DANGER OF INTRAVENOUS MERCURIAL INJECTIONS IN NEPHROSIS

bismuth On compounds. medication with and urea thyroid DANGER OF INTRAVENOUS MERCURIAL the edema cleared patient's and he was considerably discharged, IN but he NEPHROSIS returned one month later INJECTIONS with anasarca generalized and pneumococcic peritonitis. He recovered from the perito¬ MARY CATHERINE M.D. TYSON, nitis after the administration of sulfapyridine and was then NEW YORK three given injections of 1 cc. each of esidrone6 intravenously at six intervals with diuresis. day He was good discharged have Mercurial diuretics been used for more freely but considerably improved instructions as to the limita¬ ignored Poll than a dozen and Stern have years. tion of fluids and salt and was readmitted emphasized one week later with the of extreme from overenthu- a massive accumulation of dangers dehydration edema fluid. At this time blood the siastic use of these and contained and Greenwald urea 16 hundred nitrogen mg. per cubic drugs, Jacobson centimeters, have 2 cases a case cholesterol 760 albumin 1.8 and Wolf third of sud- mg., cent and 1.9 presented per globulin per cent. The urine den an a a 4 reaction for death intravenous of mer- gave plus albumin, and an following injection of average 9 Gm. of albumin was excreted I cases curial diuretic. wish to 2 further and daily. present The was 1 the patient given cc. of esidrone with to out similarities in all 5 cases. intravenously point striking excellent diuresis. Five later the dose days was Greenwald case was of a repeated. and first that Jacobson's Less than a minute within the later, limits of his circulation child who 0.5 cc. 2 with was years aged nephrosis given time, the to patient began have about mouth twitchings the of mercurial diuretic fol- neptal (a 4) intramuscularly, and stertorous and went breathing into a convul¬ generalized lowed four later. One cc. by intramuscularly days sion. He became deeply The dilated cyanotic. pupils widely week later 1 cc. of caused neptal given intravenously and did not react to He light. was and there was comatose, cardiac standstill and death within dyspnea, cyanosis, incontinence of urine a and stool. Within minute after the one case was minute of Their second that injection. injection had ceased respirations and no cardiac sounds were of a child 3 with who received audible. Artificial aged nephrosis respiration was years and administered, large 0.5 cc. of followed 0.5 doses cc. of nikethamide neptal intravenously by given epinephrine, and were aminophylline into the six later. Three later injected external vein. After jugular several minutes intravenously days days injec¬ of a respiration and the heart tion 0.5 cc. caused began again, sounds became audible. convulsion, intravenously dysp¬ For several hours the two and patient alternated between of and coma within minutes death periods nea, cyanosis coma and with several of mania, episodes in than five minutes after projectile vomiting. less injection. Consciousness returned six hours later, but retrograde amnesia was a 4 with Wolf's child years nephrosis patient aged for the three hours the preceding injection was The present. in who was gradually given salyrgan intravenously patient, nine months is in later, a mild status. No nephrotic to 1 about week increasing doses, up cc, apart. mercurial injections have been to him since. given a after the fifth the child Within minute injection dead. cried and fell Molnár a death minutes coughed, after an reported twenty of but intraperitoneal the injection merctipurin, patient REPORT OF CASES was almost moribund with severe aortic insuf¬ syphilitic 3 was admitted for the Case 1.—R. a aged years, B.,5 boy which of itself causes a sudden ficiency, frequently in first time in 1938 with a of recurrent facial edema history death. In the entire there have been literature, then, in the for one the and edema evening year. morning dependent or 5 cases of fatal almost fatal reactions intra¬ to only He had had severe albuminuria this persistent, during period. venous of mercurial and diuretics, all these injections He the clinical of A remis¬ presented typical picture nephrosis. 5 have been associated with sion with the administration of occurred coincidentally thyroid, nephrosis. and was Chastain Mackie were and the was almost edema free. He able to kill patient discharged a recently readmitted one later with severe anasarca. normal approximately year few with intravenous of mer¬ dogs injections At this time the level of urea in the blood was 14 nitrogen mg. curial diuretics, but when seven times the maxi¬ only hundred cubic centimeters and the level of cholesterol per mum was The human dose therapeutic given. major and there was with a reversal of 1,550 mg., hypoproteinemia was the in effect on T ventricle, the causing changes the albumin 1.3 and the being per cent, albumin-globulin ratio, waves and the and then ventricular QRS complex the the 2.7 cent. The urine "boiled and globulin per solid," with death about three