ABSTRACT
A 25-year-old male presented with mitral insufficiency, perimembranous type of ventricular septal defect, pulmonary edema and renal insufficiency. The initial serum creatinine level was 16.2mg/dl. Blood cultures were positive for Streptococcus viridans and appropriate antibiotic therapy was initiated. Renal biopsy revealed diffuse proliferative glomerulonephritis with crescents involving all of the glomeruli. Even after adequate duration of treatment with antibiotics, surgical therapy, and high dose steroid therapy, renal function did not recover and the patient ended up with continuous ambulatory peritoneal dialysis. We present a case of crescentic glomerulonephritis associated with bacterial endocarditis with a review of the literature.
Subject(s)
Adult , Humans , Male , Anti-Bacterial Agents , Biopsy , Creatinine , Endocarditis, Bacterial , Glomerulonephritis , Heart Septal Defects, Ventricular , Mitral Valve Insufficiency , Peritoneal Dialysis, Continuous Ambulatory , Pulmonary Edema , Renal Insufficiency , Viridans StreptococciABSTRACT
The Ajou University Hospital opened in September, 1994. We performed our first kidney transplant in June 1995. So far, we have performed 40 kidney transplants with all of the recipients having excellent renal function at present. We now report the various clinical aspects of kidney transplant recipients operated at the Ajou University Hospital. The kidney transplant program at the Ajou Univerisity Hospital has several characteristics in comparison to other hospitals in Korea. One of them is a higher proportion of cadaveric donor (37.5%). Another is ALG (anti-lymphocyte globulin) induction of immunosuppression in the selected cases of cadaveric renal transplantation. The incidence of early rejection was significantly decreased by the introduction of ALG induction in cadaveric renal transplant compared with cyclosporine induction. We have aggressively performed the renal allograft biopsies in cases of early graft dysfunction or unexplained change in graft function during the follow-up. In cases of delayed graft function, we have done routine graft biopsies at regular intervals, which helped detect early episodes of acute rejection superimposed upon severe acute tubular necrosis. The occurrence of polycythemia (20%) after renal transplantation was primarily controlled by ACE(angiotensin-convertine enzyme) inhibitor except in one case of chronic rejection. As a result of well coordinated efforts by all the members in the transplant team, all 40 patients have done exceptionally well, and the serum creatinine levels in all the patients are under 2.0 mg/dl.
Subject(s)
Humans , Allografts , Biopsy , Cadaver , Creatinine , Cyclosporine , Delayed Graft Function , Follow-Up Studies , Immunosuppression Therapy , Incidence , Kidney Transplantation , Kidney , Korea , Necrosis , Polycythemia , Tissue Donors , Transplantation , TransplantsABSTRACT
The Ajou University Hospital opened in September, 1994. We performed our first kidney transplant in June 1995. So far, we have performed 40 kidney transplants with all of the recipients having excellent renal function at present. We now report the various clinical aspects of kidney transplant recipients operated at the Ajou University Hospital. The kidney transplant program at the Ajou Univerisity Hospital has several characteristics in comparison to other hospitals in Korea. One of them is a higher proportion of cadaveric donor (37.5%). Another is ALG (anti-lymphocyte globulin) induction of immunosuppression in the selected cases of cadaveric renal transplantation. The incidence of early rejection was significantly decreased by the introduction of ALG induction in cadaveric renal transplant compared with cyclosporine induction. We have aggressively performed the renal allograft biopsies in cases of early graft dysfunction or unexplained change in graft function during the follow-up. In cases of delayed graft function, we have done routine graft biopsies at regular intervals, which helped detect early episodes of acute rejection superimposed upon severe acute tubular necrosis. The occurrence of polycythemia (20%) after renal transplantation was primarily controlled by ACE(angiotensin-convertine enzyme) inhibitor except in one case of chronic rejection. As a result of well coordinated efforts by all the members in the transplant team, all 40 patients have done exceptionally well, and the serum creatinine levels in all the patients are under 2.0 mg/dl.