Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cocaine abuse is associated with a constellation of serious medical complications. An unrecognized and recently described complication of cocaine use is rhabdomyolysis with acute renal failure. We describe the first patient identified in our institution with this entity, admitted to the medical services with oliguric acute renal failure. Three days prior to admission the patient had a cocaine snorting binge. He presented with bilateral flank pain, gross hematuria, vomiting and chills. No history of crush injury, prolonged immobilization and or seizures was reported. On admission the vital signs were normal, physical exam revealed periorbital edema and marked soft tissue neck swelling. Lab values: Bun 120 mgs%, Creat. 10.7 mgs%, Na 132 meq/lt, Co2 13mq/lt, Cl, 103meq/lt, Co2 13meq/lt, Ca 5.3 mgs%, CPK 30,800 U/L with a MM fraction of 98%, LDH 600 U/L, SGOT 300 U/L. The urine was dark red with a ph of 6.5 and 100 rbc/hpf. The anti-GBM antibody and blood cultures were negative. An abdominal sonogram was normal. He received peritoneal dialysis and was discharged on his 14th hospital day with a CPK of 2,800 U/L and decreasing azotemia. Cocaine associated rhabdomyolysis has only been recently described in the literature (AJM April, 88). Acute myoglobinuric renal failure needs to be added to the growing list of medical complications of cocaine use.
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PMID:Cocaine and rhabdomyolysis: report of a case and review of the literature. 207 48

This is a case of a 23-year-old male presenting with altered sensorium, vomiting, and right flank pain. Despite a normal osmolal gap, he was found to be suffering from ethylene glycol intoxication. This little-described presentation can result in the clinician failing to consider ethylene glycol as a causative agent.
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PMID:Case report: severe ethylene glycol intoxication with normal osmolal gap--"a chilling thought". 225 6

Double-pigtail stents are placed commonly in patients before extracorporeal shock wave lithotripsy to prevent ureteral obstruction from steinstrasse. The use of double-pigtail stents in lithotripsy patients with a moderate stone burden was studied in a prospective randomized trial. Patients with unilateral renal stone(s) with at least 1 diameter between 7 and 25 mm. were eligible for the study. Fifty patients were randomized to a control or stented group. Double-pigtail stents with an attached suture were placed immediately before extracorporeal shock wave lithotripsy in the stented group. Stents were removed by the patients 1 week after lithotripsy. A survey on pain and associated symptoms was completed by patients at 1 and 14 days after treatment. There was no statistical difference in flank or abdominal pain, nausea, vomiting, temperature or use of analgesics at 1 and 14 days after extracorporeal shock wave lithotripsy in the control and stented groups. All patients in the stented groups complained of side effects attributable to the stent including urinary frequency and urgency, bladder pain, hematuria and flank pain with urination. Of 25 patients with stents 7 (27%) had early removal because of severe irritation, early migration or accidental removal. Among the patients with follow-up x-rays 1 month after treatment 17 of 21 (81%) in the control group and 12 of 19 (63%) in the stented group showed no evidence of remaining stones. The use of double-pigtail stents is not beneficial in patients with a moderate stone burden. Double-pigtail stents are associated with considerable patient discomfort but no decrease in symptomatic ureteral obstruction or final stone eradication rate.
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PMID:Use of double-pigtail stents in extracorporeal shock wave lithotripsy. 240 62

The clinical findings of 29 patients with hemorrhagic fever with renal syndrome (HFRS) caused by Seoul virus were evaluated and compared with the previously reported clinical findings of classic Korean hemorrhagic fever (KHF). The diagnoses of these patients were made by hemagglutination inhibition test. The results were as follows: 1) The disease occurred predominantly in males with a high incidence in the third and fourth decades of life. 2) The highest incidence of the disease occurred in October-December. 3) Major symptoms were fever, abdominal or flank pain, vomiting and myalgia. 4) Major signs were petechia, CVA tenderness, pharyngeal injection, and conjunctival infection, but these signs were much less common than in patients with classic KHF. 5) The treatments were mainly conservative and there was no fatal case in the study subjects. These findings suggest that the clinical course of Seoul virus infection may be much milder than that of classic KHF and the outcome may be more favorable.
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PMID:A clinical study of hemorrhagic fever with renal syndrome caused by Seoul virus infection. 257 57

Transcatheter arterial embolization (TAE) has been widely used in the treatment of tumors as well as other lesions of the kidney. Complications most commonly encountered are post embolization syndrome, such as flank pain, fever, leucocytosis, nausea, vomiting, or ileus. They occur mostly in 24 to 48 hours and its treatment is symptomatic. We experienced a renal abscess developed in a patient of renal tumor with preexisting silent urosepsis. Precise examination of silent infection is recommended as a preprocedure test to avoid such complications.
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PMID:[Renal abscess: complication of transcatheter arterial embolization of renal cell carcinoma]. 261 Jan 81

We report the case of a 59-year-old diabetic woman with emphysematous pyelonephritis. The patient presented with nausea, vomiting, and right flank pain of three days duration. The diagnosis was established by a plain abdominal radiograph in the emergency department. Aggressive rehydration, control of diabetes, broad-spectrum antibiotic therapy, and early right nephrectomy resulted in rapid clinical improvement. Emphysematous pyelonephritis is rare and often fatal. Survival depends on early diagnosis and aggressive combined medical and surgical management.
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PMID:Emphysematous pyelonephritis: an emergency indication for the plain abdominal radiograph. 328 24

The records of 47 patients with a perinephric abscess diagnosed from 1975 to 1986 at 8 San Francisco Bay Area hospitals were reviewed. The mean age was 51 years. Fifty-five percent were females and 45%, males. The left kidney was affected in 47% of cases, the right kidney in 40%, both in 4%, and a transplanted pelvic kidney in 9%. Fever (55%), chills or diaphoresis (47%), flank pain (40%), abdominal pain (40%), and nausea or vomiting (32%) were the most common presenting symptoms. About half the patients had symptoms for 1 week or less and 12% had no symptoms. Fever was documented before diagnosis in 88% of patients. Abdominal mass (13%) or tenderness (49%), and flank mass (9%) or tenderness (42%) were seen less frequently, and 11% of patients did not have fever, flank, or abdominal findings. The most frequent underlying conditions included previous urologic surgery (45%), previous urinary tract infection (38%), diabetes mellitus (36%), and urinary tract stones (36%). Cultures of perinephric abscesses yielded gram-negative aerobes in 52% of patients, primarily Escherichia coli. Staphylococcus aureus was isolated in 26% of patients and anaerobes in 17%. A single pathogen was isolated in 71% and multiple isolates in 29%. Of interest and great potential therapeutic importance was culture of anaerobes, primarily Bacteroides spp. in 17%, Enterococcus spp. in 7%, and Candida albicans in 7%. Positive blood and urine cultures identified perinephric abscess organisms exactly in 58% and 37% of cases, respectively. Routine laboratory tests such as the white blood cell count and urinalysis were insensitive and non-specific for perinephric abscess. Leukocytosis and anemia at admission were seen in slightly more than half of the patients. For radiologic diagnosis, computerized tomographic scanning was most helpful. Ultrasound and intravenous pyelography were falsely negative in about one-third of cases. Mortality (13%) was low in this series when compared with earlier studies, and probably reflects modern medical care. Six patients (13%) died during hospitalization, 2 of whom had diagnosis of PNA established only at autopsy. Drainage of the perinephric abscess was carried out by open surgical drainage in 64% of patients, percutaneous drainage in 19%, and both in 13%. The initial procedure, whether open surgical drainage or percutaneous catheter drainage, was usually successful. Late complications included nephrocutaneous fistulas in 3 patients and disseminated candidiasis in 1 patient.
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PMID:Perinephric abscess. Modern diagnosis and treatment in 47 cases. 335 13

A 14 year old boy was admitted for vomiting, anorexia, flank pain and leukocyturia/hematuria. Shortly after admission, he developed anuria and acute renal failure so that hemodialysis had to be started. Pre- and post-renal causes were excluded. There were no signs of acute glomerulonephritis; liver enzymes were normal. The 123Iodine-Hippuran scan showed a shock kidney pattern lacking tubular clearance. Renal biopsy revealed an interstitial nephritis with edema and a mixed cellular infiltration. History was empty for nephrotoxic agents except for mushroom ingestion: Five days before admission the boy ate Cortinarius speciocissimus mushrooms, the toxine of which is known to be nephrotoxic, causing irreversible renal failure in severe cases (Orellanus Syndrome). Renal function did not improve much and renal transplantation was performed after 14 months on hemodialysis. In interstitial nephritis of unknown etiology the possibility of mushroom poisoning should be considered.
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PMID:[Terminal renal failure caused by interstitial nephritis following mushroom poisoning by Cortinarius speciocissimus]. 361 24

We report on a 67-year-old man with bilateral, synchronous, ureteral transitional cell carcinoma. He presented with bilateral flank pain accompanied by nausea, vomiting and oliguria. Bilateral hydronephrosis with upper ureteral filling defects was found on antegrade pyelogram. After urinary diversion with bilateral percutaneous antegrade drainages for 6 days, serum creatinine fell from 10.1 to 4.7 mg/dl. Exploration revealed bilateral upper ureteral tumors. Right nephroureterectomy and left ureterectomy with left nephrostomy were done.
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PMID:Obstructive uropathy caused by bilateral synchronous ureteral carcinoma: report of a case. 374 1

Acute hemolysis as a reaction to rifampicin is extremely rare; case reports number less than 15. We recently evaluated a 65-year-old Cambodian refugee who self-regulated the use of rifampicin and isoniazid for pulmonary tuberculosis. Fifteen minutes after a single discontinuous oral dose, he developed flank pain, chills, rigors, vomiting, diarrhea, fever, and brown turbid urine. Laboratory tests at presentation showed acute intravascular hemolysis. Nonoliguric renal failure ensured, and he was transferred to our institution 2 days later. The patient was group A, Rh (D) positive, P1 negative with a cold autoantibody and cold anti-P1 alloantibody. The direct antiglobulin test was negative at the time of transfer. To evaluate the hemolysis, studies were done to test for rifampicin- or isoniazid-dependent antibodies. Rifampicin-dependent antibodies were detected in the antiglobulin phase with broad spectrum anti-human globulin, monospecific anti-gamma chain, and anti-complement antisera. Agglutination titers did not change after dithiothreitol reduction of the patient's serum. We conclude that this patient developed rifampicin-dependent IgG antibodies with complement-fixing capability. The presence of rifampicin-dependent antibodies should be suspected in a patient with hemolysis and/or renal failure taking rifampicin.
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PMID:Acute hemolysis and renal failure with rifampicin-dependent antibodies after discontinuous administration. 398 5


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