scholarly journals Normocomplementaemic Urticarial Vasculitis in a 19-Month-Old Girl

2016 ◽  
Vol 2016 ◽  
pp. 1-2
Author(s):  
Peter Williams
Keyword(s):  
Renal Function ◽  
Normal Level ◽  
Vital Signs ◽  
Activated Partial Thromboplastin Time ◽  
Similar Distribution ◽  
Urticarial Vasculitis ◽  
Urticarial Rash ◽  
Erythrocyte Sedimentation ◽  
International Normalised Ratio ◽  
Purpuric Rash

Urticaria is common in children. Urticarial vasculitis (UV) is a potentially more serious, rare variant. The youngest reported case was 12 months of age. A systemically well, 19-month-old girl presented with her mother who was concerned about the development of a rash. On presentation, the child had normal vital signs, was alert, and was well and playing with toys. There was a widespread urticarial rash (raised, pruritic, and erythematous) that was most apparent on the trunk with minimal rash on the legs. Overlying this urticarial rash in a similar distribution was a blotchy, palpable purpuric rash and associated hyperpigmentation. Investigations revealed a normal level of haemoglobin, white cells, platelets, and electrolytes. Renal function, international normalised ratio, and activated partial thromboplastin time were all normal. There was no blood or protein in the urine. The erythrocyte sedimentation rate was mildly elevated at 19 mm/hour. Complement results (including C1q) obtained later were normal. This case is striking not only because of the rarity of UV in children but also due to the unique diagnostic and prognostic challenges that it raises.

scholarly journals Erythrocyte Sedimentation Rate in Patients with Renal Insufficiency and Renal Replacement Therapy

2021 ◽  
Author(s):  
Anna Buckenmayer ◽  
Lotte Dahmen ◽  
Joachim Hoyer ◽  
Sahana Kamalanabhaiah ◽  
Christian S. Haas
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Renal Insufficiency ◽  
Replacement Therapy ◽  
Sedimentation Rate ◽  
Inflammatory Markers ◽  
Erythrocyte Sedimentation ◽  
Esrd Patients

Abstract Background: The erythrocyte sedimentation rate (ESR) is a simple laboratory diagnostic tool for estimating systemic inflammation. It remains unclear, if renal function affects ESR, thereby compromising its validity. This pilot study aims to compare prevalence and extent of ESR elevations in hospitalized patients with or without kidney disease. In addition, the impact of renal replacement therapy (RRT) modality on ESR was determined.Methods: In this single-center, retrospective study, patients were screened for ESR values. ESR was compared in patients with and without renal disease and/or RRT. In addition, ESR was correlated with other inflammatory markers, the extent of renal insufficiency and clinical characteristics.Results: A total of 203 patients was identified, showing an overall elevated ESR in the study population (mean 51.7±34.6 mm/h). ESR was significantly increased in all patients with severe infection, active vasculitis or cancer, respectively, independent from renal function. Interestingly, there was no difference in ESR between patients with and without kidney disease or those having received a prior renal transplant or being on hemodialysis. However, ESRD patients treated with peritoneal dialysis presented with a significantly higher ESR (78.3±33.1 mm/h, p<0.001), while correlation with other inflammatory markers was not persuasive.Conclusions: We showed that ESR: (1) does not differ between various stages of renal insufficiency; (2) may be helpful as a screening tool also in patients with renal insufficiency; and (3) is significantly increased in ESRD patients on peritoneal dialysis per se, while it seems not to be affected by hemodialysis or renal transplantation (see graphical abstract as supplementary material).

scholarly journals Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Samshol Sukahri ◽  
Lily Diana Zainudin ◽  
Mohd Firdaus Hadi ◽  
Mohd Al-Baqlish Mohd Firdaus ◽  
Muhammad Imran Abdul Hafidz
Keyword(s):  
Vital Signs ◽  
C Reactive Protein ◽  
Nocardia Species ◽  
X Ray ◽  
Reactive Protein ◽  
Pulmonary Nocardiosis ◽  
Erythrocyte Sedimentation ◽  
Chest X Ray ◽  
The Right ◽  
Tomography Scan

