Patient: Female, 44Final Diagnosis: Deterioration of renal and heart functionSymptoms: HypercalcemiaMedication: —Clinical Procedure: LaboratorySpecialty: NephrologyObjective:Rare diseaseBackground:Fabry disease is a rare and progressive X-linked inherited disorder of glycosphingolipid metabolism that is due to deficient or absent lysosomal α-galactosidase A activity. Among its other associated signs and symptoms, patients present with renal failure and proteinuria, which are markers of disease progression. Renin-angiotensin-aldosterone system (RAAS) blockers can slow the progression of chronic renal failure and proteinuria. In fact, some studies have shown the beneficial effects of paricalcitol on proteinuria.Case Report:We present a case of a female patient with the classic variant of Fabry disease. She was treated with a high dose of paricalcitol as an antiproteinuric agent due to unsatisfactory double-RAAS blockage, which resulted in transient worsening of cardiac and renal function.Conclusions:Despite the positive effects of paricalcitol as an antiproteinuric agent, as previously shown by some authors, our case highlights the possible serious adverse effects associated with the use of high doses of this drug.
Our results on in-hospital glycemia management seem comparable to previously published data. Patients with newly discovered diabetes, type 1 diabetes, treated with steroids and those eating improperly should be closely monitored. Additional education on guidelines and steroid-induced hyperglycemia accompanied by updated medical charts represent possible improvements. Quality standards for in-hospital glycemia management should be established.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.