Rare complication of ceftriaxone therapy: drug-induced thrombocytopenia (DITP)

2021 ◽  
Vol 14 (9) ◽  
pp. e245228
Author(s):  
Aishwarya Sharma ◽  
Devendranath Mannuru ◽  
Abhishek Matta ◽  
Amit Kaushal
Keyword(s):  
End Stage Renal Disease ◽  
Rare Complication ◽  
Blood Cultures ◽  
Streptococcus Dysgalactiae ◽  
Drug Induced ◽  
Platelet Counts ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

A 62-year-old woman with a history of end-stage renal disease on haemodialysis, essential hypertension and type 2 diabetes mellitus was diagnosed with sepsis and placed on 600 mg oral linezolid every 12 hours and 1 g intravenous ceftriaxone every 24 hours. Blood cultures grew Streptococcus dysgalactiae, and she was switched to intravenous ceftriaxone 2 g daily. Platelet counts slowly trended down after starting ceftriaxone reaching 5 K/μL on day 12 of treatment. Ceftriaxone was discontinued and heparin-induced thrombocytopaenia was ruled out. She was switched to vancomycin and her platelet count improved. Given the temporal relationship between changing platelet counts and starting and discontinuing ceftriaxone, a diagnosis of drug-induced thrombocytopaenia was made.

A Case of Gabapentin-induced Myoclonus in a Type 2 Diabetic Patient with End-stage Renal Disease

2011 ◽  
Vol 12 (3) ◽  
pp. 171
Author(s):  
Eun Yeong Choe ◽  
Byung-Wan Lee ◽  
Kyeong Hye Park ◽  
Hannah Seok ◽  
Daham Kim ◽  
...  
Keyword(s):  
Renal Disease ◽  
Diabetic Patient ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage ◽  
Type 2 Diabetic

scholarly journals Sevelamer-associated ischemic colitis with perforation

2015 ◽  
Vol 6 (1) ◽  
Author(s):  
Rachel Hudacko ◽  
Peter Kaye
Keyword(s):  
Ischemic Colitis ◽  
End Stage Renal Disease ◽  
Subtotal Colectomy ◽  
Bowel Necrosis ◽  
Drug Induced ◽  
Colonic Injury ◽  
Colonic Wall ◽  
Sevelamer Carbonate ◽  
Stage Renal Disease ◽  
End Stage

We present a case of an 83-year-old woman with end-stage renal disease and hyperphosphatemia treated with sevelamer carbonate, who underwent subtotal colectomy for diffuse bowel necrosis and two perforations in the transverse colon. Histologic examination revealed ischemic colitis with crystals consistent with sevelamer carbonate embedded in ulcer debris and within the colonic wall in areas of transmural necrosis. This is a novel cause of drug-induced ischemic colitis with subsequent perforation that has not yet been reported in the literature. Clinicians and pathologists should be aware of the potential complications of sevelamer use and the histologic features of sevelamer-induced colonic injury.

DIABETIC RETINOPATHY, CLASSIFIED USING THE LESION-AWARE DEEP LEARNING SYSTEM, PREDICTS DIABETIC END-STAGE RENAL DISEASE IN CHINESE PATIENTS

2020 ◽  
Vol 26 (4) ◽  
pp. 429-443 ◽  
Author(s):  
Lijun Zhao ◽  
Honghong Ren ◽  
Junlin Zhang ◽  
Yana Cao ◽  
Yiting Wang ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Deep Learning ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Learning System ◽  
Chinese Patients ◽  
Glomerular Lesions ◽  
Stage Renal Disease ◽  
End Stage

Objective: To characterize the relationship between diabetic retinopathy (DR) and diabetic nephropathy (DN) in Chinese patients and to determine whether the severity of DR predicts end-stage renal disease (ESRD). Methods: Bilateral fundic photographs of 91 Chinese type 2 diabetic patients with biopsy-confirmed DN, not in ESRD stage, were obtained at the time of renal biopsy in this longitudinal study. The baseline severity of DR was determined using the Lesion-aware Deep Learning System (RetinalNET) in an open framework for deep learning and was graded using the Early Treatment Diabetic Retinopathy Study severity scale. Cox proportional hazard models were used to estimate the hazard ratio (HR) for the effect of the severity of diabetic retinopathy on ESRD. Results: During a median follow-up of 15 months, 25 patients progressed to ESRD. The severity of retinopathy at the time of biopsy was a prognostic factor for progression to ESRD (HR 2.18, 95% confidence interval 1.05 to 4.53, P = .04). At baseline, more severe retinopathy was associated with poor renal function, and more severe glomerular lesions. However, 30% of patients with mild retinopathy and severe glomerular lesions had higher low-density lipo-protein-cholesterol and more severe proteinuria than those with mild glomerular lesions. Additionally, 3% of patients with severe retinopathy and mild glomerular changes were more likely to have had diabetes a long time than those with severe glomerular lesions. Conclusion: Although the severity of DR predicted diabetic ESRD in patients with type 2 diabetes mellitus and DN, the severities of DR and DN were not always consistent, especially in patients with mild retinopathy or microalbuminuria. Abbreviations: CI = confidence interval; DM = diabetic mellitus; DN = diabetic nephropathy; DR = diabetic retinopathy; eGFR = estimated glomerular filtration rate; ESRD = end-stage renal disease; HbA1c = hemoglobin A1c; HR = hazard ratio; NPDR = nonproliferative diabetic retinopathy; PDR = proliferative diabetic retinopathy; SBP = systolic blood pressure; T2DM = type 2 diabetes mellitus; VEGF = vascular endothelial growth factor

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