Hepatic and pulmonary metastases from a meningeal hemangiopericytoma and severe hypoglycemia due to abnormal secretion of insulin-like growth factor: a case report.

A 42-year-old woman was hospitalized for severe hypoglycemic coma. She had a voluminous hepatic metastasis and multiple small lung metastases from a meningeal hemangiopericytoma initially operated on 11 years earlier. High blood levels of an abnormal form of insulin-like growth factor type 2 (IGF II) associated with low blood levels of insulin, growth hormone, IGF I, and IGF BP3 were observed. After surgical resection of the liver and pulmonary metastases, serum glucose levels and hormonal abnormalities returned to normal.

[Use in hemodialysis and hemofiltration of CY 216 (Fraxiparine) administered via intravenous bolus in patients with acute and chronic renal insufficiency with and without hemorrhagic risk]. / Utilisation en hémodialyse et en hémofiltration du CY 216 (Fraxiparine) en bolus intraveineux, chez des patients insuffisants rénaux aigus et chroniques, avec et sans risque hémorragique.

The effectiveness and safety of CY 216 as anticoagulant for extracorporeal circulation were evaluated in 403 haemodialysis of haemofiltration sessions performed in 33 patients with chronic [24] or acute [9] renal failure; 149 of the sessions were carried at risk of haemorrhage. Initially CY 216 was administered as a bolus intravenous injection in doses of 7,500 anti-Xa Institut Choay units (AXa.IC.U) to patients under 50 kg, 15,000 AXa.IC.U to patients weighting between 50 and 80 kg and 22,500 AXa.IC.U to patients over 80 kg. Subsequently dosage was adjusted according to clinical results. With a median dose of 250 AXa.IC.U per kg, no haemorrhage was observed. Blood restitution was satisfactory in 84.6% of the cases, extracorporeal circulation was without clotting of fibrin deposit in 90% of the cases and the incidence of total coagulation was only 0.5%. Using CY 216 seems to be effective in preventing coagulation in the extracorporeal circuit and was well tolerated by all patients whether or not they were carried at risk of haemorrhage.

[Anaphylactic reactions during hemodialysis: responsibility of the dialysis membrane (cuprophane)]. / Réactions anaphylactiques au cours de l'hémodialyse: responsabilité de la membrane de dialyse (cuprophane).

Iterative hemodialysis causes only exceptionally anaphylactic reactions. In those cases it has been possible to incriminate sterilizing agents (ethylene oxide, formaldehyde) and in a few cases the membrane. We report the case of one patient suffering from a chronic renal failure who had been undergoing hemodialysis treatment for more than six years in whom we noticed anaphylactic reactions at the beginning of each dialysis session carried on with cuprophan. We were able to use three different types of dialysis membranes: cuprophan, polyacrylonitrile and cellulose acetate, and two means of sterilization: ethylene oxide and gamma rays. The disorders we observed do not seem to be related to the phenomena usually observed during hemodialysis. The clinical signs linked with hypereosinophilia (13,000/mm3), hyperbasophilia (140/mm3) and an increase in total serum IgE disappeared when cuprophan membrane was replaced by cellulose acetate. One year later, hypereosinophilia had disappeared, hyperbasophilia had subsided, total IgE remained high. We conclude that IgE dependent anaphylaxis might be due to one component of the cuprophan membrane.