Pulmonary nocardiosis is a rare disorder that mainly affects immune-compromised patients. We report a 37-year-old male who presented with persistent fever associated with productive cough. During this course of therapy, he had recurrent admissions for empyema thoracic. Clinically, his vital signs were normal. Blood investigations show leukocytosis with a significantly raised erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Sputum acid-fast bacilli (AFB) was scanty 1+ and sputum mycobacterium culture was negative. Chest X-ray (CXR) showed consolidative changes with mild to moderate pleural effusion on the right side. Skin biopsy was taken and showed Paecilomyces species. A computed tomography scan (CT thorax) was performed and revealed a multiloculated collection within the right hemithorax with a split pleura sign. Decortications were performed and tissue culture and sensitivity (C+S) growth of Nocardia species. And it is sensitive to sulfamethoxazole-trimethoprim and completed treatment for 4 months. This case highlights that pulmonary nocardiosis should be kept in mind in also immune-competent patients, especially in suspected cases of tuberculosis not responding to antitubercular therapy.

Iodixanol in Cardioangiography

1994 ◽  
Vol 35 (6) ◽  
pp. 614-618 ◽  
Author(s):  
K. Tveit ◽  
K.-D. Bolz ◽  
B. Bolstad ◽  
T. Haugland ◽  
K. J. Berg ◽  
...  
Keyword(s):  
Heart Rate ◽  
Renal Function ◽  
Adverse Events ◽  
Contrast Media ◽  
Contrast Medium ◽  
Normal Renal Function ◽  
Clinical Chemistry ◽  
Vital Signs ◽  
Diagnostic Information

Iodixanol (Visipaque) 320 mg I/ml, a non-ionic, dimeric, isotonic contrast medium, was compared to ioxaglate (Hexabrix) 320 mg I/ml in cardioangiography. One hundred and two patients with normal renal function were included in the study. The objectives were to evaluate safety, tolerability, radiographic efficacy and effects on renal function. Adverse events, discomfort, vital signs, clinical chemistry parameters, diagnostic information and radiographic density were recorded. Both contrast media had minor effects on the renal function parameters monitored. The patients who received iodixanol experienced fewer adverse events, significantly less discomfort and had a lower increase in heart rate than did the patients in the ioxaglate group. The radiographic efficacy was good in both groups. Iodixanol 320 mg I/ml is safe and effective for use in cardioangiography.

scholarly journals Effects of intraoperative hypotension on postoperative renal function in arthroscopic shoulder surgery: a retrospective study

2020 ◽  
Author(s):  
Chaeseong Lim ◽  
Seounghun Lee ◽  
Woosuk Chung ◽  
Hoseop Kim ◽  
Seungbin Jeon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Shoulder Arthroscopy ◽  
Vital Signs ◽  
Shoulder Surgery ◽  
Factors Affecting ◽  
Beach Chair Position ◽  
Intraoperative Hypotension ◽  
Arthroscopic Shoulder Surgery ◽  
Beach Chair

Abstract Background: Arthroscopic shoulder surgery tends to cause a drop in blood pressure due to the beach chair position used during the procedure, including activation of the Bezold-Jarisch reflex. We hypothesized that patients with low blood pressure undergoing arthroscopic shoulder surgery in the beach chair position would also have reduced renal function after surgery.Methods: The medical records of patients (N = 643) undergoing arthroscopic shoulder surgery in the beach chair position between July 2013 and May 2015 were examined. The vital signs were measured at 5-minute intervals, and the number of non-invasive blood pressure (NIBP) measurements in the upper arm dropping below a mean arterial pressure (MAP) of 50 mmHg (MAP50) or 60 mmHg (MAP60) were recorded. The primary outcome was change in creatinine immediately after surgery relative to the preoperative level (Cr post/pre). The factors affecting Cr post/pre were examined by correlation analysis.Results: A total of 597 patients were included in the analysis. Longer duration of hypotension during surgery (MAP50) was correlated with higher Cr post/pre (R = 0.107, P = 0.010). However, the correlation between MAP60 and Cr post/pre was not significant (R = 0.033, P = 0.431).Conclusions: It is necessary to ensure that the MAP does not fall below 50 mmHg to ensure sufficient renal function during general anesthesia for shoulder arthroscopy in a beach chair position.

