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  • 1
    ISSN: 1433-0474
    Keywords: Schlüsselwörter ; Akutes Nierenversagen ; Borsäurevergiftung ; Eosinophilie ; Erythem ; Hämodialyse ; Key words ; Acute renal failure ; Borate ; Eosinophilia ; Erythema ; Hemodialysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Today borate is a rarely used agent. Only few reports about borate intoxication have been published within the last few years. Acute renal failure and skin-lesions are well-known symptoms of an acute borate intoxication. We report on a 14 year old girl with a suicidal ingestion of about 4 g borate. Twelve hours later the girl developed an acute renal failure, which was compensated by hemodialysis. Twenty five days later an allergic-toxic erythema appeared (”boiled lobster syndrome”) in parallel with an eosinophilia of 50% (5184 eosinophiles/µl) in the peripheral blood smear. Under symptomatic therapy eosinophilia and other symptoms resolved completely. Discussion: The very late development of the typical erythema is as remarkable as the unusual, enormous eosinophilia, which has not been reported before in this context. Mostly, mild courses are seen. Our patient recovered completely.
    Notes: Zusammenfassung Borsäure wird heute sehr selten benutzt. Entsprechend sind die Erfahrungen mit Borsäureintoxikationen in den letzten Jahren gering. Akutes Nierenversagen und desquamative Hauterosionen sind bekannte Intoxikationserscheinungen. Ein 14jähriges Mädchen entwickelte 12 h nach der Ingestion von etwa 4 g Borsäure in suizidaler Absicht ein akutes Hämodialyse-pflichtiges Nierenversagen mit Anurie über 14 Tage. 25 Tage nach der Ingestion kam es zu einem desquamativen Exanthem (Boiled-lobster-Syndrom) sowie zu einer ausgeprägten Eosinophilie von 5184/µl bei einer Gesamtleukozytenzahl von 10800/µl. Unter symptomatischer Therapie kam es zu einer schnellen und vollständigen Remission der klinischen Symptomatik sowie der Eosinophilie. Diskussion: Das späte Auftreten des typischen Exanthems sowie die ausgeprägte Eosinophilie sind bemerkenswert und in diesem Ausmaß bisher noch nicht beschrieben.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1238
    Keywords: Key words Intensive care ; Critical care ; Acute respiratory distress syndrome ; Persistent pulmonary hypertension of the newborn ; Feedback inhibition
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To examine the kinetics of successful nitric oxide (NO) withdrawal in vivo and in vitro.¶Design and setting: Prospective study in a university pediatric intensive care ward and research laboratory.¶Patients and materials: Nineteen patients with acute respiratory distress syndrome (ARDS) or persistent pulmonary hypertension of the newborn (PPHN). Primary porcine pulmonary artery cells in vitro.¶Interventions: NO inhalation and withdrawal in patients; exposure to NO donor sodium nitroprusside (SNP) and gaseous NO in vitro.¶Measurements and results: In patients: a slight, but significant, increase of oxygenation index (OI) from 4.57 ± 0.24 cmH2O/torr (mean ± SEM) to 4.90 ± 0.26 cmH2O/torr after withdrawal of NO (p 〈 0.001). Recovery of OI (4.43 ± 0.23 cmH2O/torr) 30 min after weaning, a significant drop after 4 h (3.72 ± 0.17 cmH2O/torr; p 〈 0.001), values restored after 12 h.¶In vitro: NO synthase (NOS) activity was significantly lower in SNP-incubated cells (20.0 ± 4.0 μm/min) than in control cells (37.6 ± 7.0 μm/min; p 〈 0.05). Thirty minutes after SNP withdrawal there was NOS activity of 35.8 ± 10.0 μm/min with a significant increase by 4 h (p 〈 0.05). No alteration of endothelial NOS (ENOS) mRNA expression by NO (Northern Blot).¶Conclusion: In patients there is a slight, but significant, reversible increase of OI after successful weaning from NO. In vitro, NO leads to a reversible decrease of ENOS activity on a post mRNA level, resembling clinical observations.
    Type of Medium: Electronic Resource
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