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Case Reports in Nephrology

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https://www.readbyqxmd.com/read/27891268/a-case-report-describing-a-rare-presentation-of-simultaneous-occurrence-of-mpo-anca-associated-vasculitis-and-rheumatoid-arthritis
#1
Nathalie Foray, Tamer Hudali, Muralidhar Papireddy, John Gao
Background. Renal-limited myeloperoxidase vasculitis with simultaneous rheumatoid arthritis is reported as a rare occurrence. Review of literature suggests that most patients had a diagnosis of rheumatoid arthritis for several years prior to presenting with renal failure from myeloperoxidase vasculitis. Case Presentation. A 58-year-old Caucasian male presented to the hospital experiencing malaise, fevers, decreased oral intake, nausea, and vomiting for one week duration. His past medical history consisted of newly diagnosed but untreated rheumatoid arthritis, hypertension, and non-insulin-dependent diabetes mellitus...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27847659/interferon-induced-focal-segmental-glomerulosclerosis
#2
Yusuf Kayar, Nuket Bayram Kayar, Nadir Alpay, Jamshid Hamdard, Iskender Ekinci, Sebnem Emegil, Rabia Bag Soydas, Birol Baysal
Behçet's disease is an inflammatory disease of unknown etiology which involves recurring oral and genital aphthous ulcers and ocular lesions as well as articular, vascular, and nervous system involvement. Focal segmental glomerulosclerosis (FSGS) is usually seen in viral infections, immune deficiency syndrome, sickle cell anemia, and hyperfiltration and secondary to interferon therapy. Here, we present a case of FSGS identified with kidney biopsy in a patient who had been diagnosed with Behçet's disease and received interferon-alpha treatment for uveitis and presented with acute renal failure and nephrotic syndrome associated with interferon...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27840752/apolipoprotein-c-ii-deposition-amyloidosis-a-potential-misdiagnosis-as-light-chain-amyloidosis
#3
Sadichhya Lohani, Emily Schuiteman, Lohit Garg, Dhiraj Yadav, Sami Zarouk
Hereditary amyloidoses are rare and pose a diagnostic challenge. We report a case of hereditary amyloidosis associated with apolipoprotein C-II deposition in a 61-year-old female presenting with renal failure and nephrotic syndrome misdiagnosed as light chain amyloidosis. Renal biopsy was consistent with amyloidosis on microscopy; however, immunofluorescence was inconclusive for the type of amyloid protein. Monoclonal gammopathy evaluation revealed kappa light chain. Bone marrow biopsy revealed minimal involvement with amyloidosis with kappa monotypic plasma cells on flow cytometry...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27840751/systemic-toxicity-of-intraperitoneal-vancomycin
#4
Teerath Kumar, Iris Teo, Brendan B McCormick
Intraperitoneal vancomycin is used for empiric treatment of peritoneal dialysis peritonitis. It is dosed intermittently and a high systemic concentration is often achieved. Despite this, there are very few reports of systemic toxicity from intraperitoneal vancomycin. We report the course of a patient who developed a drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome after three weeks of intraperitoneal vancomycin. We review the literature and conclude that this is the first ever reported case of DRESS syndrome from intraperitoneal vancomycin...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27800197/a-swelling-in-the-mouth-in-a-chronic-hemodialysis-patient
#5
Arnaud Devresse, Alexandros Raptis, Anne-Sophie Claes, Laura Labriola
Oral manifestations of severe secondary hyperparathyroidism include maxillary and mandibular deformities, brown tumors, dental abnormalities, and metastatic calcification of soft tissues. We report on a chronic hemodialysis (HD) woman with severe, uncontrolled secondary hyperparathyroidism and a painful, nontender mass in the floor of her mouth. The most likely clinical diagnosis was a bone tumoral lesion of the oral cavity, secondary to renal osteodystrophy. Unexpectedly, pathological examination showed characteristic features of ossifying fibroma (OF) of the jaw, a rare, benign fibroosseous lesion characterized by the replacement of normal bone by collagen and fibroblasts containing varying amounts of mineralized substance...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27703822/interstitial-nephritis-in-a-patient-with-inflammatory-bowel-disease
#6
Payaswini Vasanth, Michelle Parmley, Jose Torrealba, Tamim Hamdi
Tubulointerstitial nephritis in patients with inflammatory bowel disease has been linked to the use of 5-ASA derivatives. Various aspects of this theory have been challenged with a potential role for the underlying autoimmune disorder. Steroids are the mainstay of treatment and mycophenolate mofetil might be an effective alternative. We report a patient who responded well to mycophenolate despite continuing mesalamine, the suspected offending agent.