scholarly journals Nephroprotective Effects of Dioscoreaalata and Moriengaolifera on Cisplatin Induced Nephrotoxicity in Rats

2019 ◽  
Vol 31 (1) ◽  
pp. 46-51
Author(s):  
AKM Shahidur Rahman ◽  
Anwar Habib ◽  
Nishat Parvin ◽  
Monjurur Rahman Shah Chowdhury
Keyword(s):  
Renal Function ◽  
Medicinal Plant ◽  
Plant Extracts ◽  
Vital Signs ◽  
Kidney Injury ◽  
Toxic Effects ◽  
Common Source ◽  
Drug Induced ◽  
Pathogenic Mechanisms ◽  
Medicinal Plant Extracts

Nephrotoxicity, which is caused by mostly due to medication, is one of most important global health problem. Drugs are a common source of acute kidney injury. Drugs shown to cause nephrotoxicity exert their toxic effects by one or more common pathogenic mechanisms. . Most drugs found to cause nephrotoxicity exert toxic effects by one or more common pathogenic mechanisms. These include altered intraglomerular hemodynamics, tubular cell toxicity, inflammation, crystal nephropathy, rhabdomyolysis, and thrombotic microangiopathy. Drug-induced nephrotoxicity tends to be more common among certain patients and in specific clinical situations. Cisplatin, one of the many drugs, is responsible for severe nephrotoxicity. General preventive measures to avoid nephrotoxicity include using alternative non-nephrotoxic drugs; correcting risk factors; assessing baseline renal function before initiation of therapy, followed by adjusting the dosage; monitoring renal function and vital signs during therapy; and avoiding nephrotoxic drug combinations, using of several nephroprotective agents including medicinal plant extracts. Promising results showed that the use of some medicinal plant extracts (Dioscoreaalata and Moriengaolifera) gave rise to moderate restoration of normal physiology of kidney and liver of mice. TAJ 2018; 31(1): 46-51

scholarly journals Removal of Abnormal M Protein in Patients with Multiple Myeloma By Plasma-Free Exchange

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 29-29
Author(s):  
Fuling Zhou ◽  
Dandan Liu ◽  
Tianzhi Wu
Keyword(s):  
Multiple Myeloma ◽  
Renal Function ◽  
Erythrocyte Sedimentation Rate ◽  
Serum Calcium ◽  
Sedimentation Rate ◽  
Adverse Reactions ◽  
Conflicts Of Interest ◽  
Remission Rate ◽  
M Protein ◽  
Erythrocyte Sedimentation

ObjectiveBased on the albumin substitution fluid, we performed plasma-free exchange in the removal of abnormal M protein for patients with multiple myeloma using Fresenius COM.TEC machine MethodsFrom February 2016 to August 2018, 70 patients with multiple myeloma, who have indication of plasma exchange because of increased M protein, were treated with plasma-free exchange. Record the relevant basic information, the clinical symptoms and related disease indicators, and use SPSS 20.0 to analyze the changes of erythrocyte sedimentation rate, blood routine, albumin, renal function, serum calcium and immunoglobulin, and report adverse reactions. ResultsAfter treatment, the patient's erythrocyte sedimentation rate, serum calcium, serum creatinine, β2-microglobulin, uric acid, IgG, IgA were significantly reduced; hemoglobin, white blood cell level were not statistically significant. The creatinine remission rate was 97%, and the platelet decline was only 17.8%, and no adverse reactions related to thrombocytopenia such as hemorrhage and ecchymoses were observed. Patients with IgG type responded better than IgA-free treatment to plasma-free exchange. There were no serious adverse reactions after treatment, 1 case of blood pressure drop, 2 cases of low calcium reaction, all in the normal range, and recovered after the end of treatment. ConclusionPlasma-free exchange is an effective technology reducing M protein, which can effectively improve the erythrocyte sedimentation index, renal function index and blood viscous state. Patients with IgG type or higher ISS stage have more obvious effects. Plasma-free exchange significantly get rid of the application of fresh frozen plasma. Disclosures No relevant conflicts of interest to declare.

