Résumé
Symptoms of tuberous scelrosis (TS) are mainly related with brain and kidneys. Seizure, mental retardation, other behavioral problems are dominant. A spectrum of renal tumors from benign angiomyolipoma (AML) to polycystic kidney disease, and rarely malignant renal cell carcinoma have been observed. Cystic AML is a rare phenotype of AML. No case of TS with renal cystic AML has been reported in Korea yet. And chronic kidney disease (CKD) in TS has been seldom reported. We experienced a TS case accompanied by renal cystic AML and CKD diagnosed in a 48-year-old female patient who was hospitalized for left side weakness and seizure under the diagnosis of acute cerebral infarction.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Angiomyolipome , Encéphale , Néphrocarcinome , Infarctus cérébral , Diagnostic , Déficience intellectuelle , Rein , Défaillance rénale chronique , Corée , Phénotype , Polykystoses rénales , Insuffisance rénale chronique , Sclérose , Crises épileptiques , Complexe de la sclérose tubéreuseRésumé
A 59-year-old woman was admitted to our hospital with polydipsia and general weakness. She had a 30-year history of bipolar disorder and was being treated with risperidone (4 mg/day) and lithium carbonate (1,200 mg/day). During her time in hospital, her urine output and serum osmolality increased, and her urine osmolality decreased. She was found to have myoglobulinuria, an elevated creatine kinase level, and abnormal renal function. Based on these findings, the patient was diagnosed with diabetes insipidus and rhabdomyolysis secondary to lithium therapy. After fluid therapy and the withdrawal of lithium, her clinical symptoms improved significantly. Her urine volume decreased gradually after treatment with amiloride. The effects of lithium on the muscle system are unknown. Hyperosmolarity caused by lithium-induced diabetes insipidus is considered a contributing factor in rhabdomyolysis.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Amiloride , Trouble bipolaire , Creatine kinase , Diabète insipide , Diabète insipide néphrogénique , Traitement par apport liquidien , Lithium , Carbonate de lithium , Muscles , Concentration osmolaire , Polydipsie , Rhabdomyolyse , RispéridoneRésumé
A 59-year-old woman was admitted to our hospital with polydipsia and general weakness. She had a 30-year history of bipolar disorder and was being treated with risperidone (4 mg/day) and lithium carbonate (1,200 mg/day). During her time in hospital, her urine output and serum osmolality increased, and her urine osmolality decreased. She was found to have myoglobulinuria, an elevated creatine kinase level, and abnormal renal function. Based on these findings, the patient was diagnosed with diabetes insipidus and rhabdomyolysis secondary to lithium therapy. After fluid therapy and the withdrawal of lithium, her clinical symptoms improved significantly. Her urine volume decreased gradually after treatment with amiloride. The effects of lithium on the muscle system are unknown. Hyperosmolarity caused by lithium-induced diabetes insipidus is considered a contributing factor in rhabdomyolysis.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Amiloride , Trouble bipolaire , Creatine kinase , Diabète insipide , Diabète insipide néphrogénique , Traitement par apport liquidien , Lithium , Carbonate de lithium , Muscles , Concentration osmolaire , Polydipsie , Rhabdomyolyse , RispéridoneRésumé
Cyclosporine is an immunosuppressive agent that plays an important therapeutic role for organ transplantation. However, complications due to type 1 renal tubular acidosis, albeit rare, have been reported. We experienced a case of severe metabolic acidosis associated with cyclosporine administration after renal transplantation. A 54-year old man was hospitalized for seizure, confusion and weakness. He demonstrated severe metabolic acidosis and hypokalemia. Continuous renal replacement therapy was started and sodium bicarbonate was administered to correct the acidosis and the dosage of cyclosporine was reduced. Thereafter, the cyclosporine level in whole blood decreased gradually, and the metabolic acidosis improved.