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Case Reports in Nephrology

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https://www.readbyqxmd.com/read/29732228/de-novo-atypical-haemolytic-uremic-syndrome-after-kidney-transplantation
#1
Arnaud Devresse, Martine de Meyer, Selda Aydin, Karin Dahan, Nada Kanaan
De novo thrombotic microangiopathy (TMA) can occur after kidney transplantation. An abnormality of the alternative pathway of complement must be suspected and searched for, even in presence of a secondary cause. We report the case of a 23-year-old female patient who was transplanted with a kidney from her mother for end-stage renal disease secondary to Hinman syndrome. Early after transplantation, she presented with 2 episodes of severe pyelonephritis, associated with acute kidney dysfunction and biological and histological features of TMA...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29682371/colonic-mucosal-ulceration-and-gastrointestinal-bleeding-associated-with-sevelamer-crystal-deposition-in-a-patient-with-end-stage-renal-disease
#2
Sudheer Nambiar, Unnikrishnan Kunjan Pillai, Joe Devasahayam, Tony Oliver, Asha Karippot
End stage renal disease (ESRD) population account for 1.9 per patient year of hospital admissions annually. ESRD population are at increased risk of bleeding secondary to use of anticoagulation during hemodialysis and uremia induced platelet dysfunction. Gastrointestinal bleeding accounts for 3-7% of all deaths in ESRD population. Lower gastrointestinal bleeding refers to blood loss from a site in the gastrointestinal tract distal to the ligament of Treitz. It is usually suspected when a patient complains of hematochezia...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29682370/fatal-pneumococcus-sepsis-after-treatment-of-late-antibody-mediated-kidney-graft-rejection
#3
Gunilla Einecke, Jan Hinrich Bräsen, Nils Hanke, Hermann Haller, Anke Schwarz
Antibody-mediated rejection (ABMR) is a major cause of late renal allograft dysfunction and graft loss. Risks and benefits of treatment of late ABMR have not been evaluated in randomized clinical trials. We report on a 35-year-old patient with deterioration in renal function and progressive proteinuria 15 years after transplantation. Recurrent infections after a splenectomy following traumatic splenic rupture 3 years earlier had led to reduction of immunosuppression. Renal transplant biopsy showed glomerular double contours, 40% fibrosis/tubular atrophy, peritubular capillaritis, and positive C4d staining indicating chronic-active ABMR...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29666729/posttransplant-lymphoproliferative-disorder-presenting-as-testicular-lymphoma-in-a-kidney-transplant-recipient-a-case-report-and-review-of-the-literature
#4
Steve Omoruyi Obanor, Michelle Gruttadauria, Kayla Applebaum, Mohammad Eskandari, Michelle Lieberman Lubetzky, Stuart Greenstein
Posttransplant lymphoproliferative disorder (PTLD) is a malignancy caused by the immunosuppression that occurs after transplantation. It is primarily a nodal lesion but frequently it involves extranodal masses. Treatment is usually by reducing immunosuppressive therapy. Testicular lymphoma as PTLD is notably rare in documented literature and there is limited evidence of definitive treatment guidelines. This manuscript describes a patient who developed diffuse large B-cell lymphoma of his right testis one year following kidney transplantation...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29666728/a-rare-benign-tumor-in-a-14-year-old-girl
#5
Meral Hassan Abualjadayel, Osama Y Safdar, Maysaa Adnan Banjari, Sherif El Desoky, Ghadeer A Mokhtar, Raed A Azhar
Background: Oncocytomas are the second most common benign renal neoplasm but, unfortunately, they are difficult to differentiate from renal cell carcinoma. Renal oncocytomas are rare and have mostly been reported in adults. To our knowledge, this is only the sixth pediatric reported case of renal oncocytoma worldwide. Case Presentation: A 14-year-old Yemeni girl with a recurrent history of urinary tract infections came to our clinic complaining of left flank pain with a frontal headache...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29610689/acquired-perforating-dermatosis-in-a-patient-on-peritoneal-dialysis-a-case-report-and-review-of-the-literature
#6
Talha H Imam, Hassan Patail, Nabeela Khan, Phillip T Hsu, David S Cassarino
Acquired perforating dermatosis (APD) is a debilitating and itchy skin disease. Its diagnosis is based on biopsy and the treatment is not very clear. It is not well established as to how wide spread it is in patients on peritoneal dialysis (PD) and its implications in this population have not been well studied. Here we present a case of APD that developed in a patient on PD. Its pathology and treatment options are reviewed. More studies are needed to assess the prevalence of APD in PD population.
