Renal proximal tubular dysfunction and paroxysmal nocturnal hemoglobinuria.
Am J Med
; 62(1): 125-9, 1977 Jan.
Article
em En
| MEDLINE
| ID: mdl-13653
ABSTRACT
A patient with paroxysmal nocturnal hemoglobinuria, who required many blood transfusions for hemolytic episodes, had a persistent hyperchloremic metabolic acidosis. Bicarbonate infusion demonstrated a large fractional excretion of bicarbonate (28.6 per cent at a plasma bicarbonate level of 23 meq/liter) which was consistent with proximal renal tubular acidosis. Generalized aminoaciduria and decreased tubular reabsorption of phosphate were also present. Marked deposition of iron in renal proximal tubules was associated with these functional abnormalities. We believe that, as systemic acidosis can promote hemolysis in patients with paroxysmal nocturnal hemoglobinuria, hemolysis can lead, by way of iron deposition in renal tubules, to further acidosis. This cycle should be interrupted with appropriate doses of bicarbonate.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Acidose Tubular Renal
/
Hemoglobinúria Paroxística
Limite:
Adult
/
Humans
/
Male
Idioma:
En
Revista:
Am J Med
Ano de publicação:
1977
Tipo de documento:
Article