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2.
Scand J Urol Nephrol ; 35(4): 330-3, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11676362

ABSTRACT

A 36-year-old renal transplant patient developed 9 years after a successful transplantation a fatal secondary varicella infection. The disseminated varicella infection was associated with hepatitis with liver necrosis, disseminated intravascular coagulation and fibrinolysis and glomerulonephritis. To our knowledge this is the first description of glomerulonephritis associated with varicella infection in a renal transplanted patient. The autopsy showed morphologically a mesangial glomerulonephritis with minor proliferative activity and extensive deposits by electronmicroscopy, mainly in the mesangium. The ongoing immunosuppression may have modified the mesangial cell response to the deposition of immune complexes.


Subject(s)
Abdominal Pain/etiology , Chickenpox/complications , Glomerulonephritis/complications , Hepatitis, Viral, Human/complications , Kidney Transplantation , Adult , Chickenpox/pathology , Glomerulonephritis/pathology , Hepatitis, Viral, Human/diagnosis , Hepatitis, Viral, Human/pathology , Humans , Kidney/pathology , Liver/pathology , Male
3.
Tidsskr Nor Laegeforen ; 121(15): 1789-90, 2001 Jun 10.
Article in Norwegian | MEDLINE | ID: mdl-11464682

ABSTRACT

BACKGROUND: Renal artery stenosis may present as acute pulmonary oedema and be misinterpreted as congestive heart failure. ACE inhibitors and angiotensin-II antagonists are widely used among patients with congestive heart failure and hypertension. MATERIAL AND METHODS: The authors present a patient with congestive heart failure caused by a combination of coronary heart disease and bilateral renal artery stenosis. The patient developed acute kidney failure secondary to ACE inhibitor and angiotensin II antagonist treatment. RESULTS: Mechanisms behind pulmonary oedema secondary to renovascular hypertension are discussed. INTERPRETATION: Revascularisation is the treatment of choice for this patient category.


Subject(s)
Pulmonary Edema/etiology , Renal Artery Obstruction/complications , Acute Kidney Injury/chemically induced , Acute Kidney Injury/complications , Adult , Angiotensin II/antagonists & inhibitors , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Angiotensin-Converting Enzyme Inhibitors/adverse effects , Antihypertensive Agents/administration & dosage , Antihypertensive Agents/adverse effects , Diagnosis, Differential , Enalapril/administration & dosage , Enalapril/adverse effects , Heart Failure/diagnosis , Humans , Hypertension/complications , Hypertension/drug therapy , Hypertension, Renovascular/complications , Male , Pulmonary Edema/diagnosis , Renal Artery Obstruction/diagnosis , Renal Artery Obstruction/surgery
4.
Tidsskr Nor Laegeforen ; 121(15): 1829, 2001 Jun 10.
Article in Norwegian | MEDLINE | ID: mdl-11464691

ABSTRACT

A rare side effect from metformin is lactic acidosis. There have been much concern about the reported risk when metformin was combined with contrast medium. Almost all reported cases following combination with contrast media occurred when pre-existing poor renal function was present. A recent review of the literature has resulted in new recommendations in Europe and the USA. We suggest new guidelines for Norway with regard to the use of metformin in patients undergoing radiological examination with contrast media.


Subject(s)
Acidosis, Lactic/chemically induced , Contrast Media/adverse effects , Hypoglycemic Agents/adverse effects , Metformin/adverse effects , Contrast Media/administration & dosage , Contrast Media/pharmacokinetics , Drug Synergism , Humans , Hypoglycemic Agents/administration & dosage , Hypoglycemic Agents/pharmacokinetics , Metformin/administration & dosage , Metformin/pharmacokinetics , Norway , Practice Guidelines as Topic , Risk Factors
5.
Obstet Gynecol ; 92(4 Pt 2): 698-700, 1998 Oct.
Article in English | MEDLINE | ID: mdl-9764670

ABSTRACT

BACKGROUND: Postpartum renal failure in previously healthy subjects is associated most often with preeclampsia and/or hypertension; hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome, hemolytic uremic syndrome; or thrombotic thrombocytopenic purpura. Transient oliguria associated with preeclampsia is common, but renal failure is rare. Coexistence of HELLP and hemolytic uremic syndromes has been suggested, but histopathologic documentation of this combination has been scarce. CASE: A 30-year-old primigravida with severe preeclampsia at 35 weeks and 3 days' gestation presented with the development of HELLP syndrome and renal failure postpartum. Histopathologic lesions characteristic of hemolytic uremic syndrome were present in the kidney. CONCLUSION: Probable overlapping of HELLP and hemolytic uremic syndromes in pregnancy or postpartum should be taken into consideration when treating patients with these syndromes and associated complications, such as renal failure.


Subject(s)
HELLP Syndrome/complications , Hemolytic-Uremic Syndrome/complications , Puerperal Disorders/etiology , Renal Insufficiency/etiology , Adult , Female , Humans , Pregnancy
6.
Transplantation ; 62(1): 38-42, 1996 Jul 15.
Article in English | MEDLINE | ID: mdl-8693541

ABSTRACT

Rejection episodes in renal allograft recipients are usually efficiently treated with high doses of intravenous methylprednisolone. Rejection therapy with OKT3 is often reserved for steroid-resistant episodes. However, the optimal dose of OKT3 in the treatment of steroid-resistant rejection is not known. Therefore, we randomized renal transplant recipients with steroid-resistant rejection to treatment with a standard daily intravenous dose of either 5 mg of OKT3 (n=15) or 2.5 mg of OKT3 (n=15) for 10 days. Circulating T cells (measured as CD2+ cells) were adequately and equally depleted in the two groups. Three grafts were lost due to rejection within the first 3 months following OKT3 administration, one in the 2.5 mg OKT3 group and two in the 5 mg OKT3 group. Two nonimmunologic graft losses occurred in the 2.5 mg OKT3 group. Median serum creatinine values were not different between the two groups, neither at the start (median values: 200 micormol/L in the 5 mg OKT3 group vs. 188 micromol/L in the 2.5 mg group) nor immediately after OKT3 rescue therapy (202 micromol/L vs. 185 micromol/L, respectively). Eight cytomegalovirus infections occurred in each group. Two re-rejection episodes occurred in the 5 mg OKT3 group and one occurred in the 2.5 mg OKT3 group. All responded to treatment. Function of the remaining grafts estimated by serum creatinine after a mean long-term follow-up of 18 months (range, 6-36 months) revealed no differences (185 micromol/L in the 5 mg OKT3 group vs. 170 micromol/L in the 2.5 mg OKT3 group). We conclude that OKT3 treatment of steroid-resistant rejections in renal transplant recipients is equally effective in daily doses of 2.5 mg and 5 mg with respect to reversal rate and long-term outcome.


Subject(s)
Graft Rejection/therapy , Kidney Transplantation/immunology , Muromonab-CD3/administration & dosage , Adult , Aged , CD4 Lymphocyte Count , Creatinine/blood , Cytomegalovirus Infections/complications , Dose-Response Relationship, Immunologic , Drug Resistance , Female , Graft Survival , Humans , Immunosuppression Therapy/methods , Immunosuppressive Agents/therapeutic use , Male , Methylprednisolone/therapeutic use , Middle Aged
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