scholarly journals Pneumocystis jirovecii pneumonitis: cause of acute hypercalcaemia in chronic haemodialysis patient

2020 ◽  
Vol 13 (1) ◽  
pp. e231334 ◽  
Author(s):  
Florian Garo ◽  
Cedric Aglae ◽  
Pedram Ahmadpoor ◽  
Olivier Moranne
Keyword(s):  
Calcium Concentration ◽  
Haemodialysis Patient ◽  
Laboratory Data ◽  
Pneumocystis Jirovecii ◽  
Respiratory Sounds ◽  
Chronic Haemodialysis ◽  
Ionised Calcium ◽  
Autosomal Dominant Polycystic Kidney ◽  
Dialysate Calcium ◽  
Chest Ct Scan

A 76-year-old renal transplant patient due to autosomal dominant polycystic kidney disease who resumed chronic haemodialysis was admitted to our hospital for confusion and lassitude. He was afebrile and physical examination revealed diffuse bilateral rales with decreased respiratory sounds in lower right lung. Laboratory data showed hypercalcaemia (total calcium 3.92 mmol/L (normal range 2.2–2.6 mmol/L), ionised calcium 1.87 mmol/L (1.15–1.35 mmol/L)), low intact parathyroid hormone (iPTH) 15 ng/L, (15–65 ng/L) and high 1,25(OH)2D3 128.9 pg/mL, (15.2–90.1 pg/mL). Chest CT-scan revealed bilateral apical lung lesions after 15 days of antibiotics. Bronchoalveolar sample was PCR positive for Pneumocystis jirovecii. He was treated with an extra session of haemodialysis with 1.25 mmol/L dialysate calcium concentration, oral trimethoprim-sulfamethoxazole was started and oral corticosteroid dose increased to 1 mg/kg for 1 week. Hypercalcaemia decreased progressively after initiation of these treatments. We concluded a case of hypercalcaemia secondary to P. jirovecii infection.

Individualizing the dialysate calcium concentration

2015 ◽  
Vol 24 (6) ◽  
pp. 538-545 ◽  
Author(s):  
Guillaume Jean ◽  
Charles Chazot
Keyword(s):  
Calcium Concentration ◽  
Dialysate Calcium

Elimination of Staphylococcus aureus from the bloodstream using a novel biomimetic sorbent haemoperfusion device

2020 ◽  
Vol 13 (8) ◽  
pp. e235262
Author(s):  
Malin-Theres Seffer ◽  
Gabriele Eden ◽  
Susanne Engelmann ◽  
Jan T Kielstein
Keyword(s):  
Staphylococcus Aureus ◽  
Haemodialysis Patient ◽  
Bacterial Load ◽  
Ultrahigh Molecular Weight Polyethylene ◽  
Blood Stream ◽  
Chronic Haemodialysis ◽  
The European Union ◽  
Blood Filter ◽  
First Case ◽  
Ultrahigh Molecular Weight

Removal of bacteria from the blood by means of extracorporeal techniques has been attempted for decades. In late 2019, the European Union licensed the first ever haemoperfusion device for removal of bacteria from the blood. The active ingredient of Seraph 100 Microbind Affinity Blood Filter is ultrahigh molecular weight polyethylene beads with endpoint-attached heparin. Bacteria have been shown to bind to heparin as they would usually do to the heparan sulfate on the cell surface, thereby being removed from the blood stream. We describe the first case of a female chronic haemodialysis patient in which this device was clinically used for a Staphylococcus aureus infection that persisted for 4 days despite antibiotic therapy. After a single treatment, the bacterial load decreased and the blood cultures at the end of a 4 hour haemoperfusion exhibited no bacterial growth.

scholarly journals Serum ionised calcium concentration: measurement versus calculation.