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29552364/clinical-relapses-of-atypical-hus-on-eculizumab-clinical-gap-for-monitoring-and-individualised-therapy
#7
Chia Wei Teoh, Kathleen Mary Gorman, Bryan Lynch, Timothy H J Goodship, Niamh Marie Dolan, Mary Waldron, Michael Riordan, Atif Awan
Atypical hemolytic uremic syndrome (aHUS) is caused by dysregulation of the complement system. A humanised anti-C5 monoclonal antibody (eculizumab) is available for the treatment of aHUS. We present the first description of atypical HUS in a child with a coexistent diagnosis of a POL-III leukodystrophy. On standard eculizumab dosing regime, there was evidence of ongoing C5 cleavage and clinical relapses when immunologically challenged. Eculizumab is an effective therapy for aHUS, but the recommended doses may not be adequate for all patients, highlighting the need for ongoing efforts to develop a strategy for monitoring of treatment efficacy and potential individualisation of therapy...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29359055/bilateral-testicular-infarction-from-iga-vasculitis-of-the-spermatic-cords
#8
Mazen Toushan, Ashka Atodaria, Stephen D Lynch, Hassan D Kanaan, Limin Yu, Mitual B Amin, Mamon Tahhan, Ping L Zhang, Paul S Kellerman, Abhishek Swami
A 51-year-old man with type 2 diabetes mellitus and chronic obstructive pulmonary disease presented to the emergency room with increasing bilateral leg pain, rash, and scrotal swelling with pain. Skin biopsy from his thigh revealed IgA-associated vasculitis. Due to hematuria, a renal biopsy was performed and showed an IgA glomerulonephritis with focal fibrinoid necrosis and neutrophil accumulation. Bilateral orchiectomies were performed in two separate procedures ten and thirteen days after the renal biopsy, as a result of uncontrolled abscess formation in testicles...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29348949/cetuximab-associated-crescentic-diffuse-proliferative-glomerulonephritis
#9
Sukesh Manthri, Sindhura Bandaru, Anthony Chang, Tamer Hudali
Cetuximab-induced nephrotoxicity is very rare, occurring in less than 1% of colorectal cancer patients and not defined in other populations. We report a rare case of crescentic diffuse proliferative glomerulonephritis (GN) that developed in close temporal association with cetuximab treatment. A 65-year-old female recently completed chemotherapy with cetuximab treatment for moderately differentiated oral squamous cell carcinoma. She was admitted with acute renal failure and nephrotic-range proteinuria. Laboratory data showed serum creatinine of 6...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29333305/a-rare-case-of-transient-proximal-renal-tubular-acidosis-in-pregnancy
#10
Dennis Narcisse, Manyoo Agarwal, Aneel Kumar
Renal tubular acidosis (RTA) is a disorder that has improper function of renal acid-base regulation and is rarely encountered during pregnancy. Currently, there is no clear evidence on management and outcomes in patients with this condition. We report a case of a previously healthy 23-year-old female at 30 weeks of gestation who presented with proximal RTA and had spontaneous resolution of the condition shortly after delivery.
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29209544/a-case-of-proliferative-glomerulonephritis-with-monoclonal-igg-deposits-that-showed-predominantly-membranous-features
#11
Homare Shimohata, Kentaro Ohgi, Hiroshi Maruyama, Yasunori Miyamoto, Mamiko Takayashu, Kouichi Hirayama, Masaki Kobayashi
In 2004, the novel category of monoclonal IgG deposition disease has been proposed and termed "proliferative glomerulonephritis with monoclonal IgG deposits" (PGNMID). This disease is characterized by membranoproliferative glomerulonephritis and staining for a single light-chain isotype and gamma heavy-chain subclass. A 76-year-old male who had monoclonal gammopathy was referred to our hospital because of proteinuria. The renal biopsy showed diffuse thickening of the glomerular capillary walls with focal mesangial proliferation...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29181209/ureteropelvic-junction-obstruction-and-parathyroid-adenoma-coincidence-or-link
#12
Salah Termos, Majd AlKabbani, Tim Ulinski, Sami Sanjad, Henri Kotobi, Francois Chalard, Bilal Aoun
Congenital ureteropelvic junction obstruction (UPJO) is the most common cause of upper urinary tract obstruction in children. It is generally diagnosed in the routine work-up during antenatal period and is characterized by spontaneous recovery. It can be associated with urolithiasis; hence further investigation should be carried out. We report the case of a 15-year-old boy, who is known to have right UPJO, presented with right renal colic and discovered to have bilateral kidney stones. Further studies showed primary hyperparathyroidism and genetic analysis revealed a CDC73 mutation (initially HRPT2)...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29181208/large-retroperitoneal-haemorrhage-following-cyst-rupture-in-a-patient-with-autosomal-dominant-polycystic-kidney-disease
#13
Holly Mabillard, Shalabh Srivastava, Philip Haslam, Maciej Karasek, John A Sayer
The complications of autosomal dominant polycystic kidney disease (ADPKD) include cyst rupture and haemorrhage leading to loin pain and frank haematuria. Risk factors include large kidney volume, hypertension, and renal impairment. We present a case of a young male who, following trauma to the kidney, had a life threatening bleed from his polycystic kidney. The case was initially treated with fluid resuscitation and blood transfusion but necessitated radiological embolization of bleeding source to control the blood loss...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29158928/discontinuation-of-hemodialysis-in-a-patient-with-anti-gbm-disease-by-the-treatment-with-corticosteroids-and-plasmapheresis-despite-several-predictors-for-dialysis-dependence
