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acute kidney injury in diarrhoea conditions

Natalia L Kozlovskaya, Yulia V Korotchaeva, Larisa A Bobrova
OBJECTIVE: The aim of this case series is to raise awareness of obstetric-related atypical haemolytic uraemic syndrome (aHUS) amongst obstetricians and gynaecologists. STUDY DESIGN: Data from 20 consecutive patients, aged 19-38, with obstetric-aHUS manifestation during or immediately after pregnancy are reported. Patients were diagnosed and treatment was initiated between 2012 and 2016. RESULTS: Presentation of aHUS was mainly preceded by preeclampsia and/or haemolysis, elevated liver enzymes and low platelet count syndrome, other obstetric complications, or by diarrhoea...
April 1, 2018: Journal of Maternal-fetal & Neonatal Medicine
Sandev Singh, Larry Ee Juan Loo, Christopher Watters, Suhail Ahmed
Collagenous panenteritis is a rare inflammatory condition that causes profound diarrhoea and weight loss. There has only been a handful of cases reported in the literature. We report this rare case and the diagnostic difficulties encountered in securing the diagnosis. A 59-year-old woman presented with an 8-month history of diarrhoea and weight loss on a background of a family history of coeliac disease. Her presentation was complicated with acute kidney injury secondary to prerenal losses. Repeated gastroscopies and colonoscopies along with biopsies were inconclusive...
October 2017: Frontline Gastroenterology
Werner Keenswijk, Johan Vande Walle
A 2-year-old boy presented with severe hypotension and acute kidney injury after a prodrome of non-bloody diarrhoea and fever in the preceding 3 days. He had a mild Ebstein cardiac anomaly but otherwise a normal past history and growth. On examination, he looked ill, his temperature was 37.5 °C, circulation was poor, and there were several purpuric lesions on the face, hands and scrotum. Haemoglobin was 7.8 g/dL (11-14), total white cell count 27 × 10(9)/L, platelets 62 × 10(9)/L, blood urea nitrogen 20...
April 20, 2017: Paediatrics and International Child Health
Janna K Duong, Timothy J Furlong, Darren M Roberts, Garry G Graham, Jerry R Greenfield, Kenneth M Williams, Richard O Day
BACKGROUND: Lactic acidosis is an adverse event associated with metformin usage. Patients with metformin-associated lactic acidosis (MALA), however, often have other conditions contributing to the event. The relative contribution of metformin is often unclear. MALA is usually diagnosed without measuring the plasma concentrations of metformin. OBJECTIVES: The objectives of this study were, first, to examine the plasma concentrations of metformin, lactate and creatinine and the arterial pH of patients with suspected MALA and, second, to review critically the mechanisms of MALA...
September 2013: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Rafael Lozano, Mohsen Naghavi, Kyle Foreman, Stephen Lim, Kenji Shibuya, Victor Aboyans, Jerry Abraham, Timothy Adair, Rakesh Aggarwal, Stephanie Y Ahn, Miriam Alvarado, H Ross Anderson, Laurie M Anderson, Kathryn G Andrews, Charles Atkinson, Larry M Baddour, Suzanne Barker-Collo, David H Bartels, Michelle L Bell, Emelia J Benjamin, Derrick Bennett, Kavi Bhalla, Boris Bikbov, Aref Bin Abdulhak, Gretchen Birbeck, Fiona Blyth, Ian Bolliger, Soufiane Boufous, Chiara Bucello, Michael Burch, Peter Burney, Jonathan Carapetis, Honglei Chen, David Chou, Sumeet S Chugh, Luc E Coffeng, Steven D Colan, Samantha Colquhoun, K Ellicott Colson, John Condon, Myles D Connor, Leslie T Cooper, Matthew Corriere, Monica Cortinovis, Karen Courville de Vaccaro, William Couser, Benjamin C Cowie, Michael H Criqui, Marita Cross, Kaustubh C Dabhadkar, Nabila Dahodwala, Diego De Leo, Louisa Degenhardt, Allyne Delossantos, Julie Denenberg, Don C Des Jarlais, Samath D Dharmaratne, E Ray Dorsey, Tim Driscoll, Herbert Duber, Beth Ebel, Patricia J Erwin, Patricia Espindola, Majid Ezzati, Valery Feigin, Abraham D Flaxman, Mohammad H Forouzanfar, Francis