Radiographic follow-up of a phalangeal brown tumor.

We report the 6-year radiographic follow-up of a phalangeal brown tumor in a patient with severe hyperparathyroidism secondary to chronic renal failure treated with hemodialysis. The phalangeal lesion increased in size during the first 3 years, until the patient finally accepted to undergo parathyroidectomy. The initial radiographic change was a small intracortical lytic area. Two years later, an expansile cystic lesion was visible in the phalanx, and computed tomography showed a cortical defect. Ossification of the lesion occurred over the 2.5 years following parathyroidectomy. The epidemiology, radiographic changes and post-treatment evolution of brown tumor in dialysed patients is reviewed. Surgical parathyroidectomy is the standard treatment for brown tumor complicating secondary hyperparathyroidism. The usefulness and limitations of treatment with vitamin D analogs, recently reported in a few case reports, are discussed.

Acute renal failure as initial presentation of visceral leishmaniasis in an HIV-1-infected patient.

We report the case of an HIV-infected patient who presented with acute renal failure due to visceral leishmaniasis (VL). Although renal failure is the leading cause of death in dogs, the natural reservoir of Leishmania infantum, renal involvement is usually absent in human VL. However, L. infantum can be considered a cause of renal failure in HIV-infected patients.

[Hyponatremia during treatment with cisplatin]. / Hyponatrémie au cours des traitements par cisplatine.

BACKGROUND: Cisplatin is one of the most widely used agents in cancer treatment. Cisplatin regimens can lead to a more or less pronounced hyponatremia in 4 to 10% of cases due to salt wasting with hypomagnesemia and normokaliemia. Functional and renal failure and orthostatic hypotension can be observed. CASE REPORT: A 54-year-old woman with brain metastases of a non-small-cell lung cancer was given a chemotherapy regimen containing cisplatin. Hyponatremia with confusion occurred after each cisplatin perfusion. The diagnosis retained was cisplatin-induced salt wasting. The patient was given salt prolonged supplementation and carboplatin was substituted for cisplatin in the chemotherapy regimen. DISCUSSION: Hyponatremia frequently occurs in cancer patients. Cisplatin-induced hyponatremia requires specific management. Treatment is based on sodium intake which sometimes takes several months to replete stores. Carboplatin can be used instead of cisplatin in case of major hyponatremia.