Forty years abuse of baking soda, rhabdomyolysis, glomerulonephritis, hypertension leading to renal failure: a case report.

We present a patient who had ingested sodium bicarbonate for treatment of alcoholic dyspepsia during forty years at increasing doses. During the last year he had used more than 50 grams daily. He presented with metabolic alkalosis, epileptic convulsions, subdural hematoma, hypertension and rhabdomyolysis with end stage renal failure, for which he had to be given regular intermittent hemodialysis treatment. Untreated hypertension and glomerulonephritis was probably present prior to all these acute incidents. Examination of the kidney biopsy revealed mesangial proliferative glomerulonephritis and arterial wall thickening causing nephrosclerosis together with interstitial calcinosis. The combination of all these pathologic changes might be responsible for the development of progressive chronic renal failure ending up with the need for continuous intermittent hemodialysis treatment.

Mesangial proliferative glomerulonephritis after autologous stem cell transplantation.

Although glomerulonephritis and renal failure have been observed after allogenic stem cell transplantation, only a few such reports were published about patients undergoing autologous stem cell transplantation. We report a case of mesangial proliferative glomerulonephritis developing 4 months after autologous stem cell transplantation for chronic lymphatic leukemia. Serological test results, together with histological, immunohistochemical, and electronic microscopic findings of a kidney biopsy specimen, confirmed the diagnosis of mesangial proliferative glomerulonephritis in our patient. Complement and immunoglobulin A were not present in the kidney biopsy specimen. An abnormal clone, not previously reported, with the translocation t(5;11)(q31;q13) in blood and bone marrow was observed. The reason for and whether progenitor cells in stem cell transplantations could contribute to the development of glomerulonephritis remain open questions. Kidney biopsy should be performed in patients with microscopic hematuria and/or proteinuria after autologous stem cell transplantation.

Her-2/neu oncogene amplification and protein over-expression in interval and screen-detected breast cancers.

BACKGROUND: Studies of Her-2/neu protein expression in interval and screen-detected breast cancers have been conflicting. Therefore we assessed the Her-2/neu amplification status in these groups by using in situ hybridization. PATIENTS AND METHODS: The Her-2/neu oncogene amplification and protein over-expression were compared in 79 screen-detected and 39 interval breast carcinomas, using a novel and well-documented chromogenic in situ hybridization (CISH) method and immuhistochemistry. RESULTS: There were 33% CISH-positive cases in the interval cancer group and only 4% CISH-positive cases in the screen-detected group. The odds ratio for interval cancer was 14.1 (95% CI 2.2 to 91.0) in the CISH-positive tumours compared with CISH-negative tumours after adjustment for nodal status, tumour size and histological grade. CONCLUSION: Our results indicate, for the first time, that there is a clear-cut difference in Her-2/neu amplification between screen-detected and interval breast carcinomas. The amplification appears to be a rare event in screen-detected cancers but distinctly frequent in interval cancers when compared to cancers described in earlier studies.