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27668105/subdiaphragmatic-renal-ectopia-case-report-and-review-of-the-literature
#7
Eleftherios Zolotas, Rajesh G Krishnan
Background. We report the case of a male infant whose right kidney migrated to an ectopic position after birth. The migration of a kidney in postnatal life without any symptoms has not been reported in literature so far. Case Presentation. In a series of antenatal and the first postnatal ultrasound scans, the right kidney was normally located within the right renal fossa. During the first 3 months of life, the kidney migrated to a subdiaphragmatic position. This was confirmed on MRI scan. The infant was asymptomatic with normal renal function and blood pressure...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27651963/an-atypical-presentation-of-a-male-with-oral-facial-digital-syndrome-type-1-related-ciliopathy
#8
Sheena Sharma, Jennifer M Kalish, Ethan M Goldberg, Francis Jeshira Reynoso, Madhura Pradhan
Background. Oral-facial-digital syndrome type 1 (OFD1) is a rare condition with X-linked dominant inheritance caused by mutations in the Cxorf5 (OFD1) gene. This gene encodes the OFD1 protein located within centrosomes and basal bodies of primary cilia. Approximately 15-50% of patients with OFD1 progress to end-stage kidney disease following development of polycystic changes within the kidneys. This condition almost always causes intrauterine lethality in males. Description of Case Diagnosis and Treatment. A Caucasian male aged 9 years and 9 months presented with increased urinary frequency, increased thirst, and decreased appetite...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27635269/siadh-induced-by-pharyngeal-squamous-cell-carcinoma-case-report-and-literature-review
#9
Hafiz Muhammad Sharjeel Arshad, Aleida Rodriguez, Faten Suhail
Background. The Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is considered to be the most common cause of euvolemic hyponatremia. The most common malignancy associated with SIADH is small cell lung cancer. We present a rare case of a patient with SIADH secondary to well differentiated squamous cell carcinoma of the naso-oropharynx. Case. A 46-year-old Caucasian woman presented to emergency department with four-week history of progressive dysphagia. On examination, she was found to have a pharyngeal mass...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27525138/tuberous-sclerosis-and-bilateral-renal-angiomyolipomas-a-case-report-and-literature-review-of-emerging-treatment-strategies
#10
Francois Jo-Hoy, Omar Tolaymat, Ryan Kunjal, Leighton R James
Tuberous sclerosis complex is a rare multisystemic genetic disorder associated with the development of benign hamartomas. Angiomyolipomas are one such characteristic finding that may be seen in 55-80% of tuberous sclerosis complex patients. While being normally asymptomatic, they can also cause significant morbidity and mortality. We present the case of a patient with tuberous sclerosis complex and recently discovered bilateral renal angiomyolipomas, admitted for hematuria who underwent left renal artery embolization; however, worsening renal function necessitated subsequent nephrectomy...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27525137/aldosterone-response-in-severe-hypokalemia-and-volume-depletion-a-case-report-and-review-of-the-recent-research
#11
Keiko Kai, Naoto Tominaga, Daisuke Uchida, Nanae Fukai, Yumie Matsuura, Susumu Uda, Akio Yokochi
We report a case of severe hypokalemia and volume depletion complicated by chronic watery diarrhea resulting from chronic alcoholism in a 57-year-old man. Prompt replacement of normal saline with potassium chloride and cessation of alcohol intake resulted in a favorable outcome. We discuss the pathophysiology of the case, emphasizing the response of aldosterone in both hypokalemia and volume depletion, and provide a review of recent research.
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27403357/collapsing-glomerulopathy-in-a-child-with-galloway-mowat-syndrome
#12
Cengiz Zeybek, Gokalp Basbozkurt, Salih Hamcan, Ayhan Ozcan, Davut Gul, Faysal Gok
Galloway-Mowat syndrome (GMS) is an autosomal recessive disorder with a poor prognosis that was first defined as a triad of central nervous system involvement, hiatal hernia, and nephrotic syndrome. However, this syndrome is now known to have a heterogeneous clinical presentation. The nephrotic syndrome is steroid resistant and is responsible for the outcome. The combination of collapsing glomerulopathy and GMS is very rare. A 26-month-old boy presented with steroid-resistant nephrotic syndrome associated with neurologic findings, including microcephaly, psychomotor retardation, and nystagmus...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27293927/a-rare-cause-of-acute-kidney-injury-in-a-female-patient-with-breast-cancer-presenting-as-renal-colic
#13
Roxana Jurubita, Bogdan Obrisca, Gener Ismail
Renal infarction is a rare cause of acute kidney injury which could lead to permanent loss of renal function. A prompt diagnosis is necessary in order to achieve a successful revascularization of the occluded artery. Given the rarity of the disease and the paucity of the reported cases in the previous literature a high index of suspicion must be maintained not only in the classical cardiac sources of systemic emboli (atrial fibrillation, dilated cardiomyopathy, or endocarditis), but also in the situations when a hypercoagulable state is presumed...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27293926/cystatin-c-falsely-underestimated-gfr-in-a-critically-ill-patient-with-a-new-diagnosis-of-aids