BMJ ◽  
1978 ◽  
Vol 1 (6120) ◽  
pp. 1103-1105 ◽  
Author(s):  
S C Conceicao ◽  
D Weightman ◽  
P A Smith ◽  
J Luno ◽  
M K Ward ◽  
...  
Keyword(s):  
Calcium Concentration ◽  
Concentration Measurement ◽  
Ionised Calcium

Heparin effect on ionised calcium concentration

1981 ◽  
Vol 116 (3) ◽  
pp. 343-347 ◽  
Author(s):  
C.K. Biswas ◽  
J.M. Ramos ◽  
D.N.S. Kerr
Keyword(s):  
Calcium Concentration ◽  
Ionised Calcium

The Influence of Dialysate Calcium Concentration on the Pth Level in Children Undergoing Capd

1996 ◽  
Vol 16 (1_suppl) ◽  
pp. 567-569 ◽  
Author(s):  
Maria Sieniawska ◽  
Maria Roszkowska-Blaim ◽  
Beata Wojciechowska
Keyword(s):  
Mass Transfer ◽  
Peritoneal Dialysis ◽  
Parathyroid Hormone ◽  
Dwell Time ◽  
Calcium Concentration ◽  
Vitamin D Metabolites ◽  
Intact Parathyroid Hormone ◽  
Gland Function ◽  
Dialysate Calcium ◽  
Pth Level

In 12 children aged four-and-a-half to 18 years (mean 11 ±4.2) undergoing continuous ambulatory peritoneal dialysis (CAPO), serum intact parathyroid hormone (iPTH), ionized calcium (iCa) levels, and calcium mass transfer (CaMT) were measured on three consecutive days: day 1, after a four-hour interval between dialyses; on day 2, after four hours dwell time with peritoneal dialysis (PD) Ca 3.5 mEq/L; and on day 3, after four hours dwell time with PD Ca 2.5 mEq/L. A significantly more negative CaMT was found when PD Ca 2.5 mEq/L was used, as compared with values obtained using PD Ca 3.5 mEq/L. Significantly lower parathyroid hormone (PTH) values were found after the interval between exchanges. We conclude that in order to properly evaluate parathyroid gland function and to decide whether or not to give vitamin D metabolites, a protocol for determining PTH should be standardized.

scholarly journals MON-111 Effect of the dialysate calcium concentration and of the mineral bone disease therapies on mortality in the REIN registry

2019 ◽  
Vol 4 (7) ◽  
pp. S349-S350
Author(s):  
L. Mercadal ◽  
L. Oriane ◽  
C. Cécile ◽  
M. marie ◽  
B. philippe ◽  
...  
Keyword(s):  
Bone Disease ◽  
Calcium Concentration ◽  
Dialysate Calcium ◽  
Rein Registry

scholarly journals Eosinopenia in COVID-19 Patients: A Retrospective Analysis

2020 ◽  
Vol 8 (12) ◽  
pp. 1929
Author(s):  
Narcisse Ndieugnou Djangang ◽  
Lorenzo Peluso ◽  
Marta Talamonti ◽  
Antonio Izzi ◽  
Pierre Alain Gevenois ◽  
...  
Keyword(s):  
Ct Scan ◽  
Retrospective Analysis ◽  
Predictive Accuracy ◽  
Laboratory Finding ◽  
Laboratory Data ◽  
High Body Mass Index ◽  
Chest Ct ◽  
Diagnostic Methods ◽  
Chest Ct Scan ◽  
Pcr Test

Objectives: The aim of this study was to assess the diagnostic role of eosinophils count in COVID-19 patients. Methods: Retrospective analysis of patients admitted to our hospital with suspicion of COVID-19. Demographic, clinical and laboratory data were collected on admission. Eosinopenia was defined as eosinophils < 100 cells/mm3. The outcomes of this study were the association between eosinophils count on admission and positive real-time reverse transcription polymerase chain reaction (rRT-PCR) test and with suggestive chest computerized tomography (CT) of COVID-19 pneumonia. Results: A total of 174 patients was studied. Of those, 54% had positive rRT-PCR for SARS-CoV-2. A chest CT-scan was performed in 145 patients; 71% showed suggestive findings of COVID-19. Eosinophils on admission had a high predictive accuracy for positive rRT-PCR and suggestive chest CT-scan (area under the receiver operating characteristic—ROC curve, 0.84 (95% CIs 0.78–0.90) and 0.84 (95% CIs 0.77–0.91), respectively). Eosinopenia and high LDH were independent predictors of positive rRT-PCR, whereas eosinopenia, high body mass index and hypertension were predictors for suggestive CT-scan findings. Conclusions: Eosinopenia on admission could predict positive rRT-PCR test or suggestive chest CT-scan for COVID-19. This laboratory finding could help to identify patients at high-risk of COVID-19 in the setting where gold standard diagnostic methods are not available.

Sign in / Sign up

Export Citation Format

Share Document