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CEN Case Reports

Harini Bejjanki, Abhilash Koratala
No abstract text is available yet for this article.
November 12, 2018: CEN Case Reports
Takahiro Shinzato, Taro Kubo, Toshihiro Shimizu, Koji Nanmoku, Takashi Yagisawa
We report a 55-year-old man with a renal allograft that developed sarcoidosis. His autosomal dominant polycystic kidney disease (ADPKD) progressed to end-stage stage renal disease when he was 52 years old, and he underwent living-donor kidney transplantation at the age of 53 years. His proteinuria worsened at 19 months post-transplantation, and his renal function began to decline at 29 months post-transplantation. A renal allograft biopsy performed at 31 months post-transplantation revealed non-caseating granulomatous interstitial nephritis...
October 16, 2018: CEN Case Reports
Yasuyo Kashiwagi, Shinji Suzuki, Kazushi Agata, Yasuyuki Morishima, Natsuko Inagaki, Hironao Numabe, Hisashi Kawashima
We herein report 2 Japanese patients with X-linked Alport syndrome (XLAS), with a novel variant in COL4A5. Patient 1 was a 16-year-old Japanese girl with a history of microscopic hematuria, without proteinuria, renal dysfunction, deafness, or ocular abnormalities. At 13 years of age, renal biopsy was performed; however, a diagnosis of AS was not considered. When her mother (patient 2) was 40 years of age (3 years after patient 1 underwent a renal biopsy), patient 2 was found to have asymptomatic hematuria, proteinuria, and an increased serum creatinine level, without deafness and ocular abnormalities...
October 6, 2018: CEN Case Reports
Weijie Violet Lin, Christie Gloria Turin, David Walter McCormick, Christopher Haas, Gregory Constantine
Oxalate nephropathy is associated with hereditary hyperoxaluria, Crohn disease, and previous gastric or intestinal surgery, especially in the setting of increased oxalate intake or ethylene glycol ingestion. We present a patient whose intake of vitamin C supplements (2 g/day), exacerbated by predisposing factors of prior small bowel obstruction and resection, and benign prostate hyperplasia (BPH), resulted in acute kidney injury due to oxalate nephropathy. We review past reports of vitamin C-induced oxalate nephropathy and discuss the underlying precipitating factors...
October 1, 2018: CEN Case Reports
Yoshinosuke Shimamura, Takuto Maeda, Yufu Gocho, Yayoi Ogawa, Kunihiko Tsuji, Hideki Takizawa
Immunoglobulin A nephropathy is the most common primary glomerulonephritis worldwide, and it can be associated with liver disease. However, cases of Immunoglobulin A nephropathy secondary to Wilson's disease are very rare. A 20-year-old Japanese man presented with microscopic hematuria, proteinuria, and renal dysfunction. A renal biopsy showed mesangial cell proliferation, immunoglobulin