The commonly used rapid infusion rate (A) of FeGl causes 'oversaturation' of transferrin. This is compatible with iron toxicity due to free iron which may explain our patients' complaints. Free iron cannot be measured directly. LDH as a crude measure of cell damage was not elevated. Better measurements to prove free iron toxicity, like lipid peroxides, are not yet readily available. Infusion during a longer period at a lower dose (D) is effective and eliminates 'Oversaturation' of transferrin and probably the danger of iron toxicity.
A case report is presented, concerning a 68-year-old woman, with gastro-intestinal complaints, six weeks after an aortic arteriography. On gastroscopy a duodenal ulcer was found and multiple purple discolourations. Biopsies show that these discolourations were caused by cholesterol-emboli. As the patient's complaints resided quickly after treatment for duodenal ulcer, the cholesterol-emboli can be seen as incidental findings. The gastroscopical biopsies were an important clue to the diagnosis of the cause of the rapid progressive renal failure in this patient.
The microwave oven is a kitchen appliance that has become increasingly popular in recent years. In some instances the temperature in the microwave oven can become exceedingly high. A case is discussed of a patient with respiratory distress after inhalation of gas from an overheated microwave oven. (Thorax 1993;48:300-302) Case report A 26 year old woman presented to the outpatient department of our hospital with acute dyspnoea. Shortly before she had been cooking potatoes in a microwave oven, using conventional microwave containers for that purpose. As a result of the development of smoke, she had opened the door of the microwave oven and removed the container with the cooked potatoes. A few minutes later her two pet parakeets that were in the kitchen dropped dead. Approximately half an hour later the woman began to experience feelings of dyspnoea and tightness around the chest, and developed a non-productive cough. The complaints became increasingly intense over the next few minutes.There was a history of a left sided nephrectomy and irradiation for a Wilms' tumour at the age of two years. Otherwise she had always been healthy. There was no history of dyspnoea on exertion or at rest and no wheezing or cough. She ature, showed that the pH was 7-41, the carbon dioxide tension (Pco,) was 34-5 mm Hg (4-6 kPa), the oxygen tension (Po2) was 54-2 mm Hg (7-2 kPa), and the oxygen saturation was 89%. Serological tests for psittacosis gave negative results. The electrocardiogram was normal. Chest radiography disclosed a diffuse bilateral fine reticular pattern at the lung bases (fig 1). Pulmonary function tests, performed the day after admission, showed a restrictive ventilatory defect with decreased diffusion capacity (table). Oxygen (3 1/minute) and prednisolone (25 mg intravenously) were administered. The following day the dyspnoea had diminished, and the blood gas tensions and chest radiograph were normal. Pulmonary function indices, however, were still abnormal.The dead parakeets were retrieved for postmortem examination a few hours after the incident. Microscopic examination disclosed considerable hyperaemia of the lung parenchyma with almost total atelectasis. In
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