ABSTRACT
Generalized hyperpigmentation has a wide range of causes, including endocrine diseases, uremia, drugs, and heavy metals. Cutaneous pigmentation observed in 70% of uremic patients on hemodialysis. However, it is clinically difficult to define the exact cause of hyperpigmentation in chronic renal failure patients. We experienced a case of cutaneous hyperpigmentation caused by generalized argyria in chronic hemodialysis patient. A 38-year-old male patient presented with slowly progressive blue-black discoloration of skin. He had been on maintenance hemodialysis for 5 years and took sliver pills 36 g daily during 2.5 years to relieve thirst. The other source of silver exposure could not be determined. Pathologic examination of skin biopsy specimen showed focal deposits of fine, uniform, brownish granules along the basement membrane zone of hair in the dermis, which is characteristic findings of argyria. The silver deposits were also confirmed by increase in serum silver level and silver amount in liver and skin tissue. Argyria should be suspected in chronic hemodialysis patients presenting with a diffuse bluish-gray discoloration of the skin and nails and evaluated carefully by skin biopsy with quantitation of tissue silver level.
Subject(s)
Adult , Humans , Male , Argyria , Basement Membrane , Biopsy , Dermis , Endocrine System Diseases , Hair , Hyperpigmentation , Kidney Failure, Chronic , Liver , Metals, Heavy , Pigmentation , Renal Dialysis , Silver , Skin , Thirst , UremiaABSTRACT
Generalized hyperpigmentation has a wide range of causes, including endocrine diseases, uremia, drugs, and heavy metals. Cutaneous pigmentation observed in 70% of uremic patients on hemodialysis. However, it is clinically difficult to define the exact cause of hyperpigmentation in chronic renal failure patients. We experienced a case of cutaneous hyperpigmentation caused by generalized argyria in chronic hemodialysis patient. A 38-year-old male patient presented with slowly progressive blue-black discoloration of skin. He had been on maintenance hemodialysis for 5 years and took sliver pills 36 g daily during 2.5 years to relieve thirst. The other source of silver exposure could not be determined. Pathologic examination of skin biopsy specimen showed focal deposits of fine, uniform, brownish granules along the basement membrane zone of hair in the dermis, which is characteristic findings of argyria. The silver deposits were also confirmed by increase in serum silver level and silver amount in liver and skin tissue. Argyria should be suspected in chronic hemodialysis patients presenting with a diffuse bluish-gray discoloration of the skin and nails and evaluated carefully by skin biopsy with quantitation of tissue silver level.
Subject(s)
Adult , Humans , Male , Argyria , Basement Membrane , Biopsy , Dermis , Endocrine System Diseases , Hair , Hyperpigmentation , Kidney Failure, Chronic , Liver , Metals, Heavy , Pigmentation , Renal Dialysis , Silver , Skin , Thirst , UremiaABSTRACT
No abstract available.
ABSTRACT
No abstract available.
ABSTRACT
OBJECTIVES: Hyperhomocysteinemia is frequently observed in patients with chronic renal failure and represents an independent cardiovascular risk factor in these patients. Elevated homocysteine plasma levels can result from defective remethylation of homocysteine to methionine due to decreased activity of the enzyme MTHFR. A genetic aberration in the MTHFR gene (677 C to T substitution) has been shown to result in reduced MTHFR activity. We examined whether elevation of homocysteine plasma level in hemodialysis patients is influenced by the 677 C to T mutation of the MTHFR gene. METHOD: We examined MTHFR gene mutation, homocysteine, vitamin B12, folate levels of those 106 patients on maintenance hemodialysis treatment at dialysis unit of Soonchunhyang University Chunan Hospital. RESULTS: Of 106 patients, 17 (16.0 %) were homozygous for the mutation (VV), 63 (58.4 %) were heterozygous for the mutation (AV) and remaining 26 (24.5 %) were normal. The mean homocyteine level in (VV) genotypic patients was 39.58+/-10.6 mol/L, (AV) genotypic patients was 26.24+/-3.77 mol/L and in no mutation was 26.07+/-4.52 mol/L. There was no significant difference of homocysteine levels between polymorphisms of MTHFR gene. CONCLUSION: Our data shows that the frequency of MTHFR genotype in maintenance hemodialysis patients is similar to that of previous studies. But, there is no significant relationship between the MTHFR gene mutation and homocysteine level.