Document Detail


Total knee arthroplasty and Crigler-Najjar syndrome: a case report.
MedLine Citation:
PMID:  19751978     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Crigler-Najjar (CN) syndrome is a rare genetic disease characterized by hyperbilirubinemia due to a deficiency in the hepatic enzyme UDP-glucuronosyl-transferase. We describe the first case of total knee arthroplasty in a patient with CN syndrome (type II). This procedure was complicated by kernicterus 1 week after hospital discharge. He also developed Klebsiella bacteremia and sepsis, requiring a brief ICU stay. He was discharged in good condition 2 months later. It is evident that physicians involved in the care of patients with CN syndrome in the peri-operative period need to have a high index of suspicion for the development of severe hyperbilirubinemia and kernicterus in order to appropriately manage and, possibly, prevent this complication. A literature review and intra-operative observations provide insight into the possible relationship between hyperbilirubinemia and osteoarthritis as well as the peri-operative considerations to be made for this group of patients.
Authors:
David Walmsley; Khalid Alzaharani; William J Coke; Rajiv Gandhi
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-09-13
Journal Detail:
Title:  The Knee     Volume:  17     ISSN:  1873-5800     ISO Abbreviation:  Knee     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-04-23     Completed Date:  2010-08-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9430798     Medline TA:  Knee     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  252-4     Citation Subset:  IM    
Affiliation:
Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto Western Hospital, Toronto, ON, Canada.
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MeSH Terms
Descriptor/Qualifier:
Arthroplasty, Replacement, Knee / adverse effects*
Crigler-Najjar Syndrome / complications*
Humans
Kernicterus / etiology*,  therapy
Klebsiella Infections / etiology*
Male
Middle Aged
Osteoarthritis / etiology,  surgery*
Osteophyte / etiology,  surgery
Plasma Exchange
Recovery of Function
Shock, Septic / complications,  etiology*,  microbiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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