ABSTRACT
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Subject(s)
Aged , Female , Humans , Mutation , Catheters, Indwelling , Catheterization, Central Venous , Recurrence , Methylenetetrahydrofolate Reductase (NADPH2) , Thrombophilia , Antineoplastic Combined Chemotherapy Protocols , Homocysteine , Lymphoma, Non-Hodgkin , Polymorphism, Genetic , Oxidoreductases Acting on CH-NH Group Donors , Polymorphism, GeneticSubject(s)
Calciphylaxis/etiology , Protein S Deficiency/etiology , Renal Dialysis/adverse effects , Calciphylaxis/drug therapy , Calciphylaxis/pathology , Female , Heparin, Low-Molecular-Weight/therapeutic use , Humans , Hyperparathyroidism, Secondary/etiology , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/therapy , Middle Aged , Protein S Deficiency/metabolism , Protein S Deficiency/pathology , Skin/pathologyABSTRACT
Vascular calcifications are frequent in hemodialysis patients. Its incidence ranges from 25 to 67% depending of different series. Thirty hemodialysis patients were selected from a dialysis population of 150 patients. These 30 patients were divided into two groups: group I included 15 hemodialysis patients with severe secondary hyperparathyroidism and severe, roentgenographically visible diffuse vascular calcifications, and group II included 15 other hemodialysis patients with moderate hyperparathyroidism without radiographic evidence of arterial calcifications. The control group comprised 20 normal volunteers. In all patients, measurements of protein C activity, free protein S and intact parathyroid hormone (PTH) were performed. Statistical analysis showed that free protein S in the patients of group I had a tendency to be lower than in the patients of group II (p < 0.01) and the control group (p < 0.001). We did not find significant differences in free protein S between group II and control group patients nor a significant correlation between intact PTH and free protein S in groups I and II. Protein C activity was found to be in the normal range in both groups. Free protein S deficiency in patients of group I would suggest a synthesis defect by impaired endothelial cells-due to vascular calcifications (?). Free protein S deficiency could increase the risk of thrombotic complications in these patients.
Subject(s)
Calcinosis/blood , Protein S Deficiency/etiology , Protein S/metabolism , Renal Dialysis/adverse effects , Vascular Diseases/blood , Adult , Calcinosis/etiology , Erythropoietin/therapeutic use , Female , Humans , Male , Middle Aged , Parathyroid Hormone/blood , Protein C/analysis , Protein S Deficiency/blood , Recombinant Proteins/therapeutic use , Reference Values , Vascular Diseases/etiologyABSTRACT
A patient suffering from acute lymphoblastic leukemia, in complete remission for two years, is treated for haematologic relapse with V.P.D. and C.O.A.P. consolidation. After this treatment, develops tiredness, sleepiness, a slight fever and cough, dying some days after, of interstitial pneumonia. Post-mortem anatomic-pathological studies, show giant cell multinucleated pneumopathia, with intranuclear inclusions bodies, that in ultrastructural level resembles paramyxovirus. When this complication took place, the patient had a brother with measles, but he hasn't, the typical symptomatology of said virus disease. According to Siegel, authors point out the frequency of death due to interstitial pneumonia as a complication caused by measles in immunodeficient patients, remarking the importance of an immediate diagnosis and its' prophylaxis.