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Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Based on a case report, the combined occurrence of a hypopituitary crisis and acute renal failure (ARF) is discussed. Aetiologically, the patient's disease dates back to an operation on the pituitary gland 40 years previously followed by a panhypopituitarism. The course of the disease presented initial symptoms which did not suggest a hypopituitary crisis to the first physician. The patient was hospitalized primarily on the tentative diagnosis of encephalitis. Subsequently, both laboratory findings and sonography of the abdomen pointed to chronic renal failure. The severity of the clinical course led to the transfer of the patient to our hospital for haemodialysis. Examination of the soporous patient revealed in addition to symptoms of ARF based on ambilateral pyelonephritic nephrocirrhosis typical cardinal symptoms of an endocrine insufficiency. Sopor, serious exsiccosis, pale, cool, pigmentless skin, deficiency of axillary and pubic hair, gonadal atrophy, hypotonia, hypothermia, bradypnoea and bradycardia as well as anamnesis of the patient substantiated the tentative diagnosis of a hypophysical coma based on hypopituitarism, clinically dominated by hypothyroidism. Following an immediately launched hormone substitution in combination with haemodialysis the state of the patient improved. However, during the fifth haemodialysis cardiac arrest occurred, the cause of which was put down to a dysequilibrium syndrome. The cause, however, must be seen in a continuing stress situation, inadequate hormone substitution and in sedation with diazepam. After reanimation the patient was transferred to the ICU.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pituitary crisis and acute renal failure--a case report]. 814 59

During 1993-1998, in winter time 14 elderly patients: 8 female and 6 male aged 65-88, were treated because of hypothermia. Rectal temperature on admission was 20-34.9 degrees C. Sopor was present in 2 and various grades of coma were present in 10 patients. Arterial hypotension was recorded in 5, and shock in 9 patients. Increased serum creatinine level was found in 8 patients. The mean rectal temperature in the whole group was 31.3 degrees C +/- 4.7, ranging from 20.0 to 34.9 degrees C, and the mean serum creatinine level was 172.2 +/- 93.5, in range of 66.0 to 360.0 mumol/L. Negative correlation between those two parameters was found: r = -0.572. In 2 of them parameters of renal failure were analyzed: urine sodium concentration, creatinine urine/plasma ratio, urine osmolality, urine/plasma osmolality ratio, renal failure index and fractional excretion of filtered sodium. In one of the patients all parameters were within the range of functional oliguria, in an other the urine sodium concentration serum showed acute renal failure, but all other findings showed borderline values between functional oliguria and acute renal failure. Twelve out of 14 patients died within 1-216 hours from admission.
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PMID:Hypothermia and acute renal failure in the elderly. 1009 29