32 research outputs found
Multiple bone fracture due to Fanconi\u27s syndrome in primary Sjogren\u27s syndrome complicated with organizing pneumonia.
A 66-year-old woman showing renal dysfunction with elevated serum alkaline phosphatase and anti-SS-A antibody was admitted. A labial salivary gland biopsy showing infiltration of mononuclear cells and positive anti-SS-A antibody with sicca symptoms led to a diagnosis of primary Sjogren\u27s syndrome (SS). Fanconi\u27s syndrome was diagnosed by renal tubular acidosis along with renal glucosuria or aminoaciduria and multiple bone fractures on bone scintigraphy. Typical bilateral pulmonary shadows were confirmed as organizing pneumonia (OP) determined by the analysis of bronchoalveolar lavage fluid and transbronchial lung biopsy. A rare complication of Fanconi\u27s syndrome with OP in SS is described
The liver is a common non-exocrine target in primary Sjögren's syndrome: A retrospective review
BACKGROUND: The autoimmune destruction of exocrine glands that defines primary Sjögren's syndrome (1°SS) often extends to non-exocrine organs including the liver. We aimed to determine the prevalence of liver disease in patients with 1°SS and to evaluate the association of this complication with other non-exocrine features and serologic markers of autoimmunity and systemic inflammation. METHODS: We reviewed 115 charts of patients with 1°SS and further analyzed the 73 cases that fulfilled the European Epidemiology Center Criteria, seeking evidence for clinical and subclinical liver disease. RESULTS: Liver function tests had been determined in 59 of the 73 patients. Of those, 29 patients (49.1%) had abnormal liver function tests including 20.3% with clinically overt hepatic disease. Liver disease was the most common non-exocrine feature in this cohort. Risk factors for abnormal liver function tests were distributed similarly between the patients with and without liver disease. In 60% of patients with abnormal liver function tests no explanation for this complication was found except for 1°SS. Liver involvement was significantly more common in 1°SS patients who also had evidence of lung, kidney and hematological abnormalities. Patients with abnormal liver function tests were also more likely to have an elevated sedimentation rate and a positive anti-ENA during the course of their disease. CONCLUSION: Liver involvement is a common complication in 1°SS. Its presence correlates with systemic disease. We consider that this complication should be routinely sought in patients with 1°SS, especially when a positive anti-ENA or evidence of systemic inflammation is found
LIPID ABNORMALITIES IN CHRONIC UREMIC PATIENTS - RESPONSE TO TREATMENT WITH GEMFIBROZIL
Seventy-four patients with end stage renal failure were
studied.Forty-six of them were on hemodialysis (HD) while 28 were on
continuous ambulatory peritoneal dialysis (CAPD). In addition 56
non-dialysis chronic renal failure (NDCRF) patients with various degree
of renal failure were also studied. In all groups serum triglyceride
concentrations were significantly higher and HDL cholesterol
concentrations were significantly lower compared to age- and sex-matched
controls. Total and LDL cholesterol were significantly higher in the
NDCRF and CAPD patients compared to controls. In 55 patients (20 on HD,
13 on CAPD and 22 NDCRF) with severe hypertiglyceridemia or diminished
HDL cholesterol gemfibrozil 300 mg b. i. d per os was given for 6
months. Drug treatment reduced significantly serum triglycerides in all
groups of patients and increased the levels of HDL cholesterol in CAPD
patients. Moreover, a statistically significant decrease of the levels
of total and LDL cholesterol was noticed in HD and NDCRF patients.
During treatment no significant side effects were observed and liver and
muscle enzymes remained within normal values