Subject(s)
Abdominal Abscess/etiology , Renal Dialysis , Tuberculosis, Miliary/complications , Tuberculosis, Splenic/complications , Abdominal Abscess/drug therapy , Aged , Antitubercular Agents/therapeutic use , Biopsy , Diagnosis, Differential , False Negative Reactions , Hepatitis C, Chronic/complications , Humans , Hypertension/complications , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/surgery , Kidney Failure, Chronic/therapy , Kidney Transplantation , Lymph Nodes/microbiology , Lymph Nodes/pathology , Male , Neoplasms/diagnosis , Nephrosclerosis/complications , Prednisone/adverse effects , Prednisone/therapeutic use , Staphylococcal Infections/complications , Tuberculosis, Miliary/diagnosis , Tuberculosis, Miliary/drug therapy , Tuberculosis, Splenic/diagnosis , Tuberculosis, Splenic/drug therapyABSTRACT
La rabdomiolisis es un síndrome caracterizado por necrosis muscular y liberación del contenido de las células musculares al torrente sanguíneo que presenta etiologías muy diversas, algunas sólo parcialmente explicadas. En la práctica clínica es preciso iniciar un rápido diagnóstico en aras de prevenir complicaciones tan severas como el fallo renal agudo. A continuación presentamos un caso de rabdomiolisis relacionada con el tratamiento con olanzapina (AU)
Rhabdomyolysis is a syndrome caused by injury to skeletal muscle and involves leakage of the intracellular contents into plasma. Rhabdomyolysis has many causes, some of them are more easily understood than others. The physician must be alert to the diagnosis of rhabdomyolysis and to its subtle presentation to prevent the most severe complication of acute renal failure. We report one case of rhabdomyolysis induced by treatment with olanzapine (AU)
Subject(s)
Humans , Female , Adult , Rhabdomyolysis/diagnosis , Rhabdomyolysis/therapy , Water Intoxication/pathology , Antipsychotic Agents/therapeutic use , Rhabdomyolysis , Causality , Hyponatremia/epidemiologyABSTRACT
Patients receiving recombinant human erythropoietin (rHuEPO) therapy show wide variability in their responsiveness to the drug. Variables that affect rHuEPO dose requirements can be broadly divided into modificable and immutable characteristics. Most of the scientific research on rHuEPO hyporesponsiveness has focused on modificable variables (iron status, dialysis adequacy), while immutable variables such as gender, etiology of chronic renal failure (CRF) and age have been insufficiently explored. A cross sectional study was performed in order to evaluate if immutable patient characteristics determine rHuEPO dose requirements among 215 patients (52% males; mean age 66 +/- 14 years) on hemodialysis (HD) for more than twelve months. Data were collected at 10 hemodialysis units in Aragon. Patients were divided into three groups according to their gender, their cause of CRF (diabetic nephropathy, vascular nephropathy, tubulointerstitial nephropathy and primary glomerulonephritis) and their age (younger than 60 years, from 60 to 75 years, older than 75 years). Despite a similar dose of rHuEPO, women had lower mean hemoglobin (11.1 +/- 1.5 versus 11.6 +/- 1.7 g/dl; p = 0.0258) than men. The greater hemoglobin in men than women may be attributed to greater serum albumin in men (3.5 +/- 0.3 versus 3.7 +/- 0.3 mg/dl; p = 0.0001). Requirements of rHuEPO were higher in the patients with etiology of primary glomerulonephritis compared with those with the other etiologies, even those with diabetic nephropathy (p = 0.0374). The rHuE-PO doses required to obtain similar hemoglobin levels were higher in patients younger than 60 years (p = 0.0249). We conclude that women, patients with primary glomerulonephritis as cause of CRF, and patients younger than 60 years showed the highest requirements of rHuEPO doses.
