Rhabdomyolysis in a patient taking nebivolol

β Blockers such as propranolol and labetalol are known to induce toxic myopathy because of their partial β₂ adrenoceptor agonistic effect. Nebivolol has the highest β1 receptor affinity among β blockers, and it has never been reported to induce rhabdomyolysis until now. We report a patient who developed rhabdomyolysis after changing medication to nebivolol. A 75-year-old woman was admitted to our hospital because of generalized weakness originating 2 weeks before visiting. Approximately 1 month before her admission, her medication was changed from carvedilol 12.5 mg to nebivolol 5 mg. Over this time span, she had no other lifestyle changes causing rhabdomyolysis. Her blood chemistry and whole body bone scan indicated rhabdomyolysis. We considered newly prescribed nebivolol as a causal agent. She was prescribed carvedilol 12.5 mg, which she was previously taking, instead of nebivolol. She was treated by hydration and urine alkalization. She had fully recovered and was discharged.

Severe Hypernatremia by Excessive Bamboo Salt Ingestion in Healthy Young Woman

Severe hypernatremia is an important electrolyte disorder that has serious effects. The patient had no medical history. A. 20-year-old ingested bamboo salt for digestion and weight reduction according to the folk remedies posted on an internet website. She presented with vomiting and diarrhea over ten times per day. Her initial serum sodium concentration was 174mEq/L. Her symptoms improved rapidly with hypotonic saline infusion. She recovered completely without any sequelae in three days. Severe hypernatremia in a normal young adult with clear consciousness and normal renal function has not been reported in Korea yet. So we report a case of severe hypernatremia by excessive bamboo salt ingestion in healthy young woman.

A Case of Urine Leakage: An Unusual Complication after Renal Biopsy / 전남의대학술지

Renal biopsy is a crucial method in the diagnosis and treatment of acute renal failure of unknown origin, nephrotic syndrome, suspicious interstitial nephritis, and glomerulonephritis as a possible cause of hematuria or proteinuria. Complications occur in 2% to 8% of patients after percutaneous renal biopsy. Complications include gross hematuria, perirenal hematoma, arteriovenous fistula, aneurysm, injury of other organs, and urine leakage. Urine leakage as a complication after kidney biopsy is rare. We experienced a case of urine leakage into the intra-abdominal cavity after renal biopsy.

A Case of Urine Leakage: An Unusual Complication after Renal Biopsy / 전남의대학술지

Renal biopsy is a crucial method in the diagnosis and treatment of acute renal failure of unknown origin, nephrotic syndrome, suspicious interstitial nephritis, and glomerulonephritis as a possible cause of hematuria or proteinuria. Complications occur in 2% to 8% of patients after percutaneous renal biopsy. Complications include gross hematuria, perirenal hematoma, arteriovenous fistula, aneurysm, injury of other organs, and urine leakage. Urine leakage as a complication after kidney biopsy is rare. We experienced a case of urine leakage into the intra-abdominal cavity after renal biopsy.

A Case of the Pedunculated Angiomyolipoma Attached to Renal Cortex / 대한신장학회지

A renal angiomyolipoma is uncommon congenital mixed tumor like formations consisting of blood vessel, smooth muscle cells and adipose tissue. We report a case of retroperitoneal hemorrhage from spontaneous rupture of renal angiomyolipoma in a 37 year-old woman that appeared unilateral and pedunculated attached to renal cortex. The patient presented with a clinical feature of flank pain and shock because of massive hemorrhage. Because the patient suffered from flank pain regardless of selective renal embolization, laparoscopic surgery was necessary to remove angiomyolipoma from renal cortex.

Colonic Transit Time in Maintenance Hemodialysis Patients with Constipation / 대한신장학회잡지

Many hemodialysis patients suffer from constipation. The increased incidence of constipation in long-term dialysis patients is based mainly on self-reported data. So, we conducted a survey on 10 hemodialysis patents with constipation by using total and segmental colonic transit time of radio-opaque markers. Segmental colonic transit times were calculated separately for 3 segments of the colon (right, left, and rectosigmoid) and total transit time, which was the sum of all 3 segment times. On results, colonic transit time was significantly prolonged in hemodialysis patient than in healthy control (42.2+/-20.11 versus 10.57+/-12.8 hour; p<0.0001). Increased colonic transit times in the right and especially rectosigmoid segments, but not the left segment, contributed to the prolongation in total colonic transit time. In conclusion, we suggest that colonic transit time measurement is helpful to tailor therapy because it helps us determine the prolonged segment of the colon in hemodialysis patients with constipation.

A Case of Acute Renal Failure Caused by Ingestion of Glacial Acetic Acid / 대한신장학회잡지

Acetic acid is a colorless liquid with a pungent vinegar-like order. Glacial acetic acid is 99% acetic acid. Acetic acid may lead to different effect on the damaged organ. Acetic acid ingestion is most common and results in pharyngeal, esophageal and GI burns, bleeding and volume depletion. Systemic effect include hemolysis, hepatic dysfunction, hypotension, renal failure and disseminated intravascular coagulation after ingestion of 90-100% acetic acid. Acute renal failure in acetic acid poisoning is rare and the mechanism of acute renal failure remains unclear. But tubular toxic effect of myoglobin or hemoglobin and direct action of acetic acid are suggested as the mechanism. Because of the acute renal failure may be fatal, the immediate treatment of hemolysis, substitution of blood and clotting factor and hemodialysis lead to improvement in general condition and renal function.

A Case of Primary Sjogren's Syndrome associated with Minimal Change Nephrotic Syndrome Concurrently Manifested with Sicca Complex / 대한신장학회잡지

Sjogren's syndrome is an autoimmune disease causing eye or dry mouth from the lymphocytic infiltration in the lacrimal gland and the salivary gland, and is classified as primary or secondary based on the absence or presence of complicating systemic rheumatic diseases. Extraglandular systemic lesions involving organs such as the lungs, liver, and kidney are seen, and renal involvement of these is reported to occur in 20% to 50% of patients with primary Sjogren's syndrome, and most commonly manifested with a tubulointerstitial nephritis. But a little over 20 cases with glomerulonephritis have been reported in the literature review, and only one case was reported in Korea. Glomerulonephritis is a late sequelae in the course of the disease, and is most attributed to deposition of immune complexes. Membranoproliferative glomerulonephritis are the most common glomerular lesions and only one case of minimal change nephrotic syndrome was reported in the literature review, and no previous case was reported in Korea. We report a minimal change nephrotic syndrome that is concurrently manifested with sicca complex in a case of Sjogren's syndrome.