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RISS 인기검색어
- 검색키워드
- 저자 : ( Rukiye Kara ) (검색결과 2 건)
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( Zeynep Tugba Guven ),( Selma Karaahmetoglu ),( Ali Atilla Aydin ),( Rukiye Kara ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Introduction: Hemolytic anemia, following mitral ring annuloplasty, is a rare entity. In this case hemolysis following mitral ring annuloplasty and iron defi ciency anemia caused by duodenal diverticulum will be presented. Case report: 55 years old women admitted to our Internal Medicine Department with the complaints of weakness, fatigue and dispnea. She had history of hypertension and coronary artery disease. Her complaints had been beginning two months after the mitral annuloplasty operation. Her physical examination revealed; subicterus, paleness of conjunctuvia and 3/6 systolic murmur on mitral region. In biochemical evolution; Hemoglobin 7. 2 mg/dl, Htc 25. 4%, total bilirubin 2. 7 mg/dl, direct bilirubin 0. 8 mg/ dl, LDH 1881 U/L. There wasn`t occult blood in the stool. Both LDH1 and LDH2 were increased. Hypochromia, microcytosis and anisocytosis was detected in the peripheral blood smear and reticulocyte value was 3. 1%. Serum iron level 28 mg/dl, iron binding capacity 357 mg/dl, ferritin 21. 4 mg/dl and haptoglobin level was 7. 2 mg/dl. Direct coombs test was detected +2. findings were supporting hemolytic anemia. Ejection fraction was calculated in normal range at transthoracic echocardiography. There was an annuloplasty ring at mitral level, third degree mitral regurgitation and left atrial dilatation. TEE was supporting the same fi ndings. Gastroduodenoscopy revealed; a large and deep diverticulum in postbulbar area and in the second part of duodenum. Since the patient did not accept coronary artery angiography and the operation, she was discharged. Conclusion: We decided that intravascular hemolysis was due to mitral valve annuloplasty. After this operation, hemolytic anemia is a rare condition. Because if a patient admits after valvular operation with anemia; we should keep in mind that it can be hemolytic anemia. The patient should be examined in terms of other types of anemia like iron defi ciency anemia.
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( Attila Aydin ),( Cemile Aydin ),( Selma Karaahmetogluozkan ),( Zeynep Guven ),( Rukiye Kara ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: End stage renal failure is an increasing clinical problem. That is why we should prevent it and capture patients in earlier stages in order to stop their progression. We should determine the causes of hospitalization and acute complications. Methods: The patients who were hospitalized for End Stage Renal Disease (ESRD) between March 2009-2011 patients were studied. We studied the causes of hospitalization in concern with established parameters. The datas were analyzed in SPSS program. Results: The total number of patients were 98 including 50 men and 48 women. The ages of patients were between 27-93. Chronic Kidney Disease (CKD) duration was 2-240 months, the dialysis duration was 0.5-240 months. The most common cause of emergency department admission was infection 39 (%39.8). The Patients admitted with an infection were taken dialysis treatment longer than other patients (p=0.034) and they had a higher initial hemoglobin level (p=0.002) and were hospitalized longer than the other patients (p=0.047). The most common type of infection was pneumonia (%43.6). The most common cause of mortality was sepsis with %40 and pneumonia with %20. There was no statistically difference in terms of albumin level between patients with infection and the others. Although in the exitus group albumin was statically lower than the survivors (p<0.05). Conclusions: The most common cause of ESRD was infection. The most common cause of mortality was also infection; sepsis and pneumonia. We determined that a low albumin level was a bad prognostic factor.
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