Rapid recovery of diabetes two months after discontinuation of tacrolimus [FK-506] in a single lung transplant patient

Post-transplant diabetes mellitus [PTDM], developing in almost one quarter of renal transplant patients within three years after the procedure, contributes to post-transplant morbidity and mortality by increasing the risk of infection and cardiovascular events. PTDM is considered a variant of diabetes mellitus [DM] type II and results in similar microvascular and macrovascular diabetic complications seen in non-transplant patients. In this article, we present a case of single lung transplant patient who developed PTDM with a severe DKA as the first manifestation of the disease. PTDM resolved rapidly after discontinuing tacrolimus

Achalasia as a potential predisposing factor for lung allograft rejection

Microaspiration secondary to gastroesophageal reflux has been postulated to be a predisposing factor for development of bronchiolitis obliterans syndrome after lung transplantation. Esophageal manometry and ambulatory pH monitoring have been suggested as a screening test in patients with end-stage lung disease. We report a single lung transplant patient who developed allograft rejection presumed to be due to underlying achalasia as the patient's clinical status and lung function improved markedly following the treatment of achalasia

Helicobacter pylori seroprevalence in patients with bronchiectasis

This study assessed Helicobacter pylori [HP] seroprevalence in bronchiectatic patients and determined whether there is a potential association between bronchiectasis and H.pylori infection or not. This study was conducted on forty consecutive patients [26 men, 14 women; mean age 48.90 +/- 16.67 years, range 21-86 years] with bronchiectasis diagnosed by clinical symptoms and high resolution CT-scan. Helicobacter pylori IgG serum levels were measured in serum by enzyme-linked immunosorbent assay. Forty healthy subjects [25 men, 15 women; mean age 55.50 +/- 11.91 years, range 16-77 years] were selected as controls with no history of cerebrovascular, ischemic heart or respiratory diseases. Control subjects were matched for age, gender and socioeconomic status. Significant differences were observed in the seroprevalence of H.pylori between the two groups, who had similar age, gender distribution and socioeconomic status [76.0% vs. 54.4%, p=0.001]. Similarly, H.pylori IgG levels were significantly higher in bronchiectatic patients than in control subjects attended the hospital with non-respiratory conditions [1.43 +/- 0.55 and 1.07 +/- 0.44 U/ml, respectively; p < 0.05]. The association between Hp infection and bronchiectasis was confirmed in this study. Additional studies with larger numbers of patients and randomized control studies should be undertaken to assess the relationship and impact of the H.pylori eradication on bronchiectasis

Enuresis persisting into adulthood

Nocturnal enuresis is a very common finding in children to the extent that many families and caregivers, alike, may dismiss it as a developmental stage rather than a disease. Persistence of nocturnal enuresis into adulthood, however, has received little discussion and is surrounded by fallacies. All existing literature cited in PubMed between 1970 and 2005 were reviewed using the search entries "nocturnal enuresis AND adult". Of the 220 papers reviewed, enuresis persisting into adulthood was covered in only 87. Those aspects pertinent to this subset of patients were placed in focus. In contrast to the numerous researches on childhood enuresis, persistent adulthood enuresis is an underdiscussed subject, distinct in a few aspects of its etiology and management described herein