ABSTRACT
Acute renal failure is a rare complication of acute pyelonephritis. Therefore, acute pyelonephritis is not usually considered in the differential diagnosis of acute renal failure. However, it is important to consider this entity because of potential for recovery of renal function if appropriate early antibiotics are instituted. We report a case of biopsy proven acute pyelonephritis which was manifested as acute renal failure. A 38 year old women was admitted to this hospital owing to abdominal distension and generalized edema. On admission she was started on hemodialysis because of severe hyperkalemia and marked uremic sypmtoms. She had pyuria and hematuria, but no organism was isolated at urine. We initially don't know the cause of renal failure. She was improved with antimicrobial therapy and hemodialysis. A kidney biopsy was performed on the 26th hospital day because of persistent proteinuria. Microscopic examination revealed focal tubular atrophy, necrosis or loss with heavy infilteration of leukocytes and histocytes in interstitium. Atrophic tubules contain pus casts. The patient was treated with ciprofloxacin for 4 weeks. At about 2 month follow up, proteinuria completely disappeared and serum creatinine level decreased to 1.0 mg/dL.
Subject(s)
Adult , Female , Humans , Acute Kidney Injury , Anti-Bacterial Agents , Atrophy , Biopsy , Ciprofloxacin , Creatinine , Diagnosis, Differential , Edema , Follow-Up Studies , Hematuria , Hyperkalemia , Kidney , Leukocytes , Necrosis , Proteinuria , Pyelonephritis , Pyuria , Renal Dialysis , Renal Insufficiency , SuppurationABSTRACT
Rhododendron brachycarpum has been known as a panacea in Korean folk medicine, and is used to treat various diseases including hypertension. Excessive ingestion can cause intoxication by grayanotoxin. We experienced a 59 year-old man suffering of grayanotoxin intoxication following excessive ingestion of Rhododendron brachycarpum. The patient presented dizziness, weakness, and chest discomfort with cold sweats. Electrocardiography showed marked sinus bradycardia with atrio-ventricular dissociation. With intravenous saline and atropine, the patient recovered. This case calls attention to the potential cardiotoxicity of Korean folk medicine Rhododendron brachycarpum.
Subject(s)
Humans , Middle Aged , Atropine , Bradycardia , Dizziness , Eating , Electrocardiography , Hypertension , Medicine, Traditional , Rhododendron , Sweat , ThoraxABSTRACT
BACKGROUND AND OBJECTIVES: We investigated in patients with coronary vasospastic angina whether the exercise ECG test results are influenced by the different modes of exercise load and compared the clinical characteristics including coronary risk factors between patients with positive and negative exercise tests. MATERIALS AND METHODS: This study comprised 34 patients with documented coronary artery spasm without significant stenosis (coronary artery luminal diameter narrowing 50%, <70% of luminal diameter) or total cholesterol level between patients with positive and negative results. In 18 typical variant angina patients by clinical history, 8 of 10 patients with high disease activity (5 times or more attack per week) manifested positive result by GET or NGET, whereas 4 of 8 patients with low disease activity (80 vs. 50%, P=NS). CONCLUSION: In patients with coronary vasospastic angina, sudden rapid exercise could induce more frequently coronary artery spasm than multistage exercise. The result of an exercise test may not be correlated with coronary risk factors, coronary anatomy, effort chest pain, and the disease activity.