Converting Enzyme Inhibitors , Colon , Colonoscopy , Eating , Heart Failure , Hyponatremia , Hypothyroidism , Liver Cirrhosis , Polyethylene , Polyethylene Glycols , Renal Insufficiency , Seizures , Sodium Chloride Symporter Inhibitors , WaterABSTRACT
Posterior reversible encephalopathy syndrome (PRES) is a clinical radiologic syndrome which is characterized by reversible neurological and radiological findings. It is associated with an abrupt and severe increase in blood pressure, eclampsia, chronic kidney disease with hypertension and using various immunosupressive drugs. Patient with chronic kidney disease could be especially vulnerable to this syndrome because they are frequently exposed to several possible causes as uremia, hypertension, or electrolyte imbalance. We report a case of posterior reversible encephalopathy syndrome in a patient having continuous ambulatory peritoneal dialysis.
Subject(s)
Female , Humans , Pregnancy , Blood Pressure , Eclampsia , Hypertension , Kidney Failure, Chronic , Peritoneal Dialysis, Continuous Ambulatory , Posterior Leukoencephalopathy Syndrome , Renal Insufficiency, Chronic , UremiaABSTRACT
A 53-year-old male was hospitalized with abdominal pain and turbid peritoneal fluid. He was diagnosed with hypertension, diabetic nephropathy and started continuous ambulatory peritoneal dialysis (CAPD) 4 years ago. Initial peritoneal fluid analysis demonstrated CAPD peritonitis. As initial antibiotic therapy, ceftazidime/vancomycin were injected intraperitoneally. But drug sensitivity test revealed these regimens were ineffective. On sixth hospital day, Brevundimonas vesicularis (B. vesicularis) was cultured from peritoneal fluid, this strain was susceptible to imipenem, piperacillin and resistant to ceftazidime. Accordingly we changed the antibiotics to imipenem, which was administered for 14 days, but analysis of peritoneal fluid was seldom improved. Finally, CAPD catheter was removed, and hemodialysis was started. After CAPD catheter removal, peritonitis improved rapidly. B.vesicularis is a rare opportunistic organism in CAPD peritonitis. Because this peritonitis may not improve in spite of medical treatment with susceptible antibiotics, CAPD catheter must be removed finally.
Subject(s)
Humans , Male , Middle Aged , Abdominal Pain , Anti-Bacterial Agents , Ascitic Fluid , Catheters , Ceftazidime , Diabetic Nephropathies , Hypertension , Imipenem , Peritoneal Dialysis, Continuous Ambulatory , Peritonitis , Piperacillin , Pseudomonas , Renal Dialysis , Sprains and StrainsABSTRACT
Distal renal tubular acidosis is classified into primary and secondary. Sjogren Syndrome is the most common cause of secondary distal RTA. We experienced a 51 year-old female patient who had many manifestations of primary Sjogren syndrome which showes Distal renal tubular acidosis, acute pancreatitis, acute renal failure, possibly nephrogenic diabetes insipidus, but We found other atypical findings including ANA negative serology, high anion gap metabo1ic acidosis.
Subject(s)
Female , Humans , Middle Aged , Acid-Base Equilibrium , Acidosis , Acidosis, Renal Tubular , Acute Kidney Injury , Diabetes Insipidus, Nephrogenic , Pancreatitis , Sjogren's SyndromeABSTRACT
A 34-year-old male who has recieved regular hemodialysis three times a week for 2years due to chronic renal failure was admitted due to chest pain. Chest x-ray and computed tomography showed large sized anterior mediastinal mass compressing heart and great vessels posteriorly. Open lung biopsy was performed and the result was spindle cell type thymoma. We recommanded surgical resection but he refused and discharged. After 8 months, we observed marked regression of the thymoma without any other treatment. We report a case of spontaneous regression of thymoma in patient with chronic renal failure during regular hemodialysis.