[The pathogenesis, diagnosis and therapy of posttransplantation osteoporosis].
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Biomedical subjects
Publications and source records attributed to L C Hofbauer.
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HISTORY AND CLINICAL FINDINGS: A 47-year-old patient was admitted to hospital with fever (39.2 degrees C), weight loss and sore throat. The right thyroid area was painful on palpation. INVESTIGATIONS: The erythrocyte sedimentation rate was 56/86 mm, white blood cell count 10,600/l, with shift to the left and toxic granulations. Blood culture grew Streptococcus mitis; the echocardiogram showed vegetations on the aortic valve. Therefore aortic valve endocatidits was suspected. Ultrasound examination of the thyroid gland showed an echo poor area with an enlarged thyroid artery; thyroid cytodiagnosis was unremarkable. TREATMENT: The fever quickly subsided on administration of penicillin G (7.5 mill I.U. three times daily) and tobramycin (80 mg three times daily) for two weeks, followed by penicillin G in the same dosage for four more weeks. Vancomycin was then given for two weeks (1 g twice daily intravenously). The aortic valve vegetations were no longer seen three weeks after onset of treatment. Two months after discharge the thyroid and heart were normal on ultrasound examination. CONCLUSION: Bacterial thyroiditis was caused by embolisation to the thyroid artery from vegetations on the aortic valve in aortic valve endocarditis, probably due to carious teeth.
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Endocrine abnormalities occur frequently in HIV-infected patients. Although the majority of endocrine disorders reflect chronic infection, stress, and malnutrition, some disorders are characteristic of HIV infection or AIDS and deserve particular clinical attention. Identification of HIV patients at risk of frank endocrine disorders, rapid and correct diagnosis, and appropriate management are essential steps to minimize morbidity and mortality. Finally, increasing evidence from in vitro studies suggests that various hormones may influence HIV replication as well as the course of HIV disease and associated disorders. Future studies on the molecular mechanisms of hormones on HIV action and clinical studies on the effects of hormones as adjunctives to established forms of therapy may stimulate development of novel therapeutic strategies that will benefit HIV-infected patients.
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We describe a patient with hepatitis C related cryoglobulinemia and associated retroperitoneal fibrosis who developed massive proteinuria resulting from renal vein thrombosis.
We describe a patient in whom highly active Graves' disease occurred in close temportal relationship with extensive, recurrent, venous thrombosis due to primary antiphospholipid syndrome. (J. Rheumatol 1996;23:1435-7).
Osteoporosis following allogenic organ transplantation represents an increasingly common medical and socioeconomic problem. Contributing factors include hospitalization, long-term immobilization, and usage of immunosuppressive drugs (glucocorticoids, cyclosporine A) in patients who undergo transplantation. In addition, complications of underlying diseases and adverse effects of drugs used in their management such as glucocorticoids, laxatives, loop diuretics, and heparin may promote the development of posttransplant osteoporosis. Consideration of individual risk factors involved in the pathogenesis of posttransplant osteoporosis is mandatory for appropriate prevention and treatment.