Swiss medical weekly
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Swiss medical weekly · Apr 2000
Case Reports[Fever of unknown origin as a sign of calcium pyrophosphate deposition disease].
Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease may manifest clinically as septic fever (40 degrees C), acute pseudogout attack of knee, wrist and shoulders, or as a variety of patterns of chronic inflammatory or degenerative joint disease. The association of pseudogout with fever is less widely recognised and may lead to over-investigation, delay in appropriate treatment and disproportionate costs. ⋯ During this therapy the patient again developed septic fever and acute arthritis of the right wrist. Radiographs of the wrist, knee and symphysis pubis revealed prominent chondrocalcinosis and destructive arthropathy.
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The significance of age-induced alterations in renal function is described in order to explain clinically important entities in older people, such as hypo- and hypervolaemia, hyper- and hyponatraemia, hyperkalaemia and metabolic acidosis. A sound knowledge of the age-dependent changes in renal function enables the physician to effectively prevent many of these metabolic disturbances. Renovascular disease, nephrotic syndrome, renal cysts and acute renal failure are renal diseases which typically have a higher incidence in older people and require special consideration when evaluating renal disease in the elderly.
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Swiss medical weekly · Mar 2000
Hereditary hyperferritinaemia cataract syndrome: does it exist in Switzerland?
Recent research in iron metabolism has revealed the existence of iron-responding elements in the 5'UTR of the mRNA of ferritin. Binding of these structures with iron-regulatory proteins regulates ferritin synthesis within the cell, according to the intracellular iron level. Several mutations of the iron-responding elements located at the 5'UTR of the L-ferritin subunit, which lead to the hereditary hyperferritinaemia cataract syndrome, an autosomal dominant hereditary disease, have been described. ⋯ Our local study indicates that hereditary hyperferritinaemia cataract syndrome is extremely rare in Switzerland. However, similar studies should be carried out in other regions of the country. Iron status evaluation and ferritin level monitoring should become routine examinations in all new cases presenting with bilateral nuclear cataract before the age of 50 years.
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We report on a rare peripartal neuropathy of the leg caused by prolonged difficult labour. Immediately after delivery two patients complained of unilateral footdrop and numbness in the leg. ⋯ The outcome was favourable in both patients. If subsequent pregnancies occur, caesarean section may be indicated.