A Case Report of Pulmonary‐Renal Syndrome Treated With Continuous Hemodiafiltration and Hemodialysis
: This case describes a 40‐year‐old man complaining of general malaise, dyspnea with hemoptysis and anuria. Laboratory data indicated renal failure and the presence of systemic inflammation. His chest radiograph and computed tomography showed bilateral diffuse interstitial alveolar infiltration. Th...
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| Veröffentlicht in: | Therapeutic apheresis and dialysis 2006-10, Vol.10 (5), p.467-471 |
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| container_title | Therapeutic apheresis and dialysis |
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| creator | Uji, Yoshitaka Shimizu, Tomoharu Yoshioka, Toyokazu Yamamoto, Hiroshi Endo, Yoshihiro Tani, Toru |
| description | : This case describes a 40‐year‐old man complaining of general malaise, dyspnea with hemoptysis and anuria. Laboratory data indicated renal failure and the presence of systemic inflammation. His chest radiograph and computed tomography showed bilateral diffuse interstitial alveolar infiltration. These findings indicated acute deterioration of chronic renal dysfunction complicated by interstitial pneumonitis. He initially received daily conventional hemodialysis (HD), an antibiotic and oxygen therapy. However, his renal and pulmonary function continued to deteriorate. Antineutrophil cytoplasm antibodies against myeloperoxidase (MPO‐ANCA) and antibodies against proteinase 3 (PR3‐ANCA) were negative. We suspected that his pulmonary‐renal syndrome was caused by ANCA‐negative vasculitis. We applied mechanical ventilation, pulsed methylprednisolone therapy and continuous hemodiafiltration (CHDF) combined with HD. PaO2/FiO2 ratio and mean pulmonary arterial pressure gradually improved after initiation of CHDF. He was finally separated from mechanical ventilation after 44 days in the hospital. He is currently alive with the support of conventional HD. |
| doi_str_mv | 10.1111/j.1744-9987.2006.00411.x |
| format | Article |
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Laboratory data indicated renal failure and the presence of systemic inflammation. His chest radiograph and computed tomography showed bilateral diffuse interstitial alveolar infiltration. These findings indicated acute deterioration of chronic renal dysfunction complicated by interstitial pneumonitis. He initially received daily conventional hemodialysis (HD), an antibiotic and oxygen therapy. However, his renal and pulmonary function continued to deteriorate. Antineutrophil cytoplasm antibodies against myeloperoxidase (MPO‐ANCA) and antibodies against proteinase 3 (PR3‐ANCA) were negative. We suspected that his pulmonary‐renal syndrome was caused by ANCA‐negative vasculitis. We applied mechanical ventilation, pulsed methylprednisolone therapy and continuous hemodiafiltration (CHDF) combined with HD. PaO2/FiO2 ratio and mean pulmonary arterial pressure gradually improved after initiation of CHDF. He was finally separated from mechanical ventilation after 44 days in the hospital. He is currently alive with the support of conventional HD.</description><identifier>ISSN: 1744-9979</identifier><identifier>EISSN: 1744-9987</identifier><identifier>DOI: 10.1111/j.1744-9987.2006.00411.x</identifier><identifier>PMID: 17096703</identifier><language>eng</language><publisher>Melbourne, Australia: Blackwell Publishing Asia</publisher><subject>Adult ; ANCA ; C-Reactive Protein - analysis ; Combined Modality Therapy ; Continuous hemodiafiltration ; Glucocorticoids - administration & dosage ; Hemodiafiltration ; Hemodialysis ; Humans ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - therapy ; Leukocytes ; Lung Diseases, Interstitial - complications ; Male ; Methylprednisolone - administration & dosage ; Potassium - analysis ; Pulmonary‐renal syndrome ; Pulse Therapy, Drug ; Renal Dialysis ; Syndrome ; Tomography, X-Ray Computed ; Vasculitis - complications</subject><ispartof>Therapeutic apheresis and dialysis, 2006-10, Vol.10 (5), p.467-471</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3901-d0a95c1731112cc4358016079786d46b83be88b9a5e26bdc1c571083d5bb2cfa3</citedby><cites>FETCH-LOGICAL-c3901-d0a95c1731112cc4358016079786d46b83be88b9a5e26bdc1c571083d5bb2cfa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1744-9987.2006.00411.