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Case Reports in Nephrology

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https://www.readbyqxmd.com/read/30425869/scleroderma-renal-crisis-debute-with-thrombotic-microangiopathy-a-successful-case-treated-with-eculizumab
#1
Maite Hurtado Uriarte, Carolina Larrarte, Laura Bravo Rey
We had the challenged to treat a 40-year-old female with Systemic Scleroderma who was showing unspecific symptoms. During her time at the hospital she rapidly develops renal dysfunction, associated with hypertension. She required renal replacement therapy initiation and we observed a decline in hemoglobin and platelets numbers. We confirm a microangiopathic hemolytic anemia and rule out other immune diseases or thrombotic thrombocytopenic purpura. Systemic Sclerosis is a chronic immune disorder of unknown origin that it is not completely understood...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/30410805/renal-tubular-acidosis-and-hypokalemic-paralysis-as-a-first-presentation-of-primary-sj%C3%A3-gren-s-syndrome
#2
Arun Sedhain, Kiran Acharya, Alok Sharma, Amir Khan, Shital Adhikari
Sjögren's syndrome is an autoimmune disease with multisystem involvement and varying clinical presentation. We report the clinical course and outcome of a case who presented with repeated episodes of hypokalemia mimicking hypokalemic periodic paralysis and metabolic acidosis, which was later diagnosed as distal renal tubular acidosis secondary to primary Sjögren's syndrome. A 50-year-old lady, who was previously diagnosed as hypokalemic periodic paralysis, presented with generalized weakness and fatigue. She was found to have severe hypokalemia with normal anion-gap metabolic acidosis consistent with distal renal tubular acidosis...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/30402307/cloudy-dialysate-as-the-initial-presentation-for-lymphoma
#3
Sriram Sriperumbuduri, Deborah Zimmerman
Turbid dialysate in a patient on peritoneal dialysis is usually due to peritonitis and almost all these patients are started on empirical antibiotics pending cultures. However, in few of them with culture negative fluid, this could represent other etiologies like chyle, which requires more intensive investigations, and analysis of fluid itself reveals some rare diagnosis. We present one such report of chylous ascites with prompt investigation leading to a diagnosis of malignancy in a peritoneal dialysis patient...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/30364076/a-case-of-hepatic-glomerulosclerosis-with-monoclonal-iga1-%C3%AE%C2%BA-deposits
#4
Yusuke Okabayashi, Nobuo Tsuboi, Naoko Nakaosa, Kotaro Haruhara, Go Kanzaki, Kentaro Koike, Akihiro Shimizu, Akira Fukui, Hideo Okonogi, Yoichi Miyazaki, Tetsuya Kawamura, Makoto Ogura, Akira Shimizu, Takashi Yokoo
Glomerular immunoglobulin A (IgA) deposition is a common finding in hepatic glomerulosclerosis; thus, this disease is also called hepatic IgA nephropathy. However, only a small number of patients with hepatic IgA nephropathy have active glomerular lesions, so functional decline is slow in most cases. In this report, we describe a 60-year-old man who developed nephrotic syndrome and progressive renal impairment during follow-up for alcoholic liver cirrhosis. A renal biopsy showed a membranoproliferative glomerulonephritis-like pattern; diffuse double-contours of the glomerular basement membrane and focal active glomerular lesions with moderate-to-severe endocapillary proliferation and fibrocellular crescents...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/30254775/severe-symptomatic-hyponatremia-secondary-to-escitalopram-induced-siadh-a-case-report-with-literature-review
#5
Rishi Raj, Aasems Jacob, Ajay Venkatanarayan, Mohankumar Doraiswamy, Manjula Ashok
Hyponatremia is a well-known medication related side effect of selective serotonin reuptake inhibitors; despite its association with escitalopram, the newest SSRI is very rare. We did a review of literature and came across only 14 reported case of this rare association of SIADH with escitalopram. We hereby report a case of a 93-year-old female who presented with generalized tonic-clonic seizure and was diagnosed with severe hyponatremia due to escitalopram-induced syndrome of inappropriate antidiuretic hormone secretion (SIADH)...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/30210883/-bartonella-endocarditis-mimicking-crescentic-glomerulonephritis-with-pr3-anca-positivity
#6
Joseph Vercellone, Lisa Cohen, Saima Mansuri, Ping L Zhang, Paul S Kellerman
Bartonella henselae is a fastidious organism that causes cat scratch disease, commonly associated with fever and lymphadenopathy but, in rare instances, also results in culture-negative infectious endocarditis. We describe a patient who presented with flank pain, splenic infarct, and acute kidney injury with an active urinary sediment, initially suspicious for vasculitis, which was subsequently diagnosed as B. henselae endocarditis. Bartonella endocarditis may present with a crescentic glomerulonephritis (GN) and elevated PR3-ANCA antibody titers, mimicking ANCA-associated GN, with 54 cases reported in the literature...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/30155326/mucin-1-gene-mutation-and-the-kidney-the-link-between-autosomal-dominant-tubulointerstitial-kidney-disease-and-focal-and-segmental-glomerulosclerosis
#7
H Trimarchi, M Paulero, T Rengel, I González-Hoyos, M Forrester, F Lombi, V Pomeranz, R Iriarte, A Iotti
