[Case of young woman with Graves' disease and incomplete distal renal tubular acidosis with severe progress and cardiac arrest]. / Przypadek niekompletnej nerkowej kwasicy cewkowej typu dystalnego o ciezkim przebiegu powiklanym naglym zatrzymaniem krazenia u mlodej kobiety z choroba Graves-Basedowa.

Diagnostic of renal tubular disorders can be often difficult. Incomplete form of distal Renal Tubular Acidosis (dRta) in course of Graves' disease was de novo recognized in a young woman hospitalized with a deep deficiency of potassium in blood serum complicated with cardiac arrest. Series of tests assessing the types and severity of water-electrolyte, acid-base and thyroid disorders were performed during a complex diagnosis. During the treatment of acute phase of the disease we intensified efforts to maintain basic life functions and to eliminate deep water-electrolyte disturbances. In the second phase of the treatment we determined an underlying cause of the disease, recognized dRTA, and introduced a specific long-term electrolyte and hormonal therapy. To confirm the diagnosis oral test with ammonium chloride (Wrong-Davies' test) was performed. After completion of the diagnostic and therapeutic process, the patient was included in the nephrological supervision on an outpatient basis. The basic drug for the therapy was sodium citrate. After a year of observation and continuing treatment we evaluated therapeutic results as good and permanent.

[Rapid course of Churge-Strauss syndrome--since appearance of asthma till development of renal failure and neurological complication]. / Gwaltowny przebieg zespolu Churge-Strauss--od rozpoznania astmy oskrzelowej do rozwoju niewydolnosci nerek i powiklan neurologicznych.

Churge-Strauss Syndrome belongs to systematic, necrotic inflammation of medium and small vessels diseases. In this paper it is presented a case of 63 years old man with benign asthma, recognized six month earlier. Later occurs fever, difficulties with breathing, cough, fast progressing paresis of tree limbs, thinning and nephrotic syndrome with fast growing renal failure. Base for recognition was clinical picture and laboratory tests which showed elevetion of inflammation parameters (CRP, ESR), eosinophilia (18%) and p-ANCA antibodies. Treatment with glucocorticosteroids and cyclophosphamide was started. After six month proteinuria decreased. Paresis regressed and patient's movement abilities were improved. Renal failure stayed in fourth stadium of chronic renal disease. The aim of this paper is presentation diagnostic difficulties of Churge-Strauss Syndrome of atypical course with fast growing renal failure with neurological complications.