Malignant Hypertension and Red Cell Fragmentation Syndrome
Report of a Case
- JOHN P. CAPELLI, M.D.;
- LAURENCE G. WESSON, JR., M.D., F.A.C.P.; and
- ALLAN V. ERSLEV, M.D., F.A.C.P.
- Requests for reprints should be addressed to John P. Capelli, M.D., Department of Medicine, Jefferson Medical College Hospital, 1025 Walnut St., Philadelphia, Pa. 19107.
Excerpt
The almost invariable association of anemia with the uremic state has long been recognized (1-3), and although it is generally agreed that the major cause of anemia in chronic renal insufficiency is depression of erythropoiesis (4, 5), the mechanism remains unknown. It has been suggested that the uremia per se inhibits erythropoiesis (6, 7), but the failure of the kidney to supply an erythropoietic hormone has been considered of greater importance. The concentration of this hormone in the serum of patients with uremia and anemia is considerably less than in other states of anemia, and although it does not appear
This 100-word excerpt has been provided in the absence of an abstract.
Summario in Interlingua
Un syndrome de fragmentation erythrocytic ha previemente essite describite in varie statos morbide incluse hypertension maligne, e etiam in association con defective prostheses intracardiac. Le disruption mechanic del erythrocyto per un morbide endothelio o per un prosthese intracardiac ha essite proponite como explication del disrangiamento hematologic. Es describite un caso mortal de hypertension maligne con rapidemente progressive insufficientia renal e un syndrome de fragmentation erythrocytic in un femina negre de 48 annos de etate. Le patiente se habeva trovate in apparentemente bon stato de sanitate usque brevemente ante su hospitalisation. Immediatemente postea, illa disveloppava un anuria complete que persisteva usque a su morte. A omne phase de su curso clinic, le patiente monstrava in frottis de sanguine peripheric grande numeros de cellulas fragmentate. Thrombocytopenia, anemia sever, e reticulocytosis esseva characteristicas prominente. Series de biopsias renal monstrava progressive lesiones vascular de nephrosclerosis maligne. Tamen, le lesiones vascular pareva esser minus significative quandocunque le fragmentation erythrocytic e le thrombocytopenia esseva sever. Per consequente, explicar le fragmentation erythrocytic a base purmente mechanic es inadequate.
Article and Author Information
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From the Department of Medicine and the Cardeza Foundation, Jefferson Medical College Hospital, Philadelphia, Pa.
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- Received July 8, 1965.
- Accepted September 16, 1965.
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