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Asymmetric breast enlargement minus central venous thrombosis in a hemodialysis patient

Identifieur interne : 003827 ( Istex/Corpus ); précédent : 003826; suivant : 003828

Asymmetric breast enlargement minus central venous thrombosis in a hemodialysis patient

Auteurs : Jacques J. Youssef ; Clinton D. Brown ; Eli A. Friedman

Source :

RBID : ISTEX:77E01CFD54D978FACA9816E9C17D57908BE7FCD5

Abstract

A 76‐year‐old woman hemodialysis patient was hospitalized for community‐acquired pneumonia complicating chronic obstructive pulmonary disease. End‐stage renal disease secondary to hypertension had been diagnosed at the age of 64 for which the patient was initiated on maintenance hemodialysis. Then, she received a deceased donor kidney transplant at the age of 68 that succumbed to chronic rejection 4 years later when she was restarted on hemodialysis. Hemodialysis was performed via a right subclavian vein double lumen catheter for 2 months when a right brachio‐axillary graft was inserted. Severe venous congestion, swelling, and nipple tenderness of her right breast noted on admission had been increasing for 6 weeks before hospital admission. No arm swelling was evident. Initial management of the patient's pneumonia and chronic obstructive pulmonary disease consisted of intravenous ceftriaxone and albuterol inhaler to which intravenous oxacillin (1 g q 6 hr) was added for presumed right mastitis. Radiological work‐up for masses and malignancies was negative. An angiogram of the right upper extremity detected stenosis of the dialysis access graft at its anastomosis with the axillary vein. Angioplasty of the stenosis was performed without incident or evidence of central vein stenosis. Rapid resolution over 10 days of the unilateral breast congestion followed without complication.

Url:
DOI: 10.1111/j.1542-4758.2008.00236.x

Links to Exploration step

ISTEX:77E01CFD54D978FACA9816E9C17D57908BE7FCD5

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<p>A 76‐year‐old woman hemodialysis patient was hospitalized for community‐acquired pneumonia complicating chronic obstructive pulmonary disease. End‐stage renal disease secondary to hypertension had been diagnosed at the age of 64 for which the patient was initiated on maintenance hemodialysis. Then, she received a deceased donor kidney transplant at the age of 68 that succumbed to chronic rejection 4 years later when she was restarted on hemodialysis. Hemodialysis was performed via a right subclavian vein double lumen catheter for 2 months when a right brachio‐axillary graft was inserted. Severe venous congestion, swelling, and nipple tenderness of her right breast noted on admission had been increasing for 6 weeks before hospital admission. No arm swelling was evident. Initial management of the patient's pneumonia and chronic obstructive pulmonary disease consisted of intravenous ceftriaxone and albuterol inhaler to which intravenous oxacillin (1 g q 6 hr) was added for presumed right mastitis. Radiological work‐up for masses and malignancies was negative. An angiogram of the right upper extremity detected stenosis of the dialysis access graft at its anastomosis with the axillary vein. Angioplasty of the stenosis was performed without incident or evidence of central vein stenosis. Rapid resolution over 10 days of the unilateral breast congestion followed without complication.</p>
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<title>Asymmetric breast enlargement minus central venous thrombosis in a hemodialysis patient</title>
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<title>Unilateral breast congestion in a dialysis woman</title>
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<titleInfo type="alternative" contentType="CDATA" lang="en">
<title>Asymmetric breast enlargement minus central venous thrombosis in a hemodialysis patient</title>
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<name type="personal">
<namePart type="given">Jacques J.</namePart>
<namePart type="family">YOUSSEF</namePart>
<affiliation>Department of Medicine, Renal Disease Division, SUNY‐Downstate Medical Center, Brooklyn, New York, U.S.A.</affiliation>
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<name type="personal">
<namePart type="given">Clinton D.</namePart>
<namePart type="family">BROWN</namePart>
<affiliation>Department of Medicine, Renal Disease Division, SUNY‐Downstate Medical Center, Brooklyn, New York, U.S.A.</affiliation>
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<name type="personal">
<namePart type="given">Eli A.</namePart>
<namePart type="family">FRIEDMAN</namePart>
<affiliation>Department of Medicine, Renal Disease Division, SUNY‐Downstate Medical Center, Brooklyn, New York, U.S.A.</affiliation>
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<dateIssued encoding="w3cdtf">2008-01</dateIssued>
<edition>Manuscript received June 2007; revised September 2007.</edition>
<copyrightDate encoding="w3cdtf">2008</copyrightDate>
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<abstract lang="en">A 76‐year‐old woman hemodialysis patient was hospitalized for community‐acquired pneumonia complicating chronic obstructive pulmonary disease. End‐stage renal disease secondary to hypertension had been diagnosed at the age of 64 for which the patient was initiated on maintenance hemodialysis. Then, she received a deceased donor kidney transplant at the age of 68 that succumbed to chronic rejection 4 years later when she was restarted on hemodialysis. Hemodialysis was performed via a right subclavian vein double lumen catheter for 2 months when a right brachio‐axillary graft was inserted. Severe venous congestion, swelling, and nipple tenderness of her right breast noted on admission had been increasing for 6 weeks before hospital admission. No arm swelling was evident. Initial management of the patient's pneumonia and chronic obstructive pulmonary disease consisted of intravenous ceftriaxone and albuterol inhaler to which intravenous oxacillin (1 g q 6 hr) was added for presumed right mastitis. Radiological work‐up for masses and malignancies was negative. An angiogram of the right upper extremity detected stenosis of the dialysis access graft at its anastomosis with the axillary vein. Angioplasty of the stenosis was performed without incident or evidence of central vein stenosis. Rapid resolution over 10 days of the unilateral breast congestion followed without complication.</abstract>
<subject lang="en">
<genre>keywords</genre>
<topic>Unilateral breast engorgement</topic>
<topic>arteriovenous access</topic>
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<titleInfo>
<title>Hemodialysis International</title>
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<genre type="journal">journal</genre>
<identifier type="ISSN">1492-7535</identifier>
<identifier type="eISSN">1542-4758</identifier>
<identifier type="DOI">10.1111/(ISSN)1542-4758</identifier>
<identifier type="PublisherID">HDI</identifier>
<part>
<date>2008</date>
<detail type="volume">
<caption>vol.</caption>
<number>12</number>
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<detail type="issue">
<caption>no.</caption>
<number>1</number>
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<start>30</start>
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