José David D Orquera; Maria Marta Pernasetti; Patricia Ojeda; Griselda Aguero; Daniel Agustin Godoy
Volume 10, Issue 1 , January 2022, , Pages 44-48
Abstract
Immunoglobulin infusion (IVIG) is one of the first line therapy in Guillain Barre Syndrome (GBS). Several medical complications are associated with GBS (pneumonia, sepsis, deep vein thrombosis, dysautonomy). Acute kidney injury (AKI) is an uncommon complication during IVIG infusion. Several risk factors ...
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Immunoglobulin infusion (IVIG) is one of the first line therapy in Guillain Barre Syndrome (GBS). Several medical complications are associated with GBS (pneumonia, sepsis, deep vein thrombosis, dysautonomy). Acute kidney injury (AKI) is an uncommon complication during IVIG infusion. Several risk factors were associated with AKI during IVIG. These are an older age, previous renal disease, concomitant use of nephrotoxic agents, diabetes mellitus, hypovolemia, sepsis or using of IVIG that contained in its preparation sucrose or mannitol as stabilizers to avoid precipitation and aggregation. Infusion rate and total dose play a determinant role. The most important pathophysiological mechanism of AKI are the osmotic stress applied to the epithelium of proximal tubules and glomeruli. The osmotic overload is principally generated by IVIG stabilizers (sucrose). In general, AKI is reversible but approximately 30% hemodialysis is necessary. It is essential to respect doses, infusion rates and closely monitoring renal function parameters during IVIG infusion.
Richa Aggarwal; Anudeep Saxena; Kapil Soni
Volume 5, Issue 3 , July 2017, , Pages 215-218
Abstract
Posterior reversible encephalopathy syndrome (PRES) is a rare clinicoradiological entity characterized by neurological symptoms. It is associated with various conditions like hypertension, renal diseases and use of cytotoxic agents. It occurs more often in adults than children. PRES has been described ...
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Posterior reversible encephalopathy syndrome (PRES) is a rare clinicoradiological entity characterized by neurological symptoms. It is associated with various conditions like hypertension, renal diseases and use of cytotoxic agents. It occurs more often in adults than children. PRES has been described in pediatric patient with renal diseases like nephrotic syndrome, nephritis and in acute renal failure as in cases of Hemolytic-uremic syndrome but there are no reports of PRES in cases of recovery from acute kidney injury due to prerenal cause like hypovolemia. We herein present an interesting case of 6-year-old girl with traumatic amputation who developed PRES days after recovery of acute kidney injury. The patient was successfully managed medically. The presented clinical scenario demonstrates the fact that PRES can develop in a trauma patient in acute setting of recovering from hypovolemic acute kidney injury. Prompt recognition and treatment is important and can lead to complete recovery.