Résumé
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.
Sujets)
Adulte , Humains , Trouble bipolaire , Diabète insipide néphrogénique , Glomérulonéphrite extra-membraneuse , Rein , Corée , Lithium , Néphrite interstitielle , Néphrose lipoïdique , Syndrome néphrotique , Anatomopathologie , Polyurie , Protéinurie , Insuffisance rénale , Insuffisance rénale chroniqueRésumé
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.
Sujets)
Humains , Amphotéricine B , Antifongiques , Bactéries , Candida , Cathéters , Fluconazole , Champignons , Abandon des soins par les patients , Dialyse péritonéale continue ambulatoire , Péritonite , TrichosporonRésumé
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.
Sujets)
Adulte , Humains , Complexe antigène-anticorps , Glomérulonéphrite , Glomérulonéphrite extra-membraneuse , Maladie de Basedow , Maladies à complexes immuns , Syndrome néphrotique , Thyroïdite , Thyroïdite auto-immuneRésumé
BACKGROUND: Chemotherapy with 5-fluorouracil (5-FU) has been one of the mainstay in breast cancer treatment. The effects of high dose 5-FU on cell cycle regulation were studied in breast caner cells. METHODS: A breast cancer cell line MCF-7 was used. Protein expressions of G1/S cyclins, p21(Waf1/Cip1), cdk2, E2F1 and retinoblastoma were tested by western blot analysis. Immunoprecipitation and immune complex kinase assay were done for the assessment of E2F1/RB interacton and the activity of cdk2 respectively. RESULTS: p21(Waf1/Cip1) expression was barely detectable in control cells. With addition of 5-FU level of p21(Waf1/Cip1) were induced and cyclin D3 level was decreased as cell growth decreases. In accordance with increased expression of p21(Waf1/Cip1), cyclin E-associated cdk2 kinase activity was reduced. Retinoblastoma protein (RB) became dephosphorylated and E2F-1 binding activity with RB was increased. CONCLUSION: In this situation of high concentration of 5-FU breast cancer cells tend to be G1/S cell cycle arrested. Overexpression of p21(Waf1/Cip1) and dephosphorylation of RB may mediate the effectss of 5-FU by inhibiting E2F-1 activity, which contributes to G1/S cell cycle arrest. These results could be an indicating landmark for further study of high dose chemotherapy with 5-FU.
Sujets)
Complexe antigène-anticorps , Technique de Western , Tumeurs du sein , Région mammaire , Points de contrôle du cycle cellulaire , Cycle cellulaire , Lignée cellulaire , Cycline D3 , Cyclines , Traitement médicamenteux , Fluorouracil , Immunoprécipitation , Phosphotransferases , Rétinoblastome , Protéine du rétinoblastomeRésumé
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.
Sujets)
Humains , Adulte d'âge moyen , Anticorps antinucléaires , Atrophie , Biopsie , Cyclophosphamide , Dyspnée , Oedème , Glomérulonéphrite , Glomérulonéphrite extra-membraneuse , Hématurie , Corée , Syndrome néphrotique , Protéinurie , Silicose , ThoraxRésumé
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.
Sujets)
Humains , Adulte d'âge moyen , Anticorps antinucléaires , Atrophie , Biopsie , Cyclophosphamide , Dyspnée , Oedème , Glomérulonéphrite , Glomérulonéphrite extra-membraneuse , Hématurie , Corée , Syndrome néphrotique , Protéinurie , Silicose , ThoraxRésumé
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.