scholarly journals Spontaneous Progressive Muscle Weakness with Persistent Leukocytosis

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Sameer A. Hirji ◽  
Manish M. Karamchandani ◽  
Jonathan W. Scott ◽  
Matthew T. Menard
Keyword(s):  
Compartment Syndrome ◽  
Muscle Weakness ◽  
Diagnostic Delay ◽  
Progressive Muscle Weakness ◽  
Lower Extremity Muscle ◽  
Muscle Necrosis ◽  
Stage Renal Disease ◽  
End Stage ◽  
Prompt Diagnosis ◽  
Iliacus Muscle

Iliacus compartment syndrome is a rare clinical condition which can result in a severe, unilateral, femoral neuropraxia. Recognition of this syndrome as the cause of a developing neuropathy is often delayed given a lack of familiarity with this clinical diagnosis and the retroperitoneal location of the iliacus muscle. Prompt diagnosis is important to avoid risk of consequent muscle necrosis, rhabdomyolysis, and possibly permanent nerve injury. We describe a case of iliacus compartment syndrome in an elderly, frail woman with end-stage renal disease, anticoagulated for atrial fibrillation, who presented with subacute, progressive lower extremity muscle weakness and pain in the setting of complicated metabolic derangements. She was found to have a spontaneous large hematoma in her left iliacus muscle on computed tomography scan. Despite an initial diagnostic delay, she was successfully managed with an iliacus fasciotomy, which led to complete resolution of her symptoms.

Symptomatic kidney stones in an anuric patient on dialysis: A case report

2021 ◽  
pp. 039156032110359
Author(s):  
Hossein Dialameh ◽  
Farshad Namdari ◽  
Mehrdad Mahalleh ◽  
Mohammad Lotfi ◽  
Zoha Ali
Keyword(s):  
Renal Colic ◽  
Chest Ct ◽  
Chief Complaint ◽  
Flank Pain ◽  
The Past ◽  
Extracorporeal Shock Wave ◽  
Stage Renal Disease ◽  
End Stage ◽  
Prompt Diagnosis ◽  
Chest Ct Scan

Introduction: Renal colic is a colicky-type of flank pain that can commonly be presented in patients undergoing dialysis especially if they are anuric considering the fact that there are multiple controversies and little published experience on this topic, we found it very important to report this case. We also aimed to increase awareness and emphasize the importance of renal colic in anuric patients on dialysis. Case description: We herein report a case of a 42-year old man with a chief complaint of bilateral colic flank pain, He had developed end stage renal disease due to ADPKD and was on hemodialysis since the past 5 years. Previously, he went through a series of workup but was left undiagnosed. Abdomen-pelvic and chest CT scan without contrast was performed showing bilateral renal pelvic stones and some nephrocalcinosis in both kidneys. bilateral ureteroscopy was performed and bilateral DJ was installed for a total of 6 weeks and extracorporeal shock wave lithotripsy was done. With prompt diagnosis, the patient was pain free and stone free before discharge. The patient is also reported to be stone free 6 months after the procedure. Conclusion: Patients on dialysis are still capable of forming symptomatic renal tract stones even if they are anuric.

scholarly journals Acute Kidney Injury in Pregnant Patient With Pancreas-Kidney Transplant Caused by Abdominal Compartment Syndrome: A Case Presentation, Review of Literature, and Proposal of Diagnostic Approach

2019 ◽  
Vol 6 ◽  
pp. 205435811986194 ◽  
Author(s):  
Magdalena Michalska ◽  
Kevin Wen ◽  
Robert P. Pauly
Keyword(s):  
Abdominal Pain ◽  
Renal Transplant ◽  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
End Stage Renal Disease ◽  
Renal Allograft ◽  
Stage Renal Disease ◽  
End Stage ◽  
Abdominal Compartment ◽  
In Pregnancy

