Pneumococcal pneumonia and hemolytic uremic syndrome.
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Biomedical subjects
Publications and source records attributed to J E Springate.
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The nevoid basal cell carcinoma syndrome is a rare and complex disease with multiple manifestations. As an example, we present the case of an eight-year-old girl with this syndrome whose initial complaint was acute abdominal pain secondary to torsion of an ovarian fibroma. Because of its multisystem effects, patients with this syndrome can present to any of a number of medical or surgical specialists. Close attention to the family and past medical history and physical examination will alert the clinician to its presence, allowing for appropriate genetic counseling and serial screening for the development of malignancies and other complications.
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Because the pathogenesis of acute renal failure is multifactorial, clinical evaluation and ancillary studies must be performed systematically to reliably differentiate the various disorders. This assessment includes measurement of the serum creatinine and urea concentrations, urine composition and flow rate, and fractional excretion of sodium. Radiodiagnostic techniques such as ultrasound, radionuclide renal scans, and nuclear magnetic resonance may provide useful anatomic and functional information. With this data base, the physician can prescribe an individualized management plan that addresses the fluid, metabolic, and nutritional necessities of the child.
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An adolescent with chronic myelogenous leukemia (CML) developed gross hematuria. Evaluation included renal biopsy revealing a proliferative glomerulonephritis with mesangial deposits of immunoglobulins A and G. An association between CML and immune-complex glomerulonephritis has not been previously reported and may represent a paraneoplastic phenomenon.