scholarly journals Immunoglobulin-A Vasculitis With Renal Involvement in a Patient With COVID-19: A Case Report and Review of Acute Kidney Injury Related to SARS-CoV-2

2021 ◽  
Vol 8 ◽  
pp. 205435812199168
Author(s):  
Nicholas L. Li ◽  
Adam B. Papini ◽  
Tiffany Shao ◽  
Louis Girard
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Abdominal Pain ◽  
Renal Biopsy ◽  
Kidney Injury ◽  
Iga Vasculitis ◽  
Tubular Injury ◽  
Raas Blockade ◽  
Purpuric Rash ◽  
New Onset

Rationale: Acute kidney injury is a common complication of COVID-19 and is associated with significantly increased mortality. The most frequent renal biopsy finding with SARS-CoV-2 infection is acute tubular injury; however, new onset glomerular diseases have been reported. The development of persistent urinary abnormalities in patients with COVID-19 should prompt consideration for renal biopsy to rule out glomerulonephritis. Presenting Concerns: A 30-year-old man with no prior medical history presented to the emergency department with symptoms of COVID-19 and new onset painful purpuric rash, arthralgia, and abdominal pain. SARS-CoV-2 infection was confirmed with nucleic acid testing and laboratory investigations revealed preserved renal function with dysmorphic hematuria and nephrotic range proteinuria. Diagnosis: A skin biopsy of the purpuric rash was performed, which demonstrated leukocytoclastic vasculitis. Renal biopsy revealed focally crescentic and segmentally necrotizing IgA nephropathy. Overall, given the clinical syndrome of glomerulonephritis with purpuric rash, arthralgia, and abdominal pain, the presentation is most in keeping with a diagnosis of IgA vasculitis in the setting of COVID-19. Interventions: The patient was treated conservatively for COVID-19 in the community. A 7-day course of prednisone was started for the vasculitic rash. IgA nephropathy was managed conservatively with blood pressure control and RAAS blockade with losartan. Outcomes: With conservative management, the patient’s COVID-19 symptoms resolved completely and he did not require hospital admission. Following prednisone therapy, the patient’s rash, arthralgia, and abdominal pain improved. However, despite resolution of COVID-19, hematuria and proteinuria persisted. With the initiation of RAAS blockade, renal function remained stable and proteinuria improved dramatically at 6 weeks. Novel Findings: De novo glomerulonephritis is a renal manifestation of SARS-CoV-2 infection beyond acute tubular injury. IgA vasculitis appears to be a rare complication of COVID-19.

scholarly journals Effects of Antibiotics on Haemostatic Parameters during Pregnancy

2021 ◽  
pp. 57-62
Author(s):  
Iyevhobu Kenneth Oshiokhayamhe ◽  
Amaechi R. A. ◽  
Turay A. A. ◽  
Okobi T. J. ◽  
Usoro E. R. ◽  
...  
Keyword(s):  
Platelet Count ◽  
Pregnant Women ◽  
Prothrombin Time ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Partial Thromboplastin Time ◽  
Health Centre ◽  
Activated Partial Thromboplastin Time ◽  
Erythrocyte Sedimentation ◽  
Time Test

