ABSTRACT
Nephrogenic diabetes insipidus is a condition characterized by polyuria with dilute urine due to the inability of the principal cells of the renal collecting ducts to respond to antidiuretic hormone and concentrate urine. Nephrogenic diabetes insipidus can be drug induced, and several chemotherapeutic agents have been reported to cause it. Bendamustine is a traditional chemotherapeutic agent being studied for treatment for relapsed systemic AL amyloidosis. We report a case of a 59-year-old man with AL amyloidosis who developed partial nephrogenic diabetes insipidus after receiving bendamustine for treatment of AL amyloidosis. The nephrogenic diabetes insipidus responded well to sodium restriction, hydrochlorothiazide, and desmopressin treatment, allowing the patient to receive subsequent bendamustine cycles without polyuria. Nephrogenic diabetes insipidus resolved shortly after completion of bendamustine therapy.
Subject(s)
Amyloidosis/drug therapy , Antineoplastic Agents, Alkylating/adverse effects , Bendamustine Hydrochloride/adverse effects , Diabetes Insipidus, Nephrogenic/chemically induced , Amyloidosis/immunology , Antineoplastic Agents, Alkylating/therapeutic use , Bendamustine Hydrochloride/therapeutic use , Humans , Immunoglobulin Light Chains , Male , Middle AgedABSTRACT
BACKGROUND: The environments can be contaminated by infectious agents that constitute a major health hazards as sources of community and hospital-acquired infections due to various activities. OBJECTIVE: A comparative study on the level of bacteriological contamination of automatic teller machines (ATMs), public toilets and commercial motorcycle crash helmets were conducted in Kigali city during the period of January to March, 2013. DESIGN: Samples were collected from selected ATMs, public toilets and commercial motorcycle crash helmets surfaces. Micro-organisms identified from these samples were associated to infecting organisms recovered from unwashed hands surfaces and recorded results in the nearby hospital. SETTING: Samples from each device and subject were transported to the laboratory where they were analysed for the presence of coliforms and other airborne, human skin and intestinal disease causing microorganisms. Microbiological methods including spread plate techniques and some biochemical tests were used to partially identify the microorganisms. SUBJECTS: Subjects involved in this study were consented students from University of Rwanda and Kigali motorcyclists for collections of samples from hands and crash helmets respectively. RESULTS: The following pathogenic bacteria have been found on the devices, Staphylococcus aureus, Staphylococcus epidermis, Streptococcus species, Escherichia coli, Salmonella, Klebsiella, Enterobacter aerogenes, Pseudomonas. The commercial motorcycle crash helmets had the highest level of bacteriological contamination compared to ATMs and public toilets. There was no growth observed on samples collected after treatment from ATMs, public toilets, and commercial motorcycle crash helmets. Attempt to correlate this finding with infecting organisms recovered from unwashed hands surfaces and recorded results in the nearby hospital show that the presences of some of these infectious pathogens. CONCLUSION: This study has revealed the ability of these public devices to serve as vehicle of transmission of microorganisms with serious health implications. To improve and ensure the safety of these public devices the use of disinfectants is of high importance on reducing bacteriological load on those public devices. Proper cleaning regimen to sanitise these facilities regularly and public education on their hygienic usage are recommended to reduce the associated risks.
