RESUMO
Listeria monocytogenes peritonitis developed in a 67-year-old man on continuous ambulatory peritoneal dialysis following a catered luncheon. Alcoholic liver disease was a predisposing factor. L. monocytogenes multiplies at 4 degrees C. It is often present in imported soft cheese, less often in chicken and other refrigerated food. Listeria peritonitis has not been previously reported in Australia.
Assuntos
Listeriose , Diálise Peritoneal Ambulatorial Contínua , Peritonite/microbiologia , Idoso , Antibacterianos/uso terapêutico , Humanos , Terapia de Imunossupressão , MasculinoRESUMO
A study was conducted in oliguric and acutely azotemic patients, measuring: (i) the fractional excretion of sodium (FENa) using creatinine clearance as a measure of glomerular filtration rate, and (ii) sodium clearance relative to urea clearance, designated as the sodium/urea clearance ratio (Na:urea CR). It was found that FENa discriminated between "tubular" and "non-tubular" disorders in 96% of patients. Further, Na:urea CR was as discriminating as FENa. Patients with Na:urea CR above 2.5% can be reliably diagnosed as having acute tubular necrosis or acute urinary tract obstruction; those with a value less than 2.5% will have acute glomerulonephritis or pre-renal azotemia. As urea and sodium measurements are so readily available, this test can now be applied in the assessment of the oliguric or acutely azotemic patient in any hospital practice.
Assuntos
Injúria Renal Aguda/diagnóstico , Anuria/etiologia , Necrose Tubular Aguda/diagnóstico , Oligúria/etiologia , Nitrogênio da Ureia Sanguínea , Diagnóstico Diferencial , Taxa de Filtração Glomerular , Glomerulonefrite/diagnóstico , Humanos , Sódio/sangue , Uremia/diagnóstico , Obstrução Ureteral/diagnóstico , Obstrução do Colo da Bexiga Urinária/diagnósticoRESUMO
Renal vein thrombosis developed in 11 of 280 patients having either biopsy-proved membranous glomerulonephropathy or systemic lupus erythematosus with nephritis. All 11 also were found to have nephrotic syndrome. In nine, nephrotic syndrome developed before renal vein thrombosis; the diagnoses of nephrotic syndrome and renal vein thrombosis were made simultaneously in the other two. Ten of the 11 patients also had pulmonary emboli at or near the time of renal vein thrombosis.
Assuntos
Glomérulos Renais , Lúpus Eritematoso Sistêmico/complicações , Nefrite/complicações , Síndrome Nefrótica/complicações , Veias Renais , Trombose/etiologia , Adolescente , Adulto , Feminino , Humanos , Nefropatias/complicações , Masculino , Pessoa de Meia-Idade , Flebografia , Veias Renais/diagnóstico por imagem , Trombose/diagnóstico por imagemRESUMO
By means of renal biopsy and light, immunofluorescence, and electron microscopy, a diagnosis of membranous nephropathy (MN) was made in 100 patients. The nephrotic syndrome was present in 83 of these patients. 65 of the patients were men and 35 were women. The average period of follow-up was 99.8 months. As judged by the incidence of death and of improvement or complete healing, the women fared better than the men, whether given high-dose alternate-day prednisone therapy or not. The incidence of improvement or complete healing in the patients given prednisone was higher than the reported for patients who were not given corticosteroids. We have shown that occurrence of MN is more frequent in women than men and the course of MN is more benign in women than in men; alternate-day prednisone therapy appears to be beneficial in patients with MN.
