losartan-potassium and Amyloidosis

Thromboembolic complications are the second leading cause of death in cancer patients. In contrast to the large body of literature on venous thromboembolism (VTE), relatively few reports have focused on the pathogenesis, incidence, management and outcomes of arterial thromboembolic events in patients with malignancy. The purpose of this article is to review the current literature on the etiology, mechanisms, and prognosis of arterial thromboembolic events in cancer patients and outline appropriate screening and management guidelines that may help lower the rates of morbidity and mortality related to these events.

Topics: Algorithms; Amyloidosis; Antineoplastic Agents; Antiphospholipid Syndrome; Erythropoietin; Female; Humans; Ischemia; Male; Myeloproliferative Disorders; Neoplasms; Neurofibromatosis 1; Peripheral Arterial Disease; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prognosis; Radiation Injuries; Recombinant Proteins; Risk Factors; Thromboembolism; Thrombophilia; Transfusion Reaction

The diverse systemic effects associated with malignant renal tumours are described. It is emphasized that their recognition is essential for the early diagnosis of the tumour and that many of these effects may be overlooked unless the clinician is alert to their significance. Many of these early diagnostic clues also have a prognostic value.Although the basic management of a patient with a renal tumour continues to be a nephrectomy, the importance of tumour staging in relation to radical surgery is emphasized. Adjuvant therapy by radiotherapy, drugs, or immunotherapy is described and evaluated.

Topics: Adenocarcinoma; Alkaline Phosphatase; Alpha-Globulins; Amyloidosis; Anemia; Blood Sedimentation; Cachexia; Erythropoietin; Feeding and Eating Disorders; Fever of Unknown Origin; Hematuria; Hemoglobinometry; Humans; Immunotherapy; Kidney Neoplasms; Liver Function Tests; Medroxyprogesterone; Nephrectomy; Parathyroid Hormone; Prognosis; Renin; Urography

We report here the interesting case of a 76-year-old man with severe proteinuria who was diagnosed with systemic mastocytosis accompanied by a clonal non-mast-cell lineage haematological disorder (a non-secretory plasma cell dyscrasia). This is a unique report of systemic mastocytosis with a non-secretory plasma cell dyscrasia and nephrotic syndrome. The pathophysiological relevance between these entities along with the probability of occult amyloidosis is discussed.

Topics: Aged; Amyloidosis; Anemia; Biopsy; Bone Marrow; Clone Cells; Coloring Agents; Congo Red; Darbepoetin alfa; Drug Therapy, Combination; Erythropoietin; Factor X Deficiency; Gingiva; Hemorrhagic Disorders; Histamine Antagonists; Humans; Male; Mastocytosis, Systemic; Nephrotic Syndrome; Paraproteinemias; Prednisone; Proteinuria; Splenectomy; Splenomegaly; Subcutaneous Fat

The resistance to erythropoietin, which is used to treat normochromic, normocytic anemia in chronic renal failure, can develop in patients with conditions such as iron deficiency, aluminum toxicity, hyperparathyroidism, chronic inflammatory diseases, and primary hematological disorders. We found amyloidosis in the bone marrow of a woman without any other etiology for erythropoietin resistance who was undergoing chronic hemodialysis. Her anemia did not improve, despite 6 months of erythropoietin therapy. Bone marrow amyloidosis was found to be the reason for erythropoietin-resistant anemia in our patient with chronic renal failure and renal anemia. We present the case of bone marrow amyloidosis because it is a very rare cause of erythropoietin resistance.

Topics: Adult; Amyloidosis; Anemia; Bone Marrow Diseases; Drug Resistance; Erythropoietin; Female; Humans; Kidney Failure, Chronic; Renal Dialysis

Although the majority of patients with end stage renal failure have anemia, some have relative erythrocytosis. Patients treated with continuous ambulatory peritoneal dialysis (CAPD) having relative erythrocytosis were studied in order to determine the factors that would be responsible.. Nine out of 89 CAPD patients (10%) were identified as having relative erythrocytosis. Age-, sex- and duration of disease-matched eight patients undergoing CAPD were taken as control. Beside factors of etiologies of renal failure, smoking, renal cysts, viral hepatitides, residual renal function, the adequacy of CAPD, nutritional status, hypertension, serum levels of erythropoietin, IL-1, IL-6, TNF-, and IGF-1 levels were also investigated.. Relative erythrocytosis occurred most often in diabetic and amyloidosis patients. None of the parameters studied were found to be significantly different between groups. During 2-year follow-up, although statistically non-significant, patients having relative erythrocytosis seemed to have higher mortality rate due to vascular complications.. No single factor seemed to explain erythrocytosis in patients undergoing CAPD. Being diabetic or with amyloidosis may increase the risk.

Topics: Adult; Amyloidosis; Antigens, CD; Diabetes Complications; Erythropoietin; Female; Hepatitis, Viral, Human; Humans; Hypertension; Insulin-Like Growth Factor I; Interleukin-1; Interleukin-6; Kidney; Kidney Diseases, Cystic; Kidney Failure, Chronic; Male; Peritoneal Dialysis, Continuous Ambulatory; Polycythemia; Receptors, Tumor Necrosis Factor; Receptors, Tumor Necrosis Factor, Type I; Risk Factors; Smoking

A 60-year-old man was diagnosed to have primary systemic amyloidosis (AL type) and polycythemia (Hgb 19.1 g/dl, WBC 14,600/microliters, and platelets 60.5 x 10(4)/microliters). In vitro colony assay for hemopoietic stem cells showed increased numbers of colony-forming units (CFU)-G, CFU-GM, CFU-E, and CFU-Meg. Serum levels of erythropoietin (Epo), granulocyte colony-stimulating factor (G-CSF), interleukin (IL)-3 and IL-6 were elevated. The infiltration of amyloid fibrils into the hemopoietic factor-producing tissues may stimulate abnormal secretion of hemopoietic factors and cytokines, resulting in increased numbers of hemopoietic stem cells and polycythemia in the peripheral blood.

Topics: Amyloidosis; Bone Marrow; Colony-Stimulating Factors; Cytokines; Erythropoietin; Hematopoietic Cell Growth Factors; Humans; Interleukin-3; Interleukin-6; Male; Middle Aged; Platelet Count; Polycythemia; Reference Values

Topics: Adult; Amyloidosis; Anemia; Bone Marrow; Bone Marrow Diseases; Drug Resistance; Erythropoietin; Humans; Male; Recombinant Proteins

Topics: Aged; Amyloidosis; Anticoagulants; Chronic Kidney Disease-Mineral and Bone Disorder; Dialysis Solutions; Erythropoietin; Heart Failure; Humans; Hypotension; Kidney Diseases; Membranes, Artificial; Middle Aged; Renal Dialysis; Survival Rate