An estimated 50,000 Nigerian women die each year from complications of pregnancy and childbirth, accounting for 10% of global estimates of pregnancy maternal death with about 2% resulting from drug induction. This cross-sectional study sets out to evaluate the Prothrombin time test (PT), activated partial thromboplastin time test (aPTT) Erythrocyte sedimentation rate (ESR), and Platelet count (PC) of pregnant women attending antenatal clinics at Oredo Health Centre in Benin City, Edo State. A total number of 130 subjects comprising 100 pregnant women and 30 non-pregnant women were recruited for the study. Prothrombin time (PT), Activated Partial Thromboplastin Time (APTT), Platelet count and Erythrocyte Sedimentation Rate (ESR) were studied using standard manual methods. The prothrombin time (sec) of the pregnant women 1st trimester (19.12±0.77b), 2nd trimester (19.90±1.02 b) and 3rd trimester (19.66±0.56 b), activated partial thromboplastin time (sec) 1st trimester (44.02±1.17 b), 2nd trimester (47.72±1.47 b) and 3rd trimester (45.88±1.10b), Erythrocyte sedimentation rate (mm/hr) 1st trimester (24.37±3.04 a), 2nd trimester (37.83±4.53 a) and 3rd trimester (43.25±5.24 a) and platelet count (X109/L) 1st trimester (248.29±23.18a), 2nd trimester (236.33±13.84 b) and 3rd trimester (239.10±16.07 a) were significantly higher than the prothrombin time (sec) 16.48±0.81 a, activated partial thromboplastin time (sec) 36.53±1.42 a, ESR (mm/hr) 29.83±4.14 a and platelet count (X109/L) 201±9.54 an of the non-pregnant women (p<0.05). The ESR (mm/hr) of the 3rd trimester (43.25±5.24) was observed to be significantly higher than that of the 1st trimester (24.37±3.04) and 2nd trimester (37.83±4.53) (p<0.05). Our investigation showed that antibiotics in pregnancy have a deleterious effect on PT, ESR, APTT and PC studied. We recommend that pregnant women should be given due attention throughout the course and events of pregnancy to prevent or reduce the risk of thrombotic episodes and possible disseminated intravascular coagulation (DIC) with resultant better maternity/child safety and health outcome and educated on the effects of antibiotics to pregnancy.

scholarly journals The Influence of Stress on Erythrocyte Sedimentary Rate (ESR) for the Staff of College of Science – Diyala University

2019 ◽  
pp. 71-77 ◽  
Author(s):  
Mohammed A. Farhan ◽  
Wafaa Sh. Al-Zuhairi ◽  
Nuha Abduljaleel Imran
Keyword(s):  
Erythrocyte Sedimentation Rate ◽  
Normal Level ◽  
Sedimentation Rate ◽  
Working Hours ◽  
Stress Effect ◽  
Blood Samples ◽  
Erythrocyte Sedimentation ◽  
Before And After ◽  
Statistical Program

This study was applied on 15 teaching staffs (10 men and 5 women) from Department of Chemistry, Diyala University to measure the effect of the stress during the working hours on the erythrocyte sedimentation rate (ESR). Blood samples were taken from the teaching staffs before and after the work, as well as another sample after the end of the working hours. The results were analyzed using a statistical program. Most of the results were within the normal level of ESR. There is no stress effect on teaching staffs during the working hours.

An Evaluation and Improvement Program for Inpatient Anticoagulant Control

1997 ◽  
Vol 77 (02) ◽  
pp. 283-288 ◽  
Author(s):  
W S Phillips ◽  
J Smith ◽  
M Greaves ◽  
F E Preston ◽  
K S Channer
Keyword(s):  
Change Management ◽  
Clinical Guidelines ◽  
Activated Partial Thromboplastin Time ◽  
Improvement Program ◽  
Percentage Time ◽  
Anticoagulant Drugs ◽  
International Normalised Ratio ◽  
Program Adherence ◽  
Structured Program

SummaryTo improve the management and therapeutic control of inpatients on anticoagulant drugs, combined prescription and monitoring charts have been developed for both heparin and warfarin which incorporate clinical guidelines. These have been introduced throughout a 700-bedded acute teaching hospital via a structured program of change management.We have demonstrated improvements in the quality of anticoagulant control (assessed with a custom-written computer program), adherence to clinical guidelines and quality of monitoring and prescribing of anticoagulants in inpatients.The percentage time spent under-anticoagulated with heparin (activated partial thromboplastin time ratio <1.5) fell from 32.7% to 18.5% (p<0.0001), whereas there was no change in percentage time over-anticoagulated (5.1% vs. 5.8%; p = ns). The percentage time spent under-anticoagulated with warfarin was unaltered (26.3% vs. 29.8%; p = ns) but the percentage time spent over-anticoagulated (International Normalised Ratio >4.5) was halved from 5.4% to 2.7% (p<0.001).We conclude that the introduction of the charts led to significant improvements in anticoagulant control.

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