to five minutes after fibrillation, excreted an of 8 Gm. of albumin a Because patient average day. and the Chastain Mackie also, one of failure of the usual he was 0.5 cc. of injection. the diuretics, given following of Greenwald and on 5. to This did not Jacobson's mercupurin intravenously August drug hypotheses, attempted cc. in normal diuresis. On 6 1 of mer¬ fatal reactions cause appreciable August by any produce dogs sensitizing vein. As soon as the needle was with¬ them was with intramuscular doses and then a cupurin given by large giving had convulsion with an drawn the a generalized outcry. patient intravenous dose. No could reaction be obtained. This heart beat could not be and respirations became The heard, that was because it was the attempted conjectured the administration of slow and stertorous. Despite epinephrine from the intramuscular to the intravenous route change one and the died about intravenously intracardially, patient cause have been the of sensitization and shock may Partial revealed consider¬ minute after the injection. necropsy in human reported beings. of chronic able of the kidneys and typical changes congestion Mercurial diuretics are to cardiac in given nephrosis. patients lipoid failure in the vast of with instances, no a first entered the majority Case 2.—A. man 27, hospital S., aged sudden fatal there have which he stated reported reactions, in 1939 with a nephrotic syndrome, although typical been in which there for four months and which had been cases have been as he had had preceded by reported may as intensive both with arsenicals and with five hundred such Since the antisyphilitic therapy many injections. only such five reactions in occurred with reported patients of Dr. From the Medical Service B. S. of Mount Sinai Oppenheimer, the I believe that the use oí Hospital. syndrome, nephrotic E.: Effects of with 1. Poll, Daniel, and Stern, Untoward Diuresis J. mercurial diuretics is contraindicated in nephrosis. to Mercurial Arch. Int. Med. 58: 1087\x=req-\ Reference Diuretics, Special 1094 (Dec.) and mercuri 2. H. Jacobson, Seymour: Sudden Death Due to 6. Pyridine dicarboxy \g=b\ Greenwald, M., hydroxypropylamide-theophylline Pediat. 11:540-546 1937. (Ciba). Mercurial Diuretics, J. (Oct.) I. and H. Death with Tod noch 3. Wolf, J., Bongiorno, O.: Sudden 7. Moln\l=a'\r Pl\l=o"\tzlicher einer Salyrgan, Stephan: intraperitonealen Canad. M. A. 25:73-75 1931. Klin. Wchnschr. 14:239-240 1935. J. (July) Novurit-Injektion, (Feb. 16) amido acetic acid 4. Hydroxy mercury propanol carboxy phenoxy 8. L. and G. C.: Studies on of New Chastain, L., Mackie, Toxicity (Wallan). Mercurial Salt Diuretic (Sodium of Pyridine-Dicarboxy-Mercuri-Hydroxy\x=req-\ service of Dr. & 102:5-8 1940. 5. From the B\l=e'\a Schick. South. Med. (Jan.) pediatric Propyl Amide-Theophylline, Surg. With to the cause of these who tested 28 cases of reactions, ston,3 for regard "speed "gingivostomatitis" shock" does come into since the the virus not consideration, of and were able to recover herpes simplex 1 in shock dose was never more than cc. and some it from in cases the mouths 27. The of this virus, finding 0.5 cc. in The was made while only injection every did not solve the slowly highly suggestive, problem instance. can Wolf and with One with because the virus of has been recovered only speculate, herpes simplex Greenwald and that the reaction was from the saliva of Jacobson, prob¬ normal people.4 an one. believe that it is connected I mere a ably As Rivers has the of virus anaphylactic stated, finding in some to the altered blood a way proteins. Anaphylaxis in certain disease does of not constitute its proof is further that no the fact such reactions causal suggested by to that disease. evidence relationship Strong occurred in case with initial doses but after any a only that virus causes a disease in a and actually patient at least two which have been the doses, previous may is not a coincidental to demonstrate is the just finding the shock doses dose. sensitizing preceding as a of immune bodies the virus development against 1155 Park Avenue. In result of that disease. 1939 Burnet and Williams confirmed the uniform of virus presence simplex herpes in the mouths of their and observed the patients develop¬ ACUTE INFECTIOUS GINGIVO- of in ment antibodies the virus their blood. against that STOMATITIS concluded stomatitis was a common mani¬ They festation of infection with virus. primary herpes EPIDEMIOLOGY AND ETIOLOGY, CLINICAL PICTURE We studied number of cases of stomatitis in the A THE OF COMMON DISORDER CAUSED BY wards and the Children's of the outpatient department VIRUS OF HERPES SIMPLEX the fall and winter of 1940-1941. Hospital during early seemed T. F. McNAIR M.D. It to search for the virus SCOTT, (Cantab.), and profitable (a) the of its and thus establish an appearance F.R.C.P. (London) antibody AND for this to determine the clinical condition; etiology (b) of stomatitis thus and ALEX M.D. picture proved primary herpetic J. STEIGMAN, names eliminate a series of for the descriptive disease, With the of Technical Assistance and of to the virus in the (c) investigate spread herpes H. CONVEY JOHN families of our as an an under¬ to patients approach PHILADELPHIA of the of infection. standing epidemiology herpes Inflammation is of the mouth a common relatively PLAN OF STUDY clinical condition children, of the among particularly Clinical Material Selected.