No abstract available.
Child ; Humans ; Hypercalciuria ; Nephrocalcinosis

A 43-year-old woman who had received kidney transplantation 2 years before was admitted for masses on both axilla. Masses had variable sizes, and were round or oval-shaped with echogenicity on breast ultrasound. Pathologic examination using fine needle aspiration showed masses were fibroadenoma, fibroadenoid hyperplasia, and fat necrosis. We switched cyclosporine to tacrolimus. After 6 months of conversion, breast masses decreased in size on the follow-up breast USG.
Adult ; Axilla ; Biopsy, Fine-Needle ; Breast ; Cyclosporine ; Fat Necrosis ; Female ; Fibroadenoma ; Follow-Up Studies ; Humans ; Hyperplasia ; Kidney ; Kidney Transplantation ; Tacrolimus ; Transplants

Fungal peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients is rare. But, it is a serious complication of CAPD because of high morbidity and mortality. It is very important to diagnose and treat such infections promptly, as otherwise it has a poor prognosis. We experienced a case of peritonitis in a CAPD patient that was caused by Aspergillus flavus detected by fungal balls in blood culture bottles and treated successfully by administering anti-fungal agents and removing the peritoneal dialysis catheter.
Aspergillus ; Aspergillus flavus ; Fungi ; Humans ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Prognosis

Stent placement is widely used for vascular access stenosis in hemodialysis patients as well as coronary artery stenosis. As its complication, stent fracture is not uncommon and causes restenosis after stent placement in coronary artery stenosis, but it has been rarely reported in venous stenosis of hemodialysis patients. Here we report a case of arteriovenous fistula dysfunction due to stent fracture in the cephalic arch of a hemodialysis patient.
Arteriovenous Fistula ; Constriction, Pathologic ; Coronary Stenosis ; Humans ; Renal Dialysis ; Stents

Spontaneous splenic rupture is a rare disease but can cause a life threatening situation. It can occur under a pathological spleen such as infection, neoplastic, infiltrative and inflammatory disease. Although splenectomy is the treatment of choice for splenic rupture, it is uncertain that the effectiveness of non- surgical treatment in the hemodynamically stable patient. We report a case of a 66-year-old male undergoing hemodialysis for 4 years who presented to the emergency department with abdominal pain and distention. Blood pressure was 130/80 mmHg, heart rate was 108 bpm. White blood cell count was 7,130/mm3, hemoglobin was 6.7 g/dL, platelet was 156,000/mm3. PT INR was elevated up to 2.01 because he had taken warfarin due to splenic infarction. Abdominal CT scan revealed hemoperitoneum due to splenic rupture. We performed angiography but there was no active bleeding. We decided conservative management without embolization because of stable condition and increased bleeding risk in operation. He received 6 pints of packed red blood cell transfusion during continuous renal replacement therapy for 24 hours on ICU. He was discharged with complete recovery on the 21st hospital day. We suggest that non-surgical treatment in splenic rupture also could be considered in hemodynamically stable patients with a high risk of postoperative complication.
Abdominal Pain ; Aged ; Angiography ; Blood Platelets ; Blood Pressure ; Emergencies ; Erythrocyte Transfusion ; Heart Rate ; Hemoglobins ; Hemoperitoneum ; Hemorrhage ; Humans ; International Normalized Ratio ; Leukocyte Count ; Male ; Mustard Compounds ; Rare Diseases ; Renal Dialysis ; Renal Replacement Therapy ; Spleen ; Splenectomy ; Splenic Infarction ; Splenic Rupture ; Warfarin

Tumoral calcinosis is a periarticular calcific lesion and rare complication in patients with maintenance hemodialysis. The pathogenesis of tumoral calcinosis is poorly understood but may be due to elevated serum phosphorus, a high calcium phosphorus (Ca x P) product or secondary hyperparathyroidism in hemodialysis patients. A 30-year-old man presented with pain and palpable mass of left shoulder. He had been on maintenance hemodialysis with high flux dialyzer for 10 years. Laboratory finding showed hyperphosphatemia and elevated intact PTH concentration. A shoulder X-ray and CT scan demonstrated a massive calcification. Following partial resection, pain was relieved. Here we report a case of tumoral calcinosis of shoulder in a hemodialysis patient with untreated hyperphosphatemia and secondary hyperparathyroidism.
Adult ; Calcinosis ; Calcium ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Secondary ; Hyperphosphatemia ; Phosphorus ; Renal Dialysis ; Shoulder

