Résumé
BACKGROUND/AIMS: Aims: Inflammation is an important factor in renal injury. Ferritin, an inflammatory marker, is considered an independent predictor of rapid renal progression in patients with chronic kidney disease. However, the relationship between ferritin and residual renal function (RRF) in patients undergoing peritoneal dialysis (PD) remains unclear. METHODS: We reviewed the medical records of patients who started PD between June 2001 and March 2012 at Soonchunhyang University Bucheon Hospital, Korea. A total of 123 patients were enrolled in the study. At 1 month after the initiation of PD, RRF was determined by a 24-hour urine collection and measured every 6 months thereafter. Clinical and biochemical data at the time of the initial 24-hour urine collection were considered as baseline. RESULTS: The RRF reduction rate was significantly greater in patients with high ferritin (ferritin > or = 250 ng/mL) compared with those with low ferritin (ferritin < 250 ng/mL; -1.71 +/- 1.36 mL/min/yr/1.73 m2 vs. -0.84 +/- 1.63 mL/min/yr/1.73 m2, respectively; p = 0.007). Pearson correlation analysis revealed a significant negative correlation between the baseline serum ferritin level and the RRF reduction rate (r = -0.219, p = 0.015). Using multiple linear regression analysis and adjusting for other risk factors, baseline serum ferritin was an independent factor for the RRF reduction rate (beta = -0.002, p = 0.002). CONCLUSIONS: In this study we showed that a higher ferritin level was significantly associated with a more rapid RRF decline in patients undergoing PD.
Sujets)
Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Marqueurs biologiques/sang , Loi du khi-deux , Évolution de la maladie , Ferritines/sang , Hôpitaux universitaires , Médiateurs de l'inflammation/sang , Estimation de Kaplan-Meier , Rein/physiopathologie , Défaillance rénale chronique/sang , Modèles linéaires , Analyse multifactorielle , Dialyse péritonéale/effets indésirables , Valeur prédictive des tests , Modèles des risques proportionnels , République de Corée , Facteurs de risque , Facteurs temps , Résultat thérapeutique , Régulation positiveRésumé
A 36-year-old man with a history of Behcet's syndrome and vascular complications visited the emergency room due to sudden chest pain and dyspnea. He had no coronary risk factors. Electrocardiography showed ST elevations in multiple precordial leads. Echocardiography showed akinesia of the anterior wall, interventricular septum, and apex, with a movable round mass measuring 1.4 x 1.5 cm in the right atrium. Cardiac computed tomography (CT) suggested the presence of a thrombus in the coronary sinus protruding into the right atrium. Coronary angiography revealed total occlusion with thrombi in the proximal left anterior descending coronary artery. Thrombectomy and stent insertion were performed. After the procedure, the patient was prescribed warfarin. Follow-up CT indicated the disappearance of the thrombi originating from the coronary sinus.
Sujets)
Adulte , Humains , Maladie de Behçet , Douleur thoracique , Coronarographie , Sinus coronaire , Vaisseaux coronaires , Dyspnée , Échocardiographie , Électrocardiographie , Urgences , Études de suivi , Atrium du coeur , Infarctus du myocarde , Facteurs de risque , Endoprothèses , Thrombectomie , Thrombose , WarfarineRésumé
A 36-year-old man with a history of Behcet's syndrome and vascular complications visited the emergency room due to sudden chest pain and dyspnea. He had no coronary risk factors. Electrocardiography showed ST elevations in multiple precordial leads. Echocardiography showed akinesia of the anterior wall, interventricular septum, and apex, with a movable round mass measuring 1.4 x 1.5 cm in the right atrium. Cardiac computed tomography (CT) suggested the presence of a thrombus in the coronary sinus protruding into the right atrium. Coronary angiography revealed total occlusion with thrombi in the proximal left anterior descending coronary artery. Thrombectomy and stent insertion were performed. After the procedure, the patient was prescribed warfarin. Follow-up CT indicated the disappearance of the thrombi originating from the coronary sinus.
Sujets)
Adulte , Humains , Maladie de Behçet , Douleur thoracique , Coronarographie , Sinus coronaire , Vaisseaux coronaires , Dyspnée , Échocardiographie , Électrocardiographie , Urgences , Études de suivi , Atrium du coeur , Infarctus du myocarde , Facteurs de risque , Endoprothèses , Thrombectomie , Thrombose , WarfarineRésumé
Salmonella septic arthritis in a healthy, immunocompetent patient is extremely rare. We experienced a case of septic arthritis of the knee caused by Salmonella Group D in a patient with Non-small cell lung cancer. A 43-year-old female receiving steroid therapy for treatment of Non-small cell lung cancer with metastasis to the spinal cord complained of painful swelling of the right knee joint. Culture of synovial fluid obtained by aspiration yielded growth of Salmonella Group D. The patient was treated with ceftriaxone; however, she expired on the ninth day after treatment.
Sujets)
Femelle , Humains , Arthrite , Arthrite infectieuse , Carcinome pulmonaire non à petites cellules , Genou , Articulation du genou , Métastase tumorale , Salmonella , Salmonella enteritidis , Moelle spinale , SynovieRésumé
The transport proteins such as thyroxine-binding-globulin (TBG), albumin and transthyretin carry over 99% of circulating thyroid hormones. TBG is a major thyroid hormone transport protein in serum. Although TBG deficiency does not have metabolic consequences, it has diagnostic implications as it can lead to an incorrect interpretation of thyroid function tests. We experienced a case that a man who had an abnormal thyroid function showed unexpectedly low concentrations of serum total thyroxine. We detected the low TBG in his serum and he was diagnosed the TBG deficiency. We report this case along with a review of the related literature.