RESUMEN
Lithium is commonly employed in the treatment of bipolar disorders. The commonly reported nephrotoxic effects of lithium therapy are nephrogenic diabetes insipidus and chronic tubulointerstitial nephropathy with little or no proteinuria. Mild proteinuria is a common manifestation of most renal injuries including nephrotoxicity by lithium. But nephrotic syndrome related with lithium therapy is very rare and only one case of membranous glomerulonephritis has been reported in Korea by this time. We report a lithium toxicity case manifested by nephrotic syndrome, nephrogenic diabetes inspidus and chronic renal insufficiency in a 44-year-old man who had been taking lithium for 13 years for bipolar disorder. Kidney pathology showed minimal change disease and chronic tubulointerstitial nephritis which can be seen in chronic lithium toxicity. Polyuria and massive proteinuria disappeared with the withdrawal of lithium. Renal function was gradually improved but not to norma range. Careful and regular monitoring on the renal function in all patients on lithium treatment will be needed.
Asunto(s)
Adulto , Humanos , Trastorno Bipolar , Diabetes Insípida Nefrogénica , Glomerulonefritis Membranosa , Riñón , Corea (Geográfico) , Litio , Nefritis Intersticial , Nefrosis Lipoidea , Síndrome Nefrótico , Patología , Poliuria , Proteinuria , Insuficiencia Renal , Insuficiencia Renal CrónicaRESUMEN
Fungal peritonitis is one of the leading causes of patient dropout from continuous ambulatory peritoneal dialysis (CAPD) therapy. Although the most causative agents of peritonitis associated with CAPD are bacteria, fungi are implicated in up to 10% of cases. The most common organism of fungal peritonitis is Candida specises, but Trichosporon beigelii was reported as a rare causative agent of fungal peritonitis. We experienced a case of CAPD peritonitis by Trichosporon beigelii, which was treated with CAPD catheter removal, and antifungal agents with amphotericin B and fluconazole. Thus, we report our experience of CAPD peritonitis caused by Trichosporon beigelii and review of the literature.
Asunto(s)
Humanos , Anfotericina B , Antifúngicos , Bacterias , Candida , Catéteres , Fluconazol , Hongos , Pacientes Desistentes del Tratamiento , Diálisis Peritoneal Ambulatoria Continua , Peritonitis , TrichosporonRESUMEN
Membranous nephropathy is one of the most common causes of the nephrotic syndrome in adults. Membranous nephropathy is known as a disease associated with many other disorders and the presumed etiology of the disease is a deposition of circulating immune complexes. But, it has rarely been reported in association with autoimmune thyroiditis. We report a case of membranous nephropathy associated with Graves' disease and review the literature regarding this disease entity.
Asunto(s)
Adulto , Humanos , Complejo Antígeno-Anticuerpo , Glomerulonefritis , Glomerulonefritis Membranosa , Enfermedad de Graves , Enfermedades del Complejo Inmune , Síndrome Nefrótico , Tiroiditis , Tiroiditis AutoinmuneRESUMEN
A 63-year old man, who was a stone mason, was hospitalized due to dyspnea and generalized edema. Chest X-ray showed the presence of multiple scattered small nodular opacities in both lobes and egg-shell calcification in both hilum. Laboratory finding showed proteinuria and hematuria and antinuclear antibody was positive. Renal biopsy revealed membranous nephropathy and tubular atrophy. He was treated with cyclophosphamide, but proteinuria has been sustained. In literature reviewed, silicosis was associated with various forms of glomerulonephritis, but in Korea, such case has not been reported except the one case of microscopic polyangitis with membranous glomerulonephropathy associated with pulmonary silicosis. We experienced membranous nephropathy in a patient with pulmonary silicosis, thus we report it.
Asunto(s)
Humanos , Persona de Mediana Edad , Anticuerpos Antinucleares , Atrofia , Biopsia , Ciclofosfamida , Disnea , Edema , Glomerulonefritis , Glomerulonefritis Membranosa , Hematuria , Corea (Geográfico) , Síndrome Nefrótico , Proteinuria , Silicosis , TóraxRESUMEN
A 63-year old man, who was a stone mason, was hospitalized due to dyspnea and generalized edema. Chest X-ray showed the presence of multiple scattered small nodular opacities in both lobes and egg-shell calcification in both hilum. Laboratory finding showed proteinuria and hematuria and antinuclear antibody was positive. Renal biopsy revealed membranous nephropathy and tubular atrophy. He was treated with cyclophosphamide, but proteinuria has been sustained. In literature reviewed, silicosis was associated with various forms of glomerulonephritis, but in Korea, such case has not been reported except the one case of microscopic polyangitis with membranous glomerulonephropathy associated with pulmonary silicosis. We experienced membranous nephropathy in a patient with pulmonary silicosis, thus we report it.
Asunto(s)
Humanos , Persona de Mediana Edad , Anticuerpos Antinucleares , Atrofia , Biopsia , Ciclofosfamida , Disnea , Edema , Glomerulonefritis , Glomerulonefritis Membranosa , Hematuria , Corea (Geográfico) , Síndrome Nefrótico , Proteinuria , Silicosis , TóraxRESUMEN
Enterococcus is a normal flora of the gastrointestinal or genitourinary tract. With the increased use of vancomycin and third generation cephalosporins, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in USA and Europe since 1986. In Korea, patients with VRE infection or colonization were increasingly reported recently and VRE may become a serious nosocomial pathogen in the near future. So we report a case of vancomycin-resistant E. faecium peritonitis in a patient on continuous ambulatory peritoneal dialysis.
Asunto(s)
Humanos , Cefalosporinas , Colon , Enterococcus , Europa (Continente) , Corea (Geográfico) , Diálisis Peritoneal Ambulatoria Continua , Peritonitis , VancomicinaRESUMEN
Membranous glumerulonephrophy was found in two men who were diagnosed as psoriasis vulgaris. In the first patient, membranous glumerulonephropathy was developed during treatment of psoriasis and deterioration of proteinuria was appeared with aggravation of skin lesion although treated with cyclophosphamide. In the second patient, psoriasis developed during treatment of membranous glomerulonephropathy and we observed the improvement of nephrotic syndrome and psoriasis with prednisolone treatment. The simultaneous deterioration and improvement of proteinuria and skin lesion of psoriasis suggests that underlying common immune abnormalities may be involved in the pathogenesis of both psoriasis and membranous glomerulopathy.
Asunto(s)
Humanos , Masculino , Ciclofosfamida , Glomerulonefritis Membranosa , Síndrome Nefrótico , Prednisolona , Proteinuria , Psoriasis , PielRESUMEN
A 35-years-old man was hospitalized with gene-ralized edema. 6 months ago, the patient was operated by radical subtotal gastrectomy for advanced gastric adenocarcinoma. The patient presented with multiple liver metastasis and the massive proteinuria. The patients renal biopsy revealed minimal change nephrotic syndrome and treated with prednisolone and diuretics. The patient was improved clinical symptome and decreased 24 hours urine protein. In literature reviewed, gastric carcinoma was not associated with minimal change nephrotic syndrome. We experienced advanced gastric carcinoma associated with minimal change nephrotic syndrome, thus we report it.