Rationale: With increasing number of complex medical patients with renal transplant who get pregnant, clinicians need to be aware of abdominal compartment syndrome which may masquerade as acute renal allograft injury in pregnancy. Presenting concerns of the patient: A 34-year-old nulliparous Caucasian female with end-stage renal disease (ESRD) due to type 1 diabetes mellitus who received a simultaneous pancreas-kidney transplant (SPK) in 2006 and then after rejection of renal allograft another, kidney-only allograft from a donation after circulatory death became pregnant in May 2013 with dichorionic, diamniotic twins without reproductive technology, and during pregnancy, she developed two episodes of acute injury to the renal allograft. Diagnoses: End-stage renal disease secondary to type I diabetes, acute renal allograft injury, tacrolimus toxicity, abdominal pain. Interventions (including prevention and lifestyle): She received intravenous hydration, medications contributing to renal failure were held, and pain and nauseas were controlled appropriately. Abdominal compartment syndrome was managed by maintaining intravascular pressure and optimizing regional and systemic vascular perfusion by appropriate fluid balance, evacuating intraluminal contents by decompressing gastrointestinal system, and improving abdominal wall compliance by using appropriate analgesics, sedation, and patient positioning. Outcomes: With advancing pregnancy, the patient developed progressive abdominal pain, nausea, leg edema, and rising creatinine that were not responsive to ongoing therapies and required delivery via Cesarean section at 31 weeks of gestational age. Lessons learned: In the era of increasing number of pregnant renal transplant patients with multiple medical issues, we need organized approach to diagnosis of acute renal allograft injury in pregnancy and we need to consider abdominal compartment syndrome as one of the causes.

scholarly journals Roseomonas mucosa-Induced Peritonitis in a Patient Undergoing Continuous Cycler Peritoneal Dialysis: Case Report and Literature Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Sasmit Roy ◽  
Sumit Patel ◽  
Hardhik Kummamuru ◽  
Amarinder Singh Garcha ◽  
Rohan Gupta ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Treatment Options ◽  
Literature Analysis ◽  
Mortality And Morbidity ◽  
Roseomonas Mucosa ◽  
Stage Renal Disease ◽  
End Stage ◽  
Prompt Diagnosis ◽  
Caucasian Female

Roseomonas species, a rare Gram-negative microorganism, has seldom been reported to cause peritonitis in end-stage renal disease patients on peritoneal dialysis. Only seven cases of peritonitis by this rare microorganism have been reported worldwide. Treatment options can be challenging if not detected early and can lead to significant morbidity and mortality along with the switching of the dialysis modality to hemodialysis which is highly undesirable. Our patient is a 65-year-old Caucasian female who needed to be changed to emergency hemodialysis due to inability to perform peritoneal dialysis from suspected peritonitis and was subsequently discovered to have peritonitis from Roseomonas mucosa. She recovered with a prolonged antibiotics course and returned to peritoneal dialysis in 3 months following her treatment completion. Prompt diagnosis and prolonged antibiotics are a cornerstone in the management of this rare microorganism to prevent mortality and morbidity from peritonitis.

scholarly journals Diabetic Muscle Infarction: A Rare Cause of Acute Limb Pain in Dialysis Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
G. De Vlieger ◽  
B. Bammens ◽  
F. Claus ◽  
R. Vos ◽  
K. Claes
Keyword(s):  
Compartment Syndrome ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Diabetic Patients ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Muscle Infarction ◽  
Low Dose Aspirin ◽  
Stage Renal Disease ◽  
End Stage

Diabetic muscle infarction is a rare microangiopathic complication occurring in patients with advanced diabetes mellitus. Diabetic patients with chronic kidney disease stage Vd are prone to develop this complication. The presenting symptom is a localized painful swelling of the affected limb. Symptoms usually resolve spontaneously during the following weeks, but frequent relapse can occur and in some cases swelling may lead to compartment syndrome. Biochemical blood analyses show an elevated C-reactive protein, but creatine kinase is often normal. Diagnosis can be made on clinical presentation and imaging, with magnetic resonance imaging as the gold standard. Histology is often not contributive. Treatment consists of rest, analgesics, rigorous glycemic control and low-dose aspirin. Severe cases of compartment syndrome require fasciotomy. In the current paper, we present two diabetic patients with cystic fibrosis, who are treated with automated peritoneal dialysis and suffered from episodic lower limb infarction. We subsequently review 48 episodes of diabetic muscle infarction previously reported in the literature in patients with end-stage renal disease.