Gerry R Fowkes, Richard Franklin, Marlene Fransen, Michael K Freeman, Sherine E Gabriel, Emmanuela Gakidou, Flavio Gaspari, Richard F Gillum, Diego Gonzalez-Medina, Yara A Halasa, Diana Haring, James E Harrison, Rasmus Havmoeller, Roderick J Hay, Bruno Hoen, Peter J Hotez, Damian Hoy, Kathryn H Jacobsen, Spencer L James, Rashmi Jasrasaria, Sudha Jayaraman, Nicole Johns, Ganesan Karthikeyan, Nicholas Kassebaum, Andre Keren, Jon-Paul Khoo, Lisa Marie Knowlton, Olive Kobusingye, Adofo Koranteng, Rita Krishnamurthi, Michael Lipnick, Steven E Lipshultz, Summer Lockett Ohno, Jacqueline Mabweijano, Michael F MacIntyre, Leslie Mallinger, Lyn March, Guy B Marks, Robin Marks, Akira Matsumori, Richard Matzopoulos, Bongani M Mayosi, John H McAnulty, Mary M McDermott, John McGrath, George A Mensah, Tony R Merriman, Catherine Michaud, Matthew Miller, Ted R Miller, Charles Mock, Ana Olga Mocumbi, Ali A Mokdad, Andrew Moran, Kim Mulholland, M Nathan Nair, Luigi Naldi, K M Venkat Narayan, Kiumarss Nasseri, Paul Norman, Martin O'Donnell, Saad B Omer, Katrina Ortblad, Richard Osborne, Doruk Ozgediz, Bishnu Pahari, Jeyaraj Durai Pandian, Andrea Panozo Rivero, Rogelio Perez Padilla, Fernando Perez-Ruiz, Norberto Perico, David Phillips, Kelsey Pierce, C Arden Pope, Esteban Porrini, Farshad Pourmalek, Murugesan Raju, Dharani Ranganathan, Jürgen T Rehm, David B Rein, Guiseppe Remuzzi, Frederick P Rivara, Thomas Roberts, Felipe Rodriguez De León, Lisa C Rosenfeld, Lesley Rushton, Ralph L Sacco, Joshua A Salomon, Uchechukwu Sampson, Ella Sanman, David C Schwebel, Maria Segui-Gomez, Donald S Shepard, David Singh, Jessica Singleton, Karen Sliwa, Emma Smith, Andrew Steer, Jennifer A Taylor, Bernadette Thomas, Imad M Tleyjeh, Jeffrey A Towbin, Thomas Truelsen, Eduardo A Undurraga, N Venketasubramanian, Lakshmi Vijayakumar, Theo Vos, Gregory R Wagner, Mengru Wang, Wenzhi Wang, Kerrianne Watt, Martin A Weinstock, Robert Weintraub, James D Wilkinson, Anthony D Woolf, Sarah Wulf, Pon-Hsiu Yeh, Paul Yip, Azadeh Zabetian, Zhi-Jie Zheng, Alan D Lopez, Christopher J L Murray, Mohammad A AlMazroa, Ziad A Memish
BACKGROUND: Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex. METHODS: We attempted to identify all available data on causes of death for 187 countries from 1980 to 2010 from vital registration, verbal autopsy, mortality surveillance, censuses, surveys, hospitals, police records, and mortuaries...
December 15, 2012: Lancet
Sandrine Leroy, Arnaud Isapof, Sonia Fargue, May Fakhoury, Albert Bensman, Georges Deschênes, Evelyne Jacqz-Aigrain, Tim Ulinski
Tacrolimus is known to potentially lead to adverse events in recipients with diarrhoea and/or calcium channel blocker (CCB) co-administration. We report a renal transplant recipient who suffered from severe nephrotoxicity related to a toxic tacrolimus trough concentration in both conditions, diarrhoea and CCB co-administration, and with genotyped CYP3A system and P-glycoprotein (P-gp) polymorphisms. To our knowledge, this is the first case to be investigated for such polymorphisms. Clinicians should be reminded of the possibility of highly increased levels of tacrolimus in situations of diarrhoea and/or co-administration of CCBs...
May 2010: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
A Di Grande, F Vancheri, V Giustolisi, C Giuffrida, G Narbone, M Licata, C Le Moli, S Riccobene, A Burgio, S Bartolotta, F Nigro, V Cannone
Metformin is a biguanide commonly used in type 2 diabetes mellitus (DM). Lactic acidosis, a potentially life-threatening metabolic disorder, may be due to a number of different causes, including metformin therapy. We present a case of a severe metformin-induced lactic acidosis in a patient with type 2 DM, admitted to the emergency department with a history of dehydration due to diarrhoea and complicated by acute renal failure. Patient complained malaise and severe weakness and was tachypneic (Kussmaul's respiration), agitated and confused, with a Glasgow Coma Scale score of 13/15...
