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1 0 0 0 OA Efficacy of On-line Hemodiafiltration for Rhabdomyolysis Presenting with Acute Kidney Injury due to Unexpected Drug Abuse

著者
Naokazu Sato Koji Inagaki Masahiro Takanashi Reiko Muto Noritoshi Kato Shoichi Maruyama Toshiyuki Akahori
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
pp.1107-22, (Released:2023-02-15)
参考文献数
27
Myoglobin is a well-known cause of acute kidney injury (AKI) due to rhabdomyolysis. However, whether or not removing serum myoglobin by on-line hemodiafiltration (OHDF) improves the kidney function remains unclear. We herein report a patient with a history of methamphetamine abuse who developed AKI due to rhabdomyolysis. A urinalysis and blood collection results obtained before and after OHDF demonstrated that OHDF improved the kidney function by removing a large amount of serum myoglobin rather than via urinary excretion. In conclusion, OHDF may prevent AKI progression effectively when the urine volume is insufficient.

1 0 0 0 OA Ectopic Relapse of Anti-neutrophil Cytoplasmic Antibody-associated Pituitary Vasculitis with No Elevation of Anti-neutrophil Cytoplasmic Antibodies after Renal Remission

著者
Reiko Muto Koji Inagaki Naokazu Sato Tetsuro Sameshima Yuka Nagakura Satoshi Baba Noritoshi Kato Shoichi Maruyama Toshiyuki Akahori
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
pp.4731-20, (Released:2020-08-12)
参考文献数
32
被引用文献数
2
The relationship between anti-neutrophil cytoplasmic antibody (ANCA) titer levels and relapse risk in patients with ANCA-associated vasculitis (AAV) following clinical remission remains controversial. We herein report a case showing ectopic relapse of AAV in the pituitary with no ANCA elevation after renal remission. Magnetic resonance imaging revealed an enlarged pituitary gland. A pituitary biopsy showed geographic necrosis with multinucleated giant cells. We diagnosed this case as relapse of AAV in the pituitary. One month after rituximab therapy, the pituitary gland volume had decreased. The intensification of therapy due to the possibility of vasculitis relapse may facilitate better control of AAV.