Glomerular diseases are one of the most frequent causes of chronic kidney disease, focal and segmental glomerulosclerosis being one of the commonest glomerulopathies. However, the etiology of this glomerular entity, which merely depicts a morphologic pattern of disease, is often not established and, in most of the patients, remains unknown. Nephrologists tend to assume focal and segmental glomerulosclerosis as a definitive diagnosis. However, despite the increasing knowledge developed in the field, genetic causes of glomerular diseases are currently identified in fewer than 10% of chronic kidney disease subjects...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/30155325/-achromobacter-xylosoxidans-relapsing-peritonitis-and-streptococcus-suis-peritonitis-in-peritoneal-dialysis-patients-a-report-of-two-cases
#8
Rafał Donderski, Magdalena Grajewska, Agnieszka Mikucka, Beata Sulikowska, Eugenia Gospodarek-Komkowska, Jacek Manitius
Peritonitis is considered to be the most common complication of peritoneal dialysis (PD). It is usually caused by Gram positive Staphylococcus epidermidis. Achromobacter xylosoxidans (A. xylosoxidans) and Streptococcus suis (S. suis) are rare pathogens, but there is emerging evidence that they may be also responsible for PD related peritonitis. We described 2 cases of rare peritonitis treated in our center. In our opinion this is the first described case of PD related peritonitis caused by Streptococcus suis...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/30140476/is-it-coincidence-or-consequence-for-a-case-with-antiphospholipid-antibody-syndrome-overlapping-sle-to-develop-an-immune-complex-nephropathy-followed-by-a-nonimmune-complex-podocytopathy
#9
Jinil Yoo, Hugo Villanueva, Manimaran Kaliamurthy, John Kang, Lin Lwin
Antiphospholipid antibody syndrome (APS) may occur in a primary form or in association with SLE and seldom presents with nephrotic syndrome (NS). We present a case with APS who developed recurrent NS 6 years apart. The first episode of NS occurred with biopsy findings consistent with lupus nephritis (LN) class V (membranous) with no clear evidence of SLE, and responded to a remission with steroids and MMF. On the 2nd episode, the biopsy revealed negative immunofluorescent (IF) study for immune complexes and EM findings of complete effacement of foot processes and acellular debris in thickened capillary walls, compatible with healed previous episode of membranous LN and minimal change disease (MCD), a nonimmune complex podocytopathy...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/30057836/acute-renal-failure-due-to-a-tobramycin-and-vancomycin-spacer-in-revision-two-staged-knee-arthroplasty
#10
Ronak A Patel, Hayden P Baker, Sara B Smith
Two-stage revision total knee arthroplasty (TKA) is the standard of care for prosthetic joint infections. The first stage involves removal of the infected prosthesis and placement of an antibiotic impregnated cement spacer; following a period ranging from 4 weeks to 6 months, the spacer is then removed and replaced with a permanent prosthesis. The advantage to this approach is that antibiotic impregnated spacers provide supratherapeutic levels in the joint without toxic accumulation in serum. However, it remains important for physicians and pharmacists to be aware of antibiotic associated complications in knee revisions...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29977633/inhaling-difluoroethane-computer-cleaner-resulting-in-acute-kidney-injury-and-chronic-kidney-disease
#11
Kristen Calhoun, Laura Wattenbarger, Ethan Burns, Courtney Hatcher, Amol Patel, Manjulatha Badam, Abdul-Jabbar Khan
Difluoroethane is the active ingredient in various computer cleaners and is increasingly abused by teenagers due to its ease of access, quick onset of euphoric effects, and lack of detectability on current urine drug screens. The substance has detrimental effects on various organ systems; however, its effects on the kidneys remain largely unreported. The following case report adds new information to the developing topic of acute kidney injury in patients abusing difluoroethane inhalants. In addition, it is one of the first to show a possible relationship between prolonged difluoroethane abuse and the development of chronic kidney disease in the absence of other predisposing risk factors...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29862101/-histoplasma-peritonitis-an-extremely-rare-complication-of-peritoneal-dialysis
#12
Asjad Sardar, Bijin Thajudeen, Pradeep V Kadambi
Bacterial peritonitis is a common complication of peritoneal dialysis, but fungal peritonitis is unusual and is mostly due to Candida species. Peritonitis due to Histoplasma capsulatum is rare and we report one such case. A 63-year-old female presented with progressively worsening abdominal pain, fever, and altered mental status. She had end-stage renal disease and had been on peritoneal dialysis for 4 years. She had abdominal tenderness without rebound or guarding. Laboratory studies and CT of abdomen were significant for leukocytosis and peritoneal membrane thickening, respectively...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29862100/primary-hepatic-burkitt-lymphoma-in-a-kidney-transplant-recipient
#13
Sophia Lionaki, Eystratios Tsakonas, Athina Androulaki, George Liapis, Panagiotis Panayiotidis, George Zavos, John N Boletis
