1 / 32

Esettanulm ny

merrill
Télécharger la présentation

Esettanulm ny

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    2. Slyos nephrosis veseelgtelensggel Dr. Pintr Istvn, Dr. Degrell Pter PTE OK II. sz. Belklinika s Nephrolgiai Centrum

    3. Esetismertets Dr.TM 62 ves nyugdjas csaldorvos 2 ve ismert diabetese 2 hnappal ezelott norml vesefunkci, normotensio 3 hete kt napig tart magas lz Felvtelekor: tvgytalansg, magas vrnyoms s jelentos periferis oedema

    4. Vizsglatok eredmnyei clearance : 31 ml/min (se creat: 242mol/l) trs proteinuria ( 10,5 g die), jelentos hypoproteinaemival hyalin cylinderek a vizeletledkben norml vesemretek,fokozott echogenits parenchymval mrskelt anaemia ( htc: 36,8%)

    5. Direkt immunfluorescencia

    13. Vesebiopszia diagnozis: Focalis segmentalis glomerulosclerosis (FSGS) kollabl varins A proteinuria miatt kialakult slyos tubulris obstrukci, mely az akut veseelgtelensget okozza- okozhatta

    15. Kezels Haemodialzis (oligo-anuria miatt) 2,5 mg/ttkg/nap cyclosporin-A 1mg/ttkg/nap methylprednisolon inzulinterpia ACEI,ARB, statin, heparin

    16. Krlefolys

    17. Krlefolys cyclosporin-A dzisredukcija ( serumszint alapjn) Kt ht utn (8 kezels) a haemodialzis elhagysa Egy hnapos klinikai pols utn emisszi

    18. Ambulans kontroll Emisszija utn 3 httel: clearance:40ml/min (se creat: 127mol/l) vizelet fehrjerts: eop normalbuminaemia tensi:125/80Hgmm Terpia vltozatlan

    23. CLL-es beteg proteinurival Dr. Pintr Istvn, Dr. Degrell Pter PTE OK II. sz. Belklinika s Nephrolgiai Centrum

    24. Esetismertets BJ-n 54 ves (rokkantnyugdjas szemlyzeti vezeto) 21 ve hypertonis ( jl kezelt) 2 ve derlt ki CLL-je (kezelni nem kellett) Fl ve proteinuria (2-3g/die) miatt vizsgltuk, Leukerant kezdtnk Jelen felvtel: proteinuria miatt

    25. Vizsglati eredmnyek clearance: 77,5 ml/min (se creat: 103mol/l) vizeletben eop. proteinuria (0.76g/die) norml vesemretek fokozott echogenits parenchymval vesebiopsia

    31. Krlefolys Leukernnal remisszi (0,3g/ die proteinuria) Fl v mlva CLL relapsus s nephrosis, Leukernra reaglt 1 v mlva kombinlt cytostaticus kezels Ezt kveto fl v mlva sepsisben meghalt

    33. IMMUNOTACTOID GLOMERULOPATHIA GLOMERULOPATHIA Fibrillris Microtubulris = Immunotactoid

More Related