Atypical hemolytic uremic syndrome (HUS) in adults is a life-threatening disorder characterized by acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia, which is not related to E. coli. Digital gangrene is one of the grave signs in emergency medicine because it requires prompt evaluation and treatment. We describe a 37 year-old Thailand woman, initially treated for suspected Neisseria septicemia, who went on to develop renal complications, thrombocytopenia and hemolytic anemia, which made the diagnosis of atypical hemolytic uremic syndrome. The patient was complaining of dysesthesia on all extremities and severe pain in both legs. Serologically, she was diagnosed as systemic lupus erythematosus (SLE). She was treated with plasma exchanges using fresh frozen plasma, parenteral steroid, anticoagulant and antibiotics, successfully. This is the first report of digital gangrene complicated by atypical HUS in a patient with SLE in Korea.
Acute Kidney Injury ; Adult ; Anemia, Hemolytic ; Anti-Bacterial Agents ; Emergency Medicine ; Extremities ; Female ; Gangrene ; Hemolytic-Uremic Syndrome ; Humans ; Korea ; Leg ; Lupus Erythematosus, Systemic ; Neisseria ; Paresthesia ; Plasma ; Plasma Exchange ; Sepsis ; Thailand ; Thrombocytopenia

Anti neutrophil cytoplasmic antibody (ANCA)-positive vasculitis and crescentic glomerulonephritis has been rarely reported in patients suffering from Graves' disease and treated with Propylthiouracil. We experienced a case of ANCA-positive crescentic glomerulonephritis presenting good prognosis after discontinuing Propylthiouracil. A 40-year-old female visited due to the proteinuria and hematuria in urinalysis. She had been medicated Propylthiouracil for 3 years. Blood pressure was 100/60 mmHg. BUN and serum creatinine were 24.7 mg/dL, and 1.9 mg/dL, respectively. Urinalysis revealed protein 1481 mg/day, many RBC's/HPF (dysmorphic 80%), Serological ANCA was positive, anti-myeloperoxidase (MPO) antibody 1,922 AAU/ mL (normal <150 AAU/mL). The histologic finding showed crescentic glomerulonephritis on light microscopy, but no immuno deposit on immunofluorescence and light microscopy. So we diagnosed ANCA positive pauci-immune glomerulonephritis. Propylthiouracil was discontinued and steroid, cyclophosphamide was medicated within about 1 month, but stopped due to cytopenia. Patient's creatinine level was maintained 1.3 mg/dL and showed stable progress for about over 18 months. We report this case that showed good prognosis after discontinuation of Propylthiouracil.
Adult ; Antibodies, Antineutrophil Cytoplasmic ; Blood Pressure ; Creatinine ; Cyclophosphamide ; Female ; Fluorescent Antibody Technique ; Glomerulonephritis ; Graves Disease ; Hematuria ; Humans ; Light ; Microscopy ; Prognosis ; Propylthiouracil ; Proteinuria ; Stress, Psychological ; Urinalysis ; Vasculitis

Hemorrhagic fever with renal syndrome is an acute febrile disease with high fever, hemorrhagic symptoms, renal failure. Stress-induced cardiomyopathy is a newly described clinical entity characterized by transient left ventricular apical ballooning and left ventricular apical dyskinesis, with no stenosis on the coronary angiogram. We experienced a rare case of stress-induced cardiomyopathy associated with hemorrhagic fever with renal syndrome.
Cardiomyopathies ; Constriction, Pathologic ; Fever ; Hemorrhagic Fever with Renal Syndrome ; Renal Insufficiency

A case of a 52-year-old man with retroperitoneal fibrosis and a horseshoe kidney is presented. Horseshoe kidney is one of the most common renal anomalies and complicated with urinary tract infection, hydronephrosis, calculi, tumor of the renal pelvis, and other multiple congenital abnormalities. Idiopathic retroperitoneal fibrosis is a rare disease characterized by the presence of a retroperitoneal tissue, consisting of chronic inflammation and marked fibrosis, which often entraps ureters or other abdominal organs. The correlation between horseshoe kidney and retroperitoneal fibrosis has not been described. We report a rare case of idiopathic retroperitoneal fibrosis with horseshoe kidney disease demonstrating good response to steroid therapy.
Calculi ; Congenital Abnormalities ; Fibrosis ; Humans ; Hydronephrosis ; Inflammation ; Kidney ; Kidney Diseases ; Kidney Pelvis ; Middle Aged ; Rare Diseases ; Retroperitoneal Fibrosis ; Steroids ; Ureter ; Urinary Tract Infections