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- 저자 : ( Barbaros Basbug ) (검색결과 3 건)
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Poster Session:PS 0195 ; Endocrinology : Acute Renal Failure Due to Vitamin D Intoxication
( Yusuf Hancerli ),( Veysel Ozalper ),( Ibrahim Cetintagli ),( Barbaros Basbug ),( Seyid Ahmet Ay ),( Ramazan Arikan ),( Yalcin Onem ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Objective: Vitamin D defi ciency is associated with multpl diseases.Vitamin D becomes more popular every day with the increasing studies. Vitamin D replacement therapy cases increase as well as Vitamin D intoxication cases. We present a 80-old-female patient who developed acute renal failure due to vitamin D intoxication. Case: Patient came to the emergency room with the complaints of 4-day continuing nausea, vomiting and loss of appetite. Mucosa of the patient was dry and she was dehydrate.Tests results were urea:186mg/dL, creatinine:3.64mg/dl, albumin:3.26 g/dL, calcium:12.7mg/dL and venous blood gas results were pH:7,41,pCO2:41.9 HCO3:26.6. Calcium,urea and creatinine levels were normal in a test that was performed 2 months ago. She was diagnosed with acute pre-renal failure connected to dehydration. A detailed medical history showed that 2.5 months ago, the patient was tested vitamin d3-25-0H (kalsifediyol):6.2 ng/ml and vitamin d3 300 000 IU bulb total of 3 was prescribed to her to be taken orally once a week, however, it was realized that the relatives of the patient gave her total of 10, once a week. After this fi nding, performed test results were detected as vitamin d3-25-0H (kalsifediyol):365 ng/ml, parathyroid hormone:16.8pg/ml. The patient was hospitalized with a diagnosis of vitamin D intoxication and intravenous hydration with saline and IV furosemide infusion therapy was applied. At the end of second day her complaints have decreased and at the end of third day calcium level were 9.3mg/dl. At the tenth day test results were urea:30 mg/ dL,creatinine:1.12 mg/dL, and the patient was discharged. Conclusion: Due to growing interest in vitamin D, it is very important that clinicans should be aware and alerted of that overdose vitamin D replacement therapy can cause vitamin D intoxication.
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Poster Session:PS 0481 ; Nephrology : Analgesic Nephropathy Associated with Total Anuria
( Yaloin Onem ),( Ali Kutlu ),( Seyit Ahmet Uslu ),( Barbaros Basbug ),( Muslum Sagir ),( Yusuf Hazcerli ),( Mustafa Hatipoglu ),( Kemal Kara ),( Ramazan Arikan ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Introduction and Aim:While ischemia and nefrotoxins account for almost 45 % of all acute renal failure cases, prerenal (caused by congestive cardiac failure, liquid insuffi - ciency, sepsis and medication) azotemia accounts for around 20%. Among nefrotoxins, nonstereoid anti-infiammatory drugs (NSAII) may affect kidneys through multiple mechanisms (causing hemodynamic, acute allergic interstitial nephritis, papillary necrosis or glomerular nephritis). Herein, we present a patient who developed analgesic nephropathy associated with total anuria. Case: A patient with a medical history of benign prostatic hyperplasia, coronary artery disease, hypertension and tuberculosis was admitted to our department of emergency with complaints of dyspnea and headache. Laboratory examination revealed the following Results: urea: 138 mg/dL, kreatinin: 5,20 mg/dL, BK: 19300, ALT: 319 U/L AST: 324 U/ L LDH: 1947 U/L. The patient was diagnosed with total anuria. Because the patient had a history of analgesic usage, he was scheduled to undergo hemodialysis 3 times per week with a prediagnosis of analgesic nephropathy. Although initially renal function tests demonstrated a slight deterioration (urea: 177 mg/dL and creatinine: 8 mg/dL) they displayed a gradual decrease following ongoing hemodialysis sessions and consequently returned to normal (urea: 48 mg/dL and creatinine: 1, 25 mg/dL). The patient also received piperacillin/tazobactam 3x 2, 25 gr/day due to a concern for aspiration pneumonia. Diagnostic bronchoscopy results were in compliance with fi brosis at microscopic level. Conclusion/Recommendations: Analgesic nefropathy should be investigated when inquiring for the etiology of acute renal failure. Patients with total anuria should receive comprehensive treatment comprising renal replacement therapy such as hemodialysis. Additionally, interstitial lung disease and overlapping aspiration pneumonia may complicate the condition. Therefore, they also should be considered. Even patients with total anuria may return to normal life following a comprehensive and rigorous approach.
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Polyglandular Autoimmune Syndrome Type-Ii Presented with Acute Renal Injury
( Veysel Ozalper ),( Ibrahim Cetindagli ),( Omer Tekin ),( Yalcin Onem ),( Yusuf Hancerli ),( Eylem Cagiltay ),( Barbaros Basbug ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Introduction: Polyglandular autoimmune syndrome (PAS) is a rare disease, characterized by failure of more than two endocrine glands. Type-II of this syndrome is the most common of the immunoendocrinopathy syndromes and characterized by the obligatory occurrence of autoimmune Addison disease in combination with thyroid autoimmune diseases and/or type-I diabetes mellitus. We report a case of PAS-TypeII presented with prerenal acute renal failure. Case Report: A twenty-two-year-old man had a hyperpigmentation of gingiva within three months, fatigue and amnesia within two months, emesis and vomit within one months, admitted because of persistent vomiting and ten kilogram weight loss. Initial laboratory fi ndings were: urea:87mg/dl, kreatinin:1.31mg/dl, sodium:125mmol/L, potassium: 5.6mmol/L, albumin:4.16g/dl, calcium:123mg/dl. In his arterial blood gas analyse, he had a normal anion gap metabolic asidosis. pH:7.24, HCO3:12.8mEq/L, pCO2:30mm- Hg. He had a prerenal acute renal injury because of persistent vomiting. Other laboratory fi ndings were Hemoglobine:12.9g/dl, TSH:0,004 uIU/ml, FreeT4:2,16ng/dl, Anti-TPO:876 IU/ml, AntiThyroglobulin:9,72IU/ml, Cpeptid:0,27ng/ml, Kortizol:0,1ug/dl, ACTH:22,8pg/ml, HbA1c: %4,7.. A thyroid-scintigraphy showed diffuse homogenous thyroid involvement. His pituitary magnetic-resonance-imaging, thoracoabdominal- tomography and esophagogastroscopy was normal. Based on his fi ndings above and intravenous ACTH stimulation test, adrenal insuffi ency and otoimmune thyroiditis were diagnosed. General condition improved gradually following the administration of hydrocortisone, fl udrocortisone, thyromazol, propranolol. Conclusions: As a conclusion, in persistant vomiting patients, endocrine functions must be performed. A patient who presents with a single autoimmune diseases must be considered at risk of other autoimmune diseases. High index of suspicion, early recognition and treatment can be life-saving, particularly when there is adrenal and thyroid component.
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