#14
Caitlin S Brown, Kianoush B Kashani, Jeremy M Clain, Erin N Frazee
Cystatin C has been suggested to be a more accurate glomerular filtration rate (GFR) surrogate than creatinine in patients with acquired immunodeficiency syndrome (AIDS) because it is unaffected by skeletal muscle mass and dietary influences. However, little is known about the utility of this marker for monitoring medications in the critically ill. We describe the case of a 64-year-old female with opportunistic infections associated with a new diagnosis of AIDS. During her course, she experienced neurologic, cardiac, and respiratory failure; yet her renal function remained preserved as indicated by an eGFR ≥ 120 mL/min and a urine output > 1 mL/kg/hr without diuresis...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27293925/granulomatosis-with-polyangiitis-presenting-as-pauci-immune-crescentic-glomerulonephritis-in-pregnancy
#15
Ryan Kunjal, Raafat Makary, Andreea Poenariu
Antineutrophil cytoplasmic antibody (ANCA) associated vasculitis rarely affects females of reproductive age. A 28-year-old African American woman presented at 8 weeks of gestation with intractable vomiting attributed to hyperemesis gravidarum. She was found to have acute kidney injury that was unresponsive to vigorous fluid resuscitation and urine sediment examination was suggestive of an underlying glomerulonephritis. Serum c-ANCA and PR3 were elevated and there was no peripheral eosinophilia. During her course she also developed one episode of small volume hemoptysis with right upper lobe infiltrates on CT Chest...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27200198/febuxostat-and-increased-dialysis-as-a-treatment-for-severe-tophaceous-gout-in-a-hemodialysis-patient
#16
Lynda Ann Frassetto, Suzanne Gibson
Uric acid accumulates in renal failure and is thought to be a uremic toxin-that is, higher levels of uric acid are more damaging to the kidneys. Urate crystals can precipitate in the kidney tubules, cause urate stones, and promote inflammatory changes in the renal interstitium and vascular endothelium. Uric acid is also a small non-protein-bound molecule and therefore easily dialyzable. Here, we present the case of an anuric hemodialysis patient with severe tophaceous gout who regained some renal function and whose gout burden significantly decreased resulting in marked improvement in functional status using a new gout medication, febuxostat, and increased frequency of dialysis...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27190662/suppression-of-parathyroid-hormone-in-a-patient-with-severe-magnesium-depletion
#17
Sangeeta Mutnuri, Isaac Fernandez, Tina Kochar
Hypomagnesemia is often associated with coexisting electrolyte abnormalities like hypokalemia and hypocalcemia. Hypocalcemia has been shown to be secondary to hypoparathyroidism induced by hypomagnesemia. Here, we discuss a case of a patient with severe hypomagnesemia and associated hypocalcemia. A 38-year-old lady was admitted to the hospital for weakness of lower extremities and an eventual fall. The exam was significant for decreased motor strength and some paresthesias. The laboratory data was significant for hypomagnesemia, hypokalemia, and low parathyroid level in the face of hypocalcemia...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27127666/reversible-fluindione-induced-chronic-interstitial-nephritis
#18
Thomas Crepin, Jamal Bamoulid, Cécile Courivaud, Omar Dahmani, Sophie Felix, Didier Ducloux
Fluindione is well known to induce acute drug-induced interstitial nephritis (IN). Most cases occurred soon after the onset of treatment. We report a unique case of severe subacute fluindione-induced IN diagnosed 2 years after the treatment was begun. Renal function dramatically improved after fluindione withdrawal and steroid therapy.
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27034861/resin-induced-colonic-pseudotumor-rare-complication-from-chronic-use-of-potassium-binders-in-a-hemodialysis-patient
#19
Mary Bui, Shyan-Yih Chou, Pierre Faubert, Pablo Loarte, Ronny Cohen
Potassium-binding resins are widely used in the treatment of hyperkalemia, mostly in the acute setting. Gastrointestinal adverse events, although reported, are not frequently seen due to its short course of use. This report describes a case involving an end-stage renal disease patient on hemodialysis who developed a colonic mass after being on sodium polystyrene sulfonate chronically for persistent hyperkalemia. Gastrointestinal symptoms developed late during the treatment rather than early as reported previously in the literature...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27034860/a-case-of-primary-hypoparathyroidism-presenting-with-acute-kidney-injury-secondary-to-rhabdomyolysis
#20
Abdullah Sumnu, Zeki Aydin, Meltem Gursu, Sami Uzun, Serhat Karadag, Egemen Cebeci, Savas Ozturk, Rumeyza Kazancioglu
Hypoparathyroidism is the most common cause of symmetric calcification of the basal ganglia. Herein, a case of primary hypoparathyroidism with severe tetany, rhabdomyolysis, and acute kidney injury is presented. A 26-year-old male was admitted to the emergency clinic with leg pain and cramps, nausea, vomiting, and decreased amount of urine. He had been treated for epilepsy for the last 10 years. He was admitted to the emergency department for leg pain, cramping in the hands and legs, and agitation multiple times within the last six months...
2016: Case Reports in Nephrology
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