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Biomedical subjects

C Witzleben

Publications and source records attributed to C Witzleben.

5 recordsLinked to original sources
PubMed1991

Renal dysgenesis in a monozygotic twin: association with in utero exposure to indomethacin.

We report oligohydramnios and renal dysgenesis in one of identical twins, which might have resulted from in utero exposure to early, prolonged high-dose indomethacin. The proposita was the second of twin girls born at 36 weeks of gestation. Pregnancy was complicated initially by polyhydramnios in both amniotic sacs and premature uterine contractions. After administration of indomethacin and terbutaline from 16 to 30 weeks' gestation, serial prenatal ultrasound examinations ultimately showed oligohydramnios in twin B and resolution of polyhydramnios in twin A. On day 5 twin B developed hematuria, hypertension, renal failure, hyponatremia, hyperkalemia, metabolic acidosis, sodium wasting and severe, transient inability to excrete potassium. Renal sonography showed enlarged, hyperechoic kidneys with almost no corticomedullary differentiation. Renal biopsy revealed immature glomeruli, dilated Bowman's spaces, dilated tubules, and interstitial fibrosis. The liver was histologically normal. Indomethacin may induce oligohydramnios and transient renal insufficiency in humans and renal dysgenesis in fetal monkeys; it might have induced the abnormalities in this patient.

Adult↗
PubMed1982

Pleural effusion and ascites: unusual presenting features in a pediatric patient with vitamin A intoxication.

The usual presenting features of vitamin A intoxication are pseuotumor cerebri, skeletal pain, desquamative dermatitis, and hepatic inflammation. Our patient was a nine-year-old female who had increasing cough, dyspnea, and abdominal distention for a short time prior to admission. She was said to have been treated with 10,000 units of vitamin A per day for skin rashes. Radiographic studies revealed a very large right sided pleural effusion, ascites, demineralized bones, and retarded skeletal maturation. The diagnosis of hypervitaminosis A was made. More detailed medical history confirmed that the child had, in actuality, received up to 300,000 units/day of vitamin A plus desiccated liver pills and carrot juice for the previous year. Clinical symptoms completely abated following acute medical treatment for ascites and cessation of vitamin A intake. Several months later, a sample of liver, obtained and preserved at the time of exploratory laparotomy, was homogenized and extracted with ethanol/hexane. The retinyl palmitate level was significantly elevated and consistent with vitamin A poisoning.

Age Determination by Skeleton↗
PubMed1981

Multilocular renal cysts: radiologic-pathologic correlation.

Multilocular renal cyst, a well-encapsulated benign lesion consisting of multiple noncommunicating cysts, is an uncommon entity of uncertain nature. A spectrum of histologic findings and multiple theories of pathogenesis have resulted in numerous names for the lesion, including multilocular cyst, benign cystic nephroma, cystic hamartoma, cystic lymphangioma, cystic Wilms tumor, and Perlmann tumor. We believe these names, and others, refer to the same entity, namely multilocular cyst. Radiographically a multicystic renal mass which is often calcified and which may partially protrude into the renal pelvis is seen. Although angiography cannot definitively exclude a malignant tumor, a distinctive sonographic appearance-multiple cystic masses separated by highly echogenic septa-is highly suggestive of multilocular renal cyst. Inclusion of this lesion in the preoperative differential diagnosis of a solitary and presumed malignant renal mass may have significant therapeutic implications.

Adolescent↗