Unexplained hypothermia and bradycardia in two pediatric patients with Wegener’s granulomatosis
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Lianne M. Geerdink & Linda Koster-Kamphuis & Elisabeth A. M. Cornelissen & Michèl A. Willemsen & Nicole C. A. J. van de Kar
- چاپ و سال / کشور: 2011
Description
Sirs, We report remarkable symptoms of Wegener’s granulomatosis (WG), which might occur more often than reported so far. Two patients (13 and 16 years old) with acute renal failure due to WG developed simultaneous hypothermia (<36.5°C) and bradycardia (<60 bpm) during the first weeks of treatment with intravenous pulse methylprednisolone (IPM), cyclophosphamide (CYC), hemodialysis (HD), and therapeutic plasma exchange (TPE). In both patients, rapidly progressive pauci-immune glomerulonephritis was confirmed by renal biopsy, and antineutrophil cytoplasmic antibody (ANCA)-serology was positive. They received 3-day IPM therapy (1 g/1.73 m2), followed by prednisolone and cyclophosphamide (CYC) (2 mg/kg/day). Hemodialysis and TPE were started immediately. Soon after onset of treatment, hypothermia (34.9°C) and bradycardia (40 bpm) were observed (Fig. 1). Electrocardiogram showed a sinus bradycardia; endocarditis was excluded. Serum electrolyte and calcium levels were within reference ranges; thyroid function was normal. There were no signs of infection. Funduscopy showed no papilledema or renal vascular abnormalities, and neurological examination was normal.
Pediatr Nephrol (2011) 26:325–326 DOI 10.1007/s00467-010-1635-6 Received: 29 June 2010 / Revised: 21 July 2010 / Accepted: 26 July 2010 / Published online: 22 August 2010