This is a case of a renal transplant recipient who developed a primary hepatic Burkitt lymphoma a few years after kidney transplantation. The past medical history of the patient was significant for anti-HCV positivity with liver histopathology showing minimal changes of grades 0 and 1, stage 0. She received a graft from a deceased donor, with rabbit antithymocyte globulin and methyl-prednisolone, as induction therapy, and was maintained on azathioprine, cyclosporine, and low dose methyl-prednisolone with normal renal function...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29862099/atypical-haemolytic-uraemic-syndrome-associated-with-clostridium-difficile-infection-successfully-treated-with-eculizumab
#14
Joshua M Inglis, Jeffrey A Barbara, Rajiv Juneja, Caroline Milton, George Passaris, Jordan Y Z Li
Clostridium difficile infection is a rare precipitant of atypical haemolytic uraemic syndrome (aHUS). A 46-year-old man presented with watery diarrhoea following an ileocaecal resection. He developed an acute kidney injury with anaemia, thrombocytopaenia, raised lactate dehydrogenase, low haptoglobin, and red cell fragments. Stool sample was positive for C. difficile toxin B. He became dialysis-dependent as his renal function continued to worsen despite treatment with empiric antibiotics and plasma exchange...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29854504/new-thrombolytic-infusion-application-of-dissolving-renal-artery-embolic-thrombosis-low-dose-slow-infusion-thrombolytic-therapy
#15
Ahmet Karakurt
Renal artery thromboembolism (RATE) is an uncommon complication of renal arteries from heart chamber. Although there is no treatment protocol prescribed with guidelines, thrombolytic agents such as rt-PA are frequently used. Unfortunately, current thrombolytic agent application protocol in treatment for the RATE is used in acute myocardial infarction or acute pulmonary embolism. In this protocol, 0.9-1.0% cerebral and 4-13% noncerebral hemorrhages are seen. In contrast to this protocol, we aimed to present a case of RATE, in which we applied low-dose, slow-infusion thrombolytic therapy, and we have not observed any complication such as cerebral and noncerebral hemorrhage...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29850312/rifampicin-in-nontuberculous-mycobacterial-infections-acute-kidney-injury-with-hemoglobin-casts
#16
Rishi Kora, Sergey V Brodsky, Tibor Nadasdy, Dean Agra, Anjali A Satoskar
Rifampicin is a key component of multidrug regimens not only for tuberculosis, but also nontuberculous mycobacterial infections (NTM) which are on the rise worldwide. Knowledge of the toxicity profile is important. Hepatotoxicity is a well-known side effect of Rifampicin necessitating regular liver function monitoring during therapy. Acute kidney injury (AKI) is a relatively rare complication, usually resulting from allergic interstitial nephritis (AIN). Rifampicin-induced intravascular hemolysis resulting in hemoglobinuria and AKI is even more uncommon, especially in Western countries with low prevalence of mycobacterial infections...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29850311/nontraumatic-exertional-rhabdomyolysis-leading-to-acute-kidney-injury-in-a-sickle-trait-positive-individual-on-renal-biopsy
#17
Kalyana C Janga, Sheldon Greenberg, Phone Oo, Kavita Sharma, Umair Ahmed
A 26-year-old African American male with a history of congenital cerebral palsy, sickle cell trait, and intellectual disability presented with abdominal pain that started four hours prior to the hospital visit. The patient denied fever, chills, diarrhea, or any localized trauma. The patient was at a party at his community center last evening and danced for 2 hours, physically exerting himself more than usual. Labs revealed blood urea nitrogen (BUN) level of 41 mg/dL and creatinine (Cr) of 2.8 mg/dL which later increased to 4...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29850310/sticky-platelet-syndrome-an-unrecognized-cause-of-acute-thrombosis-and-graft-loss
#18
Fabio Solis-Jimenez, Hector Hinojosa-Heredia, Luis García-Covarrubias, Virgilia Soto-Abraham, Rafael Valdez-Ortiz
Introduction: Sticky platelet syndrome (SPS) is a prothrombotic disease that is not well recognized and difficult to diagnose. Case Report: We present a case of a 49-year-old diabetic woman on ambulatory peritoneal dialysis therapy who underwent a kidney transplant from living-related donor. The donor was her sister with whom she shared one haplotype and absence of donor specific antibodies. The posttransplant evolution was torpid, developing progressive deterioration, which made us suspect a failure in the graft...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29850309/a-report-of-two-cases-of-hazards-associated-with-high-flow-arteriovenous-fistula-in-esrd-patients
#19
Vipuj Shah, Rakesh Navuluri, Yolanda Becker, Mary Hammes
High flow arteriovenous fistulas are a common clinical entity affecting patients with end-stage renal failure receiving hemodialysis. Given the difficulty in predicting who will develop a high flow arteriovenous fistula the exact prevalence is unclear. We present two cases of patients with high flow arteriovenous fistula that developed clinical cardiac failure at a time point after the fistula was placed with findings of significant cephalic arch stenosis. Both patients required treatment of cephalic arch stenosis with balloon angioplasty with subsequent surgical aneurism resection...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29732228/de-novo-atypical-haemolytic-uremic-syndrome-after-kidney-transplantation
#20
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
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