Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 2 de 2
Filter
Add more filters










Database
Publication year range
1.
Ned Tijdschr Geneeskd ; 1682024 01 16.
Article in Dutch | MEDLINE | ID: mdl-38319313

ABSTRACT

BACKGROUND: Susac's syndrome is an autoimmune angiopathy classically leading to the triad of encephalopathy, retinopathy and hearing loss. Multidisciplinarity is essential for diagnosis, which means in more detail a MRI-cerebrum, fluorescence angiography (FAG) and audiography. Early treatment is key since it is associated with better prognosis and reversibility. CASE DESCRIPTION: This article presents a 71-year-old woman with multiple episodes of separate complaints (aphasia, behavioral changes, amnesia and vertigo with tinnitus). The MRI-cerebrum suspected Susac's syndrome with typical callosal lesions. An abnormal FAG and audiography completed the diagnostic triad of Susac's syndrome. Thereafter, treatment with immunosuppressants was initiated, which resulted in cognitive improvement.


Subject(s)
Brain Diseases , Retinal Diseases , Susac Syndrome , Vascular Diseases , Female , Humans , Aged , Immunosuppressive Agents , Patients
2.
Pediatr Nephrol ; 38(4): 1087-1097, 2023 04.
Article in English | MEDLINE | ID: mdl-35916956

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) and augmented renal clearance (ARC), both alterations of the glomerular filtration rate (GFR), are prevalent in critically ill children and neonates. AKI and ARC prevalence estimates are based on estimation of GFR (eGFR) using serum creatinine (SCr), which is known to be inaccurate. We aimed to test our hypothesis that AKI prevalence will be higher and ARC prevalence will be lower in critically ill children when using iohexol-based measured GFR (mGFR), rather than using eGFR. Additionally, we aimed to investigate the performance of different SCr-based eGFR methods. METHODS: In this single-center prospective study, critically ill term-born neonates and children were included. mGFR was calculated using a plasma disappearance curve after parenteral administration of iohexol. AKI diagnosis was based on the KDIGO criteria, SCr-based eGFR, and creatinine clearance (CrCL). Differences between eGFR and mGFR were determined using Wilcoxon signed-rank tests and by calculating bias and accuracy (percentage of eGFR values within 30% of mGFR values). RESULTS: One hundred five children, including 43 neonates, were included. AKI prevalence was higher based on mGFR (48%), than with KDIGO or eGFR (11-40%). ARC prevalence was lower with mGFR (24%) compared to eGFR (38-51%). eGFR equations significantly overestimated mGFR (60-71 versus 41 ml/min/1.73 m2, p < 0.001-0.002). Accuracy was highest with eGFR equations based on age- and sex-dependent equations (up to 59%). CONCLUSION: Iohexol-based AKI prevalence was higher and ARC prevalence lower compared to standard SCr-based eGFR methods. Age- and sex-dependent equations for eGFR (eGFR-Smeets for neonates and eGFR-Pierce for children) best approached measured GFR and should preferably be used to optimize diagnosis of AKI and ARC in this population. A higher resolution version of the Graphical abstract is available as Supplementary information.


Subject(s)
Acute Kidney Injury , Iohexol , Infant, Newborn , Humans , Child , Glomerular Filtration Rate , Creatinine , Prospective Studies , Critical Illness , Acute Kidney Injury/diagnosis , Acute Kidney Injury/epidemiology
SELECTION OF CITATIONS
SEARCH DETAIL
...