アスペルギルス性膿胸と二次性副甲状腺機能こう進症を合併した維持透析例

• 松下 啓

  三井記念病院内科

• 杉本 徳一郎

  三井記念病院内科

• 岩本 彩雄

  三井記念病院内科

• 大池 裕美子

  三井記念病院内科

• 多川 斉

  三井記念病院内科

• 福内 敦

  三井記念病院外科

書誌事項

タイトル別名

• A hemodialysis patient with thoracic aspergillus empyema and secondary hyperparathyroidism.

抄録

Although visceral mycosis is a rather rare disorder in the general population, it is more common in immunocompromised hosts including dialysis patients. We recently experienced a case of thoracic aspergillus empyema in a patient in whom hyperparathyroidism appeared to have aggravated the predisposition. A 40-year-old male dialysis patient who had been on hemodialysis for 15 years was admitted to our hospital because of fever, chill and arthralgia in August 1995. The etiology of the renal failure was chronic glomerulonephritis. He was fatigued and malnourished. Marked ectopic calcifications were noticed at various sites such as around both shoulders, the middle back, and the gluteal region. The diagnosis of thoracic aspergillus empyema and secondary hyperparathyroidism was made. Pleural cavity fluid was drained off and several antifungal agents were administered without improvement in clinical or laboratory findings. Subtotal parathyroidectomy was performed under local anesthesia because of impaired respiratory function. After the operation, the arthralgia and high fever rapidly disappeared and the serum C-reactive protein level gradually decreased to normal. We consider that the secondary hyperparathyroidism had accelerated the onset and the course of aspergillosis possibly through impairment of the patient's defense mechanism.

収録刊行物

• 日本透析医学会雑誌

  日本透析医学会雑誌 30 (10), 1259-1262, 1997

  一般社団法人 日本透析医学会

キーワード

• 血液透析
• アスペルギルス性膿胸
• 二次性副甲状腺機能亢進症
• 異所性石灰化

詳細情報

• CRID: 1390282679653555712
• NII論文ID: 130003874786
• DOI: 10.4009/jsdt.30.1259
• ISSN: 1883082X
• ISSN: 13403451
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可