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September 1981

Rapidly Progressing Arterio-occlusive Syndrome in a Patient Receiving Long-term Hemodialysis: Kohlmeier-Degos Disease?

Author Affiliations

From the Division of Nephrology, the Department of Internal Medicine (Drs Barcelli, First, and Pollak); and the Department of Pathology (Dr Crissman), the University of Cincinnati Medical Center.

Arch Intern Med. 1981;141(10):1331-1335. doi:10.1001/archinte.1981.00340100087019

Victor E. Pollak, MD: An unusual clinical syndrome developed in a patient while he was being treated for chronic renal failure by maintenance hemodialysis. The syndrome was characterized by clinical, angiographic, and pathologic findings of a rapidly progressing occlusive vasculopathy. The history will be presented by Dr Barcelli.

Uno Barcelli, MD: The patient was a 43-year-old man who was admitted to the University of Cincinnati Medical Center on June 6, 1978, with papilledema, uremia, and congestive heart failure. The initial blood pressure (BP) readings averaged 244/170 mm Hg. Although he was known to have hypertension for at least six years, the patient had not complied with recommended treatments. The medical history was otherwise unremarkable. Hypertension was controlled by intravenous sodium nitroprusside and oral antihypertensive agents, and uremia was treated initially by peritoneal dialysis. A renal arteriogram demonstrated normal-sized kidneys with smooth outlines and no vascular obstruction. All other visualized branches

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