March 2008: La Clinica Terapeutica
Fernando C Fervenza, Peter M Fitzpatrick, Jim Mertz, Stephen B Erickson, Scott Liggett, Sandy Popham, Daniel N Wochos, Arkady Synhavsky, Steven Hippler, Timothy S Larson, Stephanie M Bagniewski, Jorge A Velosa et al.
BACKGROUND: Based on its success as a transplant immunosuppressor, there is intense interest in using rapamycin in the treatment of progressive glomerulopathies involving native kidneys. However, we call attention to the potential toxicity associated with the use of rapamycin in this setting. METHODS: We conducted a study to examine the efficacy and safety of rapamycin in patients with progressive chronic renal failure. Eleven patients with either focal segmental glomerulosclerosis, immunoglobulin A nephropathy, membranous nephropathy or membrano-proliferative glomerulonephritis and progressive renal failure (defined as an increase in >25% of baseline serum creatinine over the last year or loss of glomerular filtration rate > or =5 ml/min/year as determined by the Cockcroft-Gault formula), proteinuria > or =1...
May 2004: Nephrology, Dialysis, Transplantation
S Saxena
Acute renal failure is the sudden failure on the part of the kidney to maintain normal biochemical homeostasis in the body. Medical causes of acute renal failure are fluid and electrolyte depletion, infectious diarrhoea, non-diarrhoeal infections, glomerulonephritis, poisoning with heavy metals, G-6-PD deficiency, snake bite and nephrotoxic drugs. Septic abortion is the most common cause of obstetric acute renal failure. Obstructive uropathy is an important cause of surgical acute renal failure. Guidelines to non-dialytic management of acute renal failure depend on the patient's condition which includes volume status, hyperkalaemia, acidaemia, uraemia and whether he/she is receiving medication and having adequate nutrition...
July 2001: Journal of the Indian Medical Association
R Naqvi, E Ahmed, F Akhtar, I Yazdani, N Z Naqvi, A Rizvi
Factors leading to acute renal failure (ARF) were analysed in 376 consecutive patients between January 1993 and December, 1994 in a Karachi centre. Two hundred and sixteen (57%) had medical conditions, 86 (24%) obstetrical, 28 (7%) obstructive, 18 (5%) surgical and in 28 (7%) the causes were uncertain. Within the medical group, the causes were diarrhoea 30%, drugs 23%, malaria 15% and liver disease 5%. In the obstetrical group majority of the patients had multiple etiologies. Sixty percent of patients had ante-partum haemorrhage, 33% post-partum haemorrhage, intrauterine deaths were seen in 31%, septic abortions in 20% and pre-eclamptic toxemia in 22% cases...
February 1996: JPMA. the Journal of the Pakistan Medical Association
K S Chugh, A Narang, L Kumar, V Sakhuja, V N Unni, R Pirzada, N Singh, B J Pereira, P C Singhal
The pathogenetic factors leading to acute renal failure (ARF) in 223 children between the ages of 20 days and 14 years were studied. Diarrhoeal diseases were responsible for ARF in 49.8%, acute glomerulonephritis in 34.1%, drug induced intravascular hemolysis in glucose -6-phosphate dehydrogenase deficiency in 4.5%, snake bite in 4%, hemolytic uremic syndrome in 2.2%, and miscellaneous causes in 5.4%. Dialysis was instituted in 178 children and the others were treated conservatively. Renal histology in 39 out of 76 children who presented with an acute nephritic illness revealed acute endocapillary proliferative glomerulonephritis in 27 and crescentic glomerulonephritis in 12...
March 1987: International Journal of Artificial Organs
S P Wilkinson, P McHugh, S Horsley, H Tubbs, M Lewis, A Thould, M Winterton, V Parsons, R Williams
Eight sailors on board the Asiafreighter were exposed to arsine that had escaped from a cylinder in the cargo hold. Four suffered severe toxicity and within a few hours had developed fever, weakness, nausea, vomiting, diarrhoea, abdominal pain, and haemoglobinuria. These patients had pronounced intravascular haemolysis, which in one patient was complete. This patient was also stuporose and anoxic, a condition attributed to failure of oxygen transport and sludging of red cell debris in the cerebral and pulmonary circulations, but he regained a normal level of consciousness after exchange transfusion...
September 6, 1975: British Medical Journal (1857-1980)
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