The presented rare form of double myeloma disease with initial renal insufficiency underscores the importance of careful observation and teamwork that can alter the course of this serious disease.
The SLE can be initially manifested with gastroenterological symptoms without any other clinical and immunologic parameters of the disease. If in patients with SLE and gastrointestinal tract involvement malabsorption syndrom is developed, a treatment success depends on both immunosupressive therapy and total parenteral nutrition.
This case report suggests that in patients with symptoms of epileptic seizures while undergoing treatment in a hyperbaric chamber, it is always important to think of neurotoxic effects of pure oxygen which occurs at higher pressures and with a longer inhalation of 100% oxygen. In these patients, reexposure to hyperbaric conditions leads to recovery. This effect is important in daily inhalation of 100% oxygen under hyperbaric conditions which is why the use of pure oxygen is controlled and diving is allowed in shallow depths and for a limited time.
When renal failure associated with hematuria and bilateral hydronephrosis is presented in a patient with multiple myeloma, this unusual and rare extramedular localization should be also considered.
<zakljucak> Napredak u oblasti hiperbaricne medicine sve je ocigledniji, ali njena primena ne sme biti svojina male grupe ljudi, bilo zbog monopola, ili zbog neznanja i nezainteresovanosti drugih. Iako je koriscenje hiperbaricne oksigenacije kao i nabavka hiperbaricnih komora (visemesnih ili jednomesnih) uslovljena velikim finansijskim ulaganjima, korist od njene primene daleko je veca, a toga treba da budu svesni svi koji odlucuju o njoj. U poslednje vreme sve je manje dilema o opravdanosti primene HBOT, a sve vise se otvaraju nova polja moguce primene. Razvoj molekularne medicine stvorio je nove prostore u tretmanima odredjenih bolesti gde HBOT moze imati svoje mesto. U korak sa novim medicinskim saznanjima, odredjivanjem pravih indikacija, primenom korektnih doza kiseonika kao i vremena ekspozicije, napredak ce biti evidentan i moze se zakljuciti da doba HBOT tek dolazi.
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