POEMS Syndrome Complicated by Extensive Calciphylaxis: A Remarkable Recovery

2015 ◽  
Vol 19 (3) ◽  
pp. 309-312 ◽  
Author(s):  
Emilie Bourgeault ◽  
Alice Dahl ◽  
Marie-Marthe Thibeault ◽  
Audrey Dupéré ◽  
Anne-Marie Drolet ◽  
...  
Keyword(s):  
Patient Survival ◽  
Poems Syndrome ◽  
Skin Changes ◽  
Parathyroid Function ◽  
Remarkable Recovery ◽  
Life Threatening ◽  
Stage Renal Disease ◽  
End Stage ◽  
Prompt Diagnosis

Background and Objective Calciphylaxis is life threatening. It has traditionally been associated with end-stage renal disease and hyperparathyroidism but is increasingly common in other clinical contexts. The association of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome and calciphylaxis has been reported only in a few cases. This case is the first of patient survival in such widespread disease. Methods and Results A 42-year-old man with POEMS syndrome developed extensive calciphylaxis despite normal renal and parathyroid function. Rapid diagnosis, treatment, and supportive care contributed to full clinical resolution. Conclusion This is the fifth case of POEMS syndrome associated with calciphylaxis. The observations from this report suggest that POEMS syndrome might be an independent risk factor for the development of calciphylaxis. This case underlines the importance of careful follow-up in patients with POEMS syndrome and prompt diagnosis and treatment of associated calciphylaxis.

scholarly journals 1001 Atraumatic Bilateral Compartment Syndrome; A Case Report

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Warren ◽  
G Dhillon ◽  
A Abdulkarim
Keyword(s):  
Compartment Syndrome ◽  
Diagnostic Delay ◽  
Kidney Injury ◽  
Skin Grafting ◽  
Lower Leg ◽  
Sudden Onset ◽  
Leg Pain ◽  
X Rays ◽  
Split Skin Grafting ◽  
Muscle Necrosis

Abstract Introduction We present a rare case of lower leg atraumatic bilateral compartment syndrome (ABCS). To date there have only been three similar cases reported where no cause was identified. Case Study A 33-year-old male presented 12 hours following sudden onset lower leg pain. There was no history of trauma, drug, or alcohol use. On assessment he was in significant pain, not relieved by analgesia, and had clinically tense anterior compartments bilaterally. Both feet were held in fixed dorsiflexion. Creatinine kinase (CK) was 35,166 on admission. X-rays of both legs were normal. He was immediately taken to theatre for bilateral four compartment fasciotomies which revealed significant swelling in the anterior and lateral compartments with patchy pre-necrosis. Post-operatively he deteriorated, required intubation, and was admitted to ITU for acute haemofiltration to treat acute kidney injury secondary to rhabdomyolysis. Multiple operations were required for debridement, resulting in exposed tendons. Closure of the medial wounds was achieved primarily as an inpatient and he was discharged with bilateral lateral VAC dressings in situ. Lateral wounds were closed with Biodegradable Temporising Matrix followed by split skin grafting. In his second admission he suffered a pulmonary embolism. Literature Review and Discussion 20 case of ABCS have been reported, largely attributable to drugs, alcohol, or leg position. Most cases had an element of diagnostic delay. In addition to compartment pressure monitoring, testing CK can demonstrate muscle necrosis and supports the decision to proceed to surgery.

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