—Thanks the to coopera¬ class. In a cases number of the stomatitis outpatient tion of the resident we were see able to almost staff, is due to some known condition as such trauma, all cases of stomatitis at the Children's and Hospital metallic certain avitaminosis, thrush, uncom- poisons, few at the of University Pennsylvania Hospital. bacterial mon infections (Corynebacterium diphtheriae These cases were studied for the of presence herpes or Neisseria and that which gonorrheae) accompanies virus in the saliva for and the of simplex development the exanthems. there a However, remains in clinically antibodies the blood. common about the cause of which there has been group Method the Virus.—Swabs taken either of Isolating considerable doubt. from the oral lesions in or from the directly younger as to the of this condition has Uncertainty etiology saliva in older were rubbed patients fairly vigorously led a over to of in all variety names, synonyms thirty over the scarified cornea of a rabbit. Both were eyes to it. Some of e. these are being applied as a In descriptive, g. used routine. the absence of virus this pro¬ membranous or catarrhal, ulcerative, while a the aphthous, cedure causes mild irritation of which eye usually some are based on the e. "Vincent's" or clears in two to three When virus is etiology, g. the days. present, rabbit suffers a characteristic infection. From "fusospirochetal." Although fusospirochetal organisms twenty- four hours are encountered in this authors to as as seven after inoculation frequently disease, many up long days have their causal minute visible with occur These vesicles, only magnification, questioned relationship. lines of the scarification as a are not recoverable from all cases result the cornea along ; organisms presenting looks In there a severe a addition is similar clinical while on the other hand generalized appearance, hazy. also the are recoverable the of conjunctivitis membrane; from from 36 to 94 involving nictitating they gums which is normal cent of children.1 Werner and purulent discharge, bacteriologically sterile, per Lichtenberg, cases. in Most rabbits recover many from Lueck were unable develops to lesions in produce guinea pigs their for ocular infection a corneal scar of except with these it has been that varying organisms, although reported A few an to twelve severity. develop encephalitis recovered traumatic eight could be from ulcers they simple after corneal characterized inoculation, days by hyper- of animals. in the experimental Black,1 reviewing of the head one tremors, to pyrexia, pulling side, of that the problems etiology, suggested fusospirochetal of the limbs and convulsions. strains Certain paralysis were the invaders, organisms probably secondary caused an while others did not. consistently encephalitis infectious unknown but agent primary being possibly The virus was in the ocular exúdate of infected present a virus. of this idea to come Confirmation appeared as seven rabbits for as long days following inoculation, from the observations of Dodd, and Buddingh John- as could be demonstrated of the exúdate by passage onto the scarified 9. H. and of cornea of another normal rabbit. Hyman, Samuel: Studies and T., Hirschfeld, Velocity Intravenous to Injections, J. A. M. A. 96: 1221-1223 Response (April 11) Dodd, Katharine; and Buddingh, John, Johnston, Leland: Herpetic From of the Department Am. Pediatrics, University of School Stomatitis, Child. 58:907 Pennsylvania J. Dis. (Oct.) 1939. of and the of Medicine, Children's Hospital 4. A. Philadelphia. Van C. and J.: Virus Rooyen, E., Rhodes, Diseases in Man, W. Infectious 1. Black, C.: Acute ("Vincent's London, Oxford University Press, 1940. Gingivostomatitis Am. Stomatitis"), Dis. Child. 56:126-158 1938. T. M.: J. (July) 5. Rivers, Viruses and Koch's Postulates, J. Bact. 33:1-12 2. Lichtenberg, H. and Esther V.: Patho- 1937. H.; Werner, (Jan.) Marie, Lueck, of Bacillus and of Fusiform Spirillum A. M. A. 6. F. and W.: genicity Plaut-Vincent, J. Burnet, M., S. Williams, Herpes Simplex: New 100:707-711 1933. (March 11) 1:637-642 Point of View, M. J. Australia 1939. (April 29)

Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

DANGER OF INTRAVENOUS MERCURIAL INJECTIONS IN NEPHROSIS

DANGER OF INTRAVENOUS MERCURIAL INJECTIONS IN NEPHROSIS

Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

DANGER OF INTRAVENOUS MERCURIAL INJECTIONS IN NEPHROSIS

DANGER OF INTRAVENOUS MERCURIAL INJECTIONS IN NEPHROSIS

References (3)

Abstract

Journal

Recommended Articles

There are no references for this article.

Our policy towards the use of cookies