Bowel perforation with unused Tenckhoff catheters.
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Biomedical subjects
Publications and source records attributed to M Zeier.
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Epidermolysis bullosa dystrophica Hallopeau-Siemens (EBDH) is one of the most severe inherited epidermolyses, a group of mechanobullous dermatological disorders. We observed two patients presenting with a severely multilating type of EBDH who developed biopsy-proven renal disease, which substantially altered the evolution and pathogenesis of their disease. In a boy, chronic postinfectious glomerulonephritis developed, most probably due to recurring superinfections of bullous skin lesions. He also experienced acute oliguric renal failure due to severe diarrhea during exacerbation of EBDH. A female patient developed a nephrotic syndrome due to secondary amyloidosis. Hypoalbuminemia caused further fluid losses through bullous skin lesions, aggravating intravascular hypovolemia and leading to rapid renal failure secondary to bilateral renal vein thrombosis. The study shows that, although rare, renal complications may alter the natural course of EBDH.
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A man aged 41 years who spent his leisure time in a marshy region infested with brown rats developed an infectious disease with high fever associated with diarrhoea, arthralgia and lumbago. In the course of the disease an acute renal failure occurred not requiring dialysis which spontaneously receded. Histology revealed signs of an acute renal failure with sparse interstitial round-cell infiltrations. Serological investigations showed a rising titre against Hantaan virus, Strain CG 1820 (1:1024). According to experience in neighbouring countries, it may be assumed that quite a number of cases of spontaneous acute renal failure occurring in the Federal Republic of Germany is caused by Hantaan virus.
A 45-year-old man with end-stage renal disease underwent a cadaveric kidney transplantation. The allograft had to he removed 10 days after transplantation because of an acute vascular rejection. After explantation, the patient suffered from a life-threatening infection with Staphylococcus epidermidis involving lungs, eyes and liver for 11 months. Despite adequate therapy including vancomycin followed by teicoplanin, he developed spondylodiscitis requiring repeated surgical interventions. The definitive cure was achieved by a sequential therapy with chloramphenicol and quinupristin/dalfopristin.
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