Subject(s)
Coronary Disease/drug therapy , Fibrinolytic Agents/therapeutic use , Streptokinase/therapeutic use , Angiography , Coronary Disease/complications , Coronary Disease/diagnostic imaging , Humans , Injections, Intravenous , Male , Middle Aged , Shock, Cardiogenic/drug therapy , Shock, Cardiogenic/etiologyABSTRACT
Recovery of renal function and extended survival after acute renal failure due to cholesterol embolization are possible, as demonstrated by the case history of two patients. Both were treated with peritoneal dialysis during their acute insult and had a serum creatinine of 1.7 mg/100 ml and 2.4 mg/100 ml, respectively, 12 and 60 months after diagnosis. Peritoneal dialysis is the preferred procedure for the replacement of renal function in these patients since it achieves good control of blood pressure and volume overload and avoids the need for vascular access and heparin administration.
Subject(s)
Acute Kidney Injury/therapy , Embolism, Fat/complications , Peritoneal Dialysis , Acute Kidney Injury/etiology , Aged , Creatinine/blood , Humans , Male , Middle AgedABSTRACT
We studied the effect of iron depletion on reproductive function in a 37-yr-old man with hypogonadotropic hypogonadism due to idiopathic hemochromatosis. Before therapy, he was impotent and had no libido, and seminal fluid analysis revealed no spermatozoa. Testicular biopsy showed marked impairment of spermatogenesis, but no iron load deposits. Sixteen months after institution of aggressive phlebotomy therapy, serum LH, FSH, and testosterone were normal, and potency and libido had returned. Twenty months after diagnosis the patient fathered another child. Seminal fluid analysis at that time revealed an average of 65 million spermatozoa/mL. Thus, recovery of reproductive function, documented by hormone measurements, testicular biopsy, and semen analysis, was complete. We conclude that phlebotomy alone may be adequate treatment for hypogonadotropic hypogonadism in men with hemochromatosis.
Subject(s)
Bloodletting , Hemochromatosis/therapy , Hypogonadism/therapy , Spermatogenesis , Adult , Erectile Dysfunction/etiology , Erectile Dysfunction/therapy , Hemochromatosis/complications , Hemochromatosis/physiopathology , Humans , Hypogonadism/etiology , Hypogonadism/physiopathology , Iron/metabolism , Male , Sperm CountABSTRACT
A 70-year-old patient who developed ventricular tachycardia (up to several hundreds of consecutive ventricular complexes) in the presence of theophylline intoxication (29 micrograms/ml) is reported. Ventricular tachycardia is a rare complication of theophylline intoxication and, to our knowledge, has not yet been reported with theophylline levels below 40 micrograms/ml. The occurrence of hypokalemia and its possible arrhythmogenic effect in theophylline intoxication is discussed. The role of low theophylline clearance in developing iatrogenic theophylline intoxication is emphasized. Patients with theophylline intoxication should be carefully monitored, even when the serum level does not seem to be dramatically high.