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1744-9987.2006.00411.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17096703$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Uji, Yoshitaka</creatorcontrib><creatorcontrib>Shimizu, Tomoharu</creatorcontrib><creatorcontrib>Yoshioka, Toyokazu</creatorcontrib><creatorcontrib>Yamamoto, Hiroshi</creatorcontrib><creatorcontrib>Endo, Yoshihiro</creatorcontrib><creatorcontrib>Tani, Toru</creatorcontrib><title>A Case Report of Pulmonary‐Renal Syndrome Treated With Continuous Hemodiafiltration and Hemodialysis</title><title>Therapeutic apheresis and dialysis</title><addtitle>Ther Apher Dial</addtitle><description>: This case describes a 40‐year‐old man complaining of general malaise, dyspnea with hemoptysis and anuria. Laboratory data indicated renal failure and the presence of systemic inflammation. His chest radiograph and computed tomography showed bilateral diffuse interstitial alveolar infiltration. These findings indicated acute deterioration of chronic renal dysfunction complicated by interstitial pneumonitis. He initially received daily conventional hemodialysis (HD), an antibiotic and oxygen therapy. However, his renal and pulmonary function continued to deteriorate. Antineutrophil cytoplasm antibodies against myeloperoxidase (MPO‐ANCA) and antibodies against proteinase 3 (PR3‐ANCA) were negative. We suspected that his pulmonary‐renal syndrome was caused by ANCA‐negative vasculitis. We applied mechanical ventilation, pulsed methylprednisolone therapy and continuous hemodiafiltration (CHDF) combined with HD. PaO2/FiO2 ratio and mean pulmonary arterial pressure gradually improved after initiation of CHDF. He was finally separated from mechanical ventilation after 44 days in the hospital. He is currently alive with the support of conventional HD.</description><subject>Adult</subject><subject>ANCA</subject><subject>C-Reactive Protein - analysis</subject><subject>Combined Modality Therapy</subject><subject>Continuous hemodiafiltration</subject><subject>Glucocorticoids - administration & dosage</subject><subject>Hemodiafiltration</subject><subject>Hemodialysis</subject><subject>Humans</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Leukocytes</subject><subject>Lung Diseases, Interstitial - complications</subject><subject>Male</subject><subject>Methylprednisolone - administration & dosage</subject><subject>Potassium - analysis</subject><subject>Pulmonary‐renal syndrome</subject><subject>Pulse Therapy, Drug</subject><subject>Renal Dialysis</subject><subject>Syndrome</subject><subject>Tomography, X-Ray Computed</subject><subject>Vasculitis - complications</subject><issn>1744-9979</issn><issn>1744-9987</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkEtOwzAQhi0EoqVwBeQVuwY7TmJbYlNVQJEqUZUilpZjO8JVEhc7Ee2OI3BGTkJKS9kymxnN_PP6AIAYRbiz62WEaZIMOWc0ihHKIoQSjKP1EegfCseHmPIeOAthiVAcJ4Scgh6miGcUkT4oRnAsg4Fzs3K-ga6As7asXC395uvjc25qWcKnTa29qwxceCMbo-GLbV7h2NWNrVvXBjgxldNWFrZsvGysq6Gs9W-23AQbzsFJIctgLvZ-AJ7vbhfjyXD6eP8wHk2HinCEhxpJnipMSfdkrFRCUoZwhiinLNNJljOSG8ZyLlMTZ7lWWKUUI0Z0muexKiQZgKvd3JV3b60JjahsUKYsZW26S0XGcIIYTzoh2wmVdyF4U4iVt1X3tcBIbBmLpdjiE1uUYstY_DAW6671cr-jzSuj_xr3UDvBzU7wbkuz-fdgsRjNuoB8A9SIi_w</recordid><startdate>200610</startdate><enddate>200610</enddate><creator>Uji, Yoshitaka</creator><creator>Shimizu, Tomoharu</creator><creator>Yoshioka, Toyokazu</creator><creator>Yamamoto, Hiroshi</creator><creator>Endo, Yoshihiro</creator><creator>Tani, Toru</creator><general>Blackwell Publishing Asia</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200610</creationdate><title>A Case Report of Pulmonary‐Renal Syndrome Treated With Continuous Hemodiafiltration and