Sarcoidosis is a multisystemic inflammatory disease characterized by noncaseating granulomatous inflammation of unknown origin. Although, renal involvement is rare, renal manifestations of sarcoidosis include abnormal calcium metabolism, nephrocalcinosis, nephrolithiasis, nephrotic syndrome and glomerulonephritis. We report a case of sarcoidosis presented with nephrotic syndrome and diagnosed as Ig A nephropathy.
ÖZAkut fosfat nefropatisi (APN) kolonoskopi öncesi bağırsak temizliği için kullanılmakta olan oral sodyum fosfat (ONaP) içeren purgatiflere bağlı görülen bir akut böbrek hasarı formudur. Genellikle kolonoskopi yapılacak olan hastalara işlemden 12-24 saat önceden başlayarak iki kez 45 ml'lik ONaP verilmektedir. İntestinal emilim olmakta ve geçici hiperfosfatemi ile hipokalsemi hemen her hastada görülmektedir. Bunun yanı sıra ciddi hiperfosfatemi, semptomatik hipokalsemi, hipernatremi, semptomatik hiponatremi; hipokalemi, yüksek anyon açıklı metabolik asidoz ve akut böbrek hasarı (ABH) görülebilmektedir. Bu yazıda sunulan olgu 65 yaşında kadın olup tip 2 diyabet ve hipertansiyon tanıları mevcuttu. Demir eksikliği anemisinin etiyolojisinin araştırılması amacıyla kolonoskopi yapılmıştı. ONaP ile kolonoskopi hazırlığı yapılmış ve işlem sonrası klinik olarak APN ile uyumlu ABH gelişmişti.ANAhtAR SÖZCüKLER: Akut fosfat nefropatisi, Kolonoskopi, Oral sodyum fosfat
ABStRACtAcute phosphate nephropathy is a form of acute kidney injury (AKI) due to oral sodium phosphate (ONaP) purgatives used for bowel cleansing before colonoscopy. Usually, 45 ml ONaP is given two times daily 12-24 hours prior to colonoscopy. Intestinal absorption is followed by transient hypocalcemia and hyperphosphatemia in almost all patients. In addition, severe hyperphosphatemia, symptomatic hypocalcemia, hypernatremia, hypocalcemia, hyponatremia, hypokalemia, high anion gap metabolic acidosis and AKI can be seen. The patient presented in this paper is a 65-year-old female. She was diagnosed with type 2 diabetes mellitus and hypertension. Colonoscopy was performed in order to investigate the etiology of iron deficiency anemia. ONaP was administered for preparation of colonoscopy and AKI which was clinically compatible with APN developed after the procedure.KEy wORDS: Acute phosphate nephropathy, Colonoscopy, Oral sodium phosphate
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