#14
Yoshihide Fujigaki, Chikayuki Morimoto, Risa Iino, Kei Taniguchi, Yosuke Kawamorita, Shinichiro Asakawa, Daigo Toyoki, Shinako Miyano, Wataru Fujii, Tatsuru Ota, Shigeru Shibata, Shunya Uchida
A 26-year-old man highly suspected of having antiglomerular basement membrane (GBM) disease was treated with corticosteroid pulse therapy 9 days after initial infection-like symptoms with high procalcitonin value. The patient required hemodialysis the next day of the treatment due to oliguria. In addition to corticosteroid therapy, plasmapheresis was introduced and the patient could discontinue hemodialysis 43 days after the treatment. Kidney biopsy after initiation of hemodialysis confirmed anti-GBM disease with 86...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29119029/rhabdomyolysis-induced-by-coadministration-of-fusidic-acid-and-atorvastatin-a-case-report-and-comprehensive-review-of-the-literature
#15
Dimitrios Patoulias, Theodoros Michailidis, Thomas Papatolios, Rafael Papadopoulos, Petros Keryttopoulos
Statins are among the most widely prescribed medications worldwide. Acute rhabdomyolysis constitutes a potentially life-threatening side effect regardless of whether statins are administered alone or in combination. The potentially fatal combination of a statin and fusidic acid has been well described in the literature. Acute renal failure can be a direct consequence of this drug-drug interaction. We present a case of a 79-year-old woman who presented to our Emergency Department with a one-week history of limb weakness, myalgia, and inability to stand and walk...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29098097/early-renal-involvement-in-a-girl-with-classic-fabry-disease
#16
Fernando Perretta, Norberto Antongiovanni, Sebastián Jaurretche
Fabry disease is an X-linked lysosomal storage disorder resulting from the deficiency or absence of the enzyme alpha galactosidase A; this defect leads to the systemic accumulation of globotriaosylceramide and its metabolites. Organic involvement in men is well known, but in women it is controversial, mainly due to the random X-chromosome inactivation in each of their cells (Lyon hypothesis). This would explain why women (heterozygotes) present a wide variability in the severity of their phenotype. The manifestations are multisystemic and begin in early childhood, reaching a severe compromise in adulthood...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29075541/unusual-complication-of-multidrug-resistant-tuberculosis
#17
Prerna Sharma, Ravindra Nath Sahay
INTRODUCTION: Capreomycin is a second-line drug often used for multidrug-resistant tuberculosis which can result in nephrotoxic effects similar to other aminoglycosides. We describe a case of capreomycin induced Bartter-like syndrome with hypocalcemic tetany. CASE REPORT: 23-year-old female patient presented with carpopedal spasms and tingling sensations in hands. Patient was being treated with capreomycin for two months for tuberculosis. On further investigation, hypocalcemia, hyponatremia, hypomagnesemia, hypokalemia, and hypochloremic metabolic alkalosis were noted...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28959498/acute-hypocalcemia-and-metabolic-alkalosis-in-children-on-cation-exchange-resin-therapy
#18
Aadil Kakajiwala, Kevin T Barton, Elisha Rampolla, Christine Breen, Madhura Pradhan
BACKGROUND: Sodium polystyrene sulfonate (SPS) is a chelating agent used for the treatment of hyperkalemia. SPS has a wide range of exchange capacity requiring close monitoring of serum electrolytes. We observed two patients who developed acute hypocalcemia and increased metabolic alkalosis after initiating SPS therapy. We report these cases to draw attention to the potential risk of this medication in pediatric patients. CASE DIAGNOSIS/TREATMENT: Two children with chronic kidney disease on dialysis were started on SPS for hyperkalemia...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28884034/snakebite-induced-thrombotic-microangiopathy-leading-to-renal-cortical-necrosis
#19
Ying Mao Gn, Arvind Ponnusamy, Vikram Thimma
Renal complications from snakebite result in high mortality and morbidity. Acute kidney injury (AKI) occurs in 5-30% of cases. Renal manifestation could include acute tubular necrosis, cortical necrosis, interstitial nephritis, glomerulonephritis, and vasculitis. We present a case of thrombotic microangiopathy (TMA) resulting in renal cortical necrosis. Renal biopsy showed fibrin thrombi in glomeruli and arterioles with cortical necrosis. Our patient progressed to end-stage renal disease.
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28819575/therapeutic-approach-to-the-management-of-severe-asymptomatic-hyponatremia
#20
Thaofiq Ijaiya, Sandhya Manohar, Kameswari Lakshmi
Hyponatremia is an electrolyte imbalance encountered commonly in the hospital and ambulatory settings. It can be seen in isolation or present as a complication of other medical conditions. It is therefore a challenge to determine the appropriate therapeutic intervention. An understanding of the etiology is key in instituting the right treatment. Clinicians must not be too hasty to correct a random laboratory value without first understanding the physiologic principle. We present such a case of a patient who presented with sodium of 98 mmol/L, the lowest recorded in the current literature, and yet was asymptomatic...
2017: Case Reports in Nephrology
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