Hemodialysis</title><author>Uji, Yoshitaka ; Shimizu, Tomoharu ; Yoshioka, Toyokazu ; Yamamoto, Hiroshi ; Endo, Yoshihiro ; Tani, Toru</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3901-d0a95c1731112cc4358016079786d46b83be88b9a5e26bdc1c571083d5bb2cfa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>ANCA</topic><topic>C-Reactive Protein - analysis</topic><topic>Combined Modality Therapy</topic><topic>Continuous hemodiafiltration</topic><topic>Glucocorticoids - administration & dosage</topic><topic>Hemodiafiltration</topic><topic>Hemodialysis</topic><topic>Humans</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Leukocytes</topic><topic>Lung Diseases, Interstitial - complications</topic><topic>Male</topic><topic>Methylprednisolone - administration & dosage</topic><topic>Potassium - analysis</topic><topic>Pulmonary‐renal syndrome</topic><topic>Pulse Therapy, Drug</topic><topic>Renal Dialysis</topic><topic>Syndrome</topic><topic>Tomography, X-Ray Computed</topic><topic>Vasculitis - complications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Uji, Yoshitaka</creatorcontrib><creatorcontrib>Shimizu, Tomoharu</creatorcontrib><creatorcontrib>Yoshioka, Toyokazu</creatorcontrib><creatorcontrib>Yamamoto, Hiroshi</creatorcontrib><creatorcontrib>Endo, Yoshihiro</creatorcontrib><creatorcontrib>Tani, Toru</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Therapeutic apheresis and dialysis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Uji, Yoshitaka</au><au>Shimizu, Tomoharu</au><au>Yoshioka, Toyokazu</au><au>Yamamoto, Hiroshi</au><au>Endo, Yoshihiro</au><au>Tani, Toru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Case Report of Pulmonary‐Renal Syndrome Treated With Continuous Hemodiafiltration and Hemodialysis</atitle><jtitle>Therapeutic apheresis and dialysis</jtitle><addtitle>Ther Apher Dial</addtitle><date>2006-10</date><risdate>2006</risdate><volume>10</volume><issue>5</issue><spage>467</spage><epage>471</epage><pages>467-471</pages><issn>1744-9979</issn><eissn>1744-9987</eissn><abstract>: This case describes a 40‐year‐old man complaining of general malaise, dyspnea with hemoptysis and anuria. Laboratory data indicated renal failure and the presence of systemic inflammation. His chest radiograph and computed tomography showed bilateral diffuse interstitial alveolar infiltration. These findings indicated acute deterioration of chronic renal dysfunction complicated by interstitial pneumonitis. He initially received daily conventional hemodialysis (HD), an antibiotic and oxygen therapy. However, his renal and pulmonary function continued to deteriorate. Antineutrophil cytoplasm antibodies against myeloperoxidase (MPO‐ANCA) and antibodies against proteinase 3 (PR3‐ANCA) were negative. We suspected that his pulmonary‐renal syndrome was caused by ANCA‐negative vasculitis. We applied mechanical ventilation, pulsed methylprednisolone therapy and continuous hemodiafiltration (CHDF) combined with HD. PaO2/FiO2 ratio and mean pulmonary arterial pressure gradually improved after initiation of CHDF. He was finally separated from mechanical ventilation after 44 days in the hospital. He is currently alive with the support of conventional HD.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Publishing Asia</pub><pmid>17096703</pmid><doi>10.1111/j.1744-9987.2006.00411.x</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult ANCA C-Reactive Protein - analysis Combined Modality Therapy Continuous hemodiafiltration Glucocorticoids - administration & dosage Hemodiafiltration Hemodialysis Humans Kidney Failure, Chronic - complications Kidney Failure, Chronic - therapy Leukocytes Lung Diseases, Interstitial - complications Male Methylprednisolone - administration & dosage Potassium - analysis Pulmonary‐renal syndrome Pulse Therapy, Drug Renal Dialysis Syndrome Tomography, X-Ray Computed Vasculitis - complications |
| title | A Case Report of Pulmonary‐Renal Syndrome Treated With Continuous Hemodiafiltration and Hemodialysis |
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