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RISS 인기검색어
- 검색키워드
- 저자 : ( Emrullah Solmazgul ) (검색결과 2 건)
- 무료
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( Veysel Ozalper ),( Ibrahim Cetindagli ),( Ergenekon Karagoz ),( Emrullah Solmazgul ),( Cihan Top ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Objective: Hyperkalemia is a common and serious clinical problem that occurs often due to impaired urinary potassium excretion because of acute or chronic kidney disease or drugs that effect renin-angiotensin-aldosterone axis. We report a hyperkalemic patient with 9.0mEq/L without any ECG changes. Case Report: A 86-year-old-woman suffering fatigue within two days had admitted emergency service because of sudden bilateral lower extremity paralysis. She had esential hypertension, ischemic heart disease and chronic kidney disease and was using Spironolactone, silazopril, asetilsalisilik, isosorbid-5-mononitrat ve karvedilol. Initial neurological examination of extremities was; 2/5 of lower extremity, 4/5 of upper extremity. Initial laboratory fi ndings potassium:9,1mmol/L, sodium:141mmol/L, creatinine: 1,9mg/dl. In his arterial blood gas analyse, pH:7.27, HCO3:16mEq/L, pCO2:30mm- Hg, potassium:9,1mmol/L. Spironolactone and silazopril treatment had stopped. With an intensive electrolyte-follow-up, She was commenced on intravenous fl uid, injection calcium gluconate and glucose/insulin infusion. Within two hours of treatment her potassium level decreased by 1.5 mmol/L. After eight hours of intensive treatment, potassium level reached below 6,5mEq/L. Five Days later, after three days of close follow-up with normal potassium level, the patient had discharged. Conclusion: ECG differancies like fl attening in U wawe, expansion in QRS, taper in T wawe, arrhytmias, asystoles can be seen in hypercalemia. Especially in the circumstances that serum potassium level is above 8 mEq/L ECG differancy is expected to be seen. So that, it is suggested that biochemical elevation in hypercalemic cases is verifi ed with ECG. Although it is rarely seen like in our cases, it shouldn`t be forgotten that severe hypercalemia can be seen without ECG differancy.
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( Yusuf Hancerli ),( Veysel Ozalper ),( Abdullah Haholu ),( Ramazan Arikan ),( Emrullah Solmazgul ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Objective: Castleman`s disease (CD) is quite rare and its etiology is not clearly unravelled yet. It is a lymphoproliferative disease with giant lymph node hyperplasia. This report presents newly diagnosed SLE and CD association on a 21 year old male who was transferred to our hospital with weight loss, fatigue and multiple lymphadenopathy (LAP) complaints along with the pre-diagnosis of lymphoma. Case Report: In September 2013, the patient was admitted to our Hematology Clinic with the complaints of weakness, neck and arm pit swelling and weight loss. The patient was at 68 kg in November 2012, while admitted to the hospital in September 2013 he was at 47 kg. On physical examination, bilateral cervical, supraclavicular, inguinal and axillary LAP which reached 3-4 cm in size and hepatomegaly was identifi ed. He had pain in both hand`s mid-interfalengeal joints and was unable to move comfortably. Labarotary fi ndings were hemoglobin:10. 5 g/dl, direct coombs +2 positive, platelet 79100 u/l, sedim 96, C-reactive protein 26. 6, ANA: 2. 672 (cut off<0,896), AntidsDNA:2. 517 (cut off<0,947), nRNP/Sm positive, C3: 0. 675 g/dl, C4 :0. 0871 g/ dl,24- hour urine protein 1481. 24 mg. The patient was diagnosed as SLE with the present fi ndings. The excisional biopsy from the right axillary lymph node area which showed the highest activity in PET CT ( SUVmax : 6. 4) was considered signifi cant inthe terms of CD. Conclusion: Altough LAP`s most common causes are malignancy, autoimmune diseases and infections, it would be appropriate to take into consideration lymphoproliferative diseases such as CD in the stage of diagnosis evaluation in spite of very rare occurence.
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