Biomedical subjects
Publications and source records attributed to D Murnaghan.
A case of primary hyperoxaluria which presented with progressive renal failure in a 34 year old woman is reported. The patient died six years following the initial diagnosis and post mortem examination revealed widespread deposition of oxalate crystals in her tissues.
Thyroid function tests are often noted to be abnormal in patients with chronic renal failure. We investigated thyroid and pituitary function in six patients with renal failure. In order to study the effects of improvement in the uraemic state on these tests, they were repeated after regular haemodialysis was commenced. Serum thyroxine and free thyroxine levels were at the lower limit of the normal range prior to dialysis and both showed a non-significant increase after regular haemodialysis was started. The TSH response to TRH (TRH test) decreased in five of the six patients after dialysis but this did not achieve statistical significance. The abnormalities in thyroid function tests often observed in clinically euthyroid patients with renal failure do not appear to change significantly after the institution of regular dialysis.
Necrotizing myositis and acute proliferative glomerulonephritis is described in a patient with Behcet's syndrome. Both of these rare manifestations resolved spontaneously while the underlying disease remains active.
Patients with chronic renal disease had low plasma total tryptophan but an abnormally high proportion of this was in the free state. The subjects with encephalopathy had raised plasma free tryptophan, CSF tryptophan, and CSF 5-hydroxyindoleacetic acid. CSF tryptophan correlated better with plasma free than with plasma total tryptophan. Plasma and CSF tyrosine concentrations were normal but CSF homovanillic acid was raised especially in subjects with encephalopathy. The possible significance of these changes in advanced renal disease is discussed.
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