Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085584 (encephalopathy)
 18,178 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Aluminum has been implicated as a contributing factor to dialysis encephalopathy syndrome (DES) and osteomalacic osteodystrophy. Monitoring of its level together with i-PTH, desferoxamine infusion test, or bone biopsy gives the degree of intoxication. Specimens for aluminum must be collected in containers washed in nitric acid or disodium EDTA to avoid contamination. Determination is made with flameless atomic absorption spectrometry or neutron activation. Various experimental conditions for the former together with discussion on their merits and shortcomings are given. Included are protein precipitation, matrix modification, background correction, and sampling technique.
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PMID:Technical aspects of quantification of aluminum. 219 56

We evaluated the need for erythropoietin (EPO) treatment in 134 end-stage renal disease patients assuming a level of hemoglobin below 6 mmol/l (9.6 g/dl) as indication for treatment. 91 patients (68%) fulfilled this criterion. Absolute contraindications in 2 patients were previous thrombotic encephalopathy and refusal of treatment. Relative contraindications due to cardiac disease were found in 3 patients. In 15 patients additional treatment was required because of hypertension (5) or deficiency states (10). The implications of elevated serum PTH and aluminum overload are discussed.
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PMID:On the need for erythropoietin treatment in dialysis patients. A Copenhagen City Dialysis Unit study. 222 88

When the aluminium content of the water supply to our Haemodialysis Unit rose from less than 0.5 mumol/l to 6 mumol/l over a two month period, we carried out bone biopsies and desferrioxamine infusion tests on twelve (12) patients who had been on haemodialysis for less than one year (mean 8 months) and had normal serum aluminium levels. The patients had no bone symptoms. Eight patients had positive aluminium bone stains. The aluminium osteomalacia group (n = 8) had a mean PTH of 1.4 ng/ml s.e. 0.3 whereas the non-ALO group had a mean PTH of 2.9 ng/ml s.e. 0.7. The difference in mean PTH is significant (p less than 0.05). There was no evidence of encephalopathy, fractures or microcytic anaemia in the ALO positive group. The aluminium contamination of the water supply occurred because of a change in the reservoir purification system from sand-filtration to alum.
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PMID:Acute epidemic aluminium osteomalacia secondary to water supply contamination. 236 22

Aluminum intoxication is common in patients with chronic renal failure because of absorption of aluminum during dialysis from aluminum-containing dyalysate water and ingestion of phosphate binders containing aluminum. Aluminum accumulation in the body is followed by bone disease, encephalopathy and anemia. Bone diseases can be recorded in 44% of the patients treated with long-term dialysis. Two early histologic types of retarded bone turnover can be seen, i.e. osteomalacia and aplastic bone disease. In dialyzed patients, osteomalacia is usually followed by low PTH level in human serum. On the contrary, studies on uremic rats have shown that previous parathyroidectomy can prevent aluminum intoxication, because hyperparathyroidism in an early phase of chronic renal failure increases aluminum absorption from the gut and its accumulation in the body. As the pathogenesis of aluminum-induced alterations is unclear, the prevention of bone disease should be provided through lowering the aluminum intake in dialyzed patients. Bone biopsy is unavoidable for the early detection and diagnosis of the disease. Promising results in the treatment of aluminum intoxication have been obtained using deferoxamine, a chelating agent.
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PMID:[Aluminum poisoning]. 267 63

The role of PTH as possible uraemic toxin within the scope of disturbances of the central nervous system (progressive dialysis encephalopathy, PDE) was investigated in 88 patients undergoing haemodialysis. A radioimmunoassay covering the C-terminal PTH fragment was used. Patients undergoing haemodialysis with a PDE showed the highest values with 2,015.4 +/- 457.9 pg/ml, and also in the preclinical stage of a PDE the PTH values with 1,845.7 +/- 663.1 pg/ml lay significantly above those ones of the patients undergoing haemodialysis without PDE (794.8 +/- 364.7 pg/ml). The findings speak for the importance of PTH in the development of complications of the central nervous system within the scope of the uraemia syndrome.
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PMID:[Significance of parathyroid hormone (PTH) within the scope of central nervous system disorders in hemodialysis patients]. 363 Apr 25

In 25 (33.8%) of 74 chronically haemodialysed patients a distinct osteopathy with bone pain, spontaneous fractures, arthralgias and weakness of the muscles due to dialysis was present. In comparison to a group without complaints the duration of the dialysis was longer by 6 months, the mineral contents of the bones was decreased in 38%, in the comparative group in 22%. A progressive demineralisation was found in 46%, in the comparative group in 20%. Hypercalcaemias under vitamin D2 caused a therapy resistance. In 1 exemplary case (type IIc, PTH 0.3 micrograms/l) in the 3rd year of dialysis a fracture of the neck of the femur took place and an endoprosthesis was implanted. There was a progressive demineralisation of about 16%. The suspicion of a typical combination with an encephalopathy due to dialysis did not confirm itself. A pseudocyst in the brain was found. The differential diagnosis to the hypercalcaemia-induced psychosis in the osteopathy due to dialysis is discussed. In a prophylactic application dihydrotachysterine proved favourable for avoidance of an osteopathy due to dialysis. Parallel to the clinical progressing of the osteopathy due to dialysis a progressive demineralisation could be demonstrated at the peripheral mineral contents of the bones. Extreme losses of minerals appeared from the 4th to the 59th month of dialysis from - 16% to - 37% and from the 22nd to the 87th month from plus 11% to minus 14% of the age-and-sex-specific normal values. Successful transplantations led to the stagnation of the progressive demineralisation, unsucessful transplantations increase them. The influence of the non-refined water for the production of dialysate by possible aluminium intoxications on the development of the osteopathy due to dialysis is discussed.
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PMID:[Dialysis osteopathy with spontaneous fractures, progressive demineralization and therapy resistance]. 635 38

Three out of 140 patients with non-hodgkin's lymphoma treated in a Department of Internal Medicine showed hypercalcemia during their clinical course. Hypercalcemia was symptomatic in two patients causing renal failure in one of them and a metabolic encephalopathy in the other. In the third case hypercalcemia was a casual finding. Serum calcium levels varied between 14.8 and 16.6 mg/100 ml; serum phosphate and tubular reabsorption of phosphate were normal. Alkaline phosphatase were high in the three cases. Bone disease was present in two cases. Transient responses were obtained with the administration of prednisone and calcitonin associated to forced diuresis. Indomethacin was ineffective. Pathogenesis of hypercalcemia could be related to the release of an osteoclastic activator factor. The role of prostaglandins and the presence of PTH-like mechanisms were discarded in our cases by indirect methods. The poor prognosis of patients with non-hogkin's lymphoma and hypercalcemia in stressed.
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PMID:[Hipercalcemia and non-Hodgkin's lymphomas. Report of three patients (author's transl)]. 738 26

To evaluate the presence and the severity of uraemic encephalopathy (UE) in regular dialysis treatment patients in relation to dialytic age, pattern reversal visual evoked potentials (PRVEPs) and brainstem auditory evoked potentials (BAEPs) were respectively performed in 86 and 98 patients on haemodialysis for 1-194 months, divided into three subgroups according to dialytic age (group 1, < 5 years of regular dialysis; group 2, 5-10 years; group 3, > 10 years). VEPs in the whole group of 86 patients and in each subgroup with different dialytic age differed significantly from controls for both eyes, 41.7% of whom had pathological P100; no differences were observed between the three subgroups. BAEPs were pathological in 9.7% of the ears and 18.4% of patients. On the right ear the three subgroups were significantly different from controls in the latencies of peaks III and V; subgroup 2 and 3 differed from controls in the I-V interpeak, while the interpeak I-III was different from controls only in subgroup 3. On the left ear the three subgroups differed significantly from controls in the latencies of peak V; subgroup 2 and 3 were significantly different from controls in the latency of peak I; subgroup 3 was different in the peak III latency; subgroup 1 and 3 were different from controls in the interpeak I-V; no differences were observed in BAEPs between the three subgroups with increasing dialytic age. No significant correlations were found between the neurophysiological parameters and some biochemical parameters (urea, creatinine, PTH).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evoked potentials (VEPs and BAEPs) in a large cohort of short- and long-term haemodialysed patients. 827 27