RESUMO
A 52-year-old male admitted the hospital because of the spontaneous pneumothorax. About twenty years ago, he had experienced the pulmonary tuberculosis but he did not medicine the antituberculosis regulary. The pleural biopsy during right lobectomy and closed thoracotomy revealed the pleural tuberculosis and we instituted the re-trial of antituberculosis medication Acute oliguric renal failure occurred after the medications for seven days. The blood smear showed the evidence of microangiopathic hemolysis. We regarded the HUS deveoloped in this patient and four times of plasma exchage was accomplished. But the renal biopsy revealed the acute tubular necrosis due to the pigment nephropathy with interstitial inflammation and the careful laboratory evaluation showed the massive hemolysis with the compensated DIC. The rifampicin dependent antibodies were identified by indirect antiglobulin test. The microangiopathic finding would be due to DIC. We regarded that the renal failure was due to the hemolysis and, in minor part, was due to interstitial nephritis. Total plasma exchage, hemodialysis and prednisolone teatment resolved the hemolysis and the renal failure in this patient.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Anemia Hemolítica , Anticorpos , Biópsia , Teste de Coombs , Dacarbazina , Hemólise , Síndrome Hemolítico-Urêmica , Inflamação , Necrose , Nefrite Intersticial , Plasma , Pneumotórax , Prednisolona , Diálise Renal , Insuficiência Renal , Rifampina , Toracotomia , Tuberculose Pleural , Tuberculose PulmonarRESUMO
In Wegener's granulomatosis, the classical clinical picture is composed of a triad of symptoms: sinusitis-rhinitis, pulmonary lesion and glomerulonephritis with granulomatous lesions and necrotizing vasculitis of involved organs. But localization in retroperitoneal tissue is unusual. In this case, hydronephrosis and ureteral obstruction is the sole presenting symptoms of the disease. At exploratory laparotomy, the right ureter was found to be obstructed by dense, extrinsic fibroinflammatory reaction. There was a necrotizing granulomatous vasculitis in the muscle layer of the ureter.
Assuntos
Glomerulonefrite , Hidronefrose , Laparotomia , Ureter , Obstrução Ureteral , Vasculite , Granulomatose com PoliangiiteRESUMO
No abstract available.
Assuntos
Biópsia , Citoplasma , Seguimentos , Glomerulonefrite , Transplante de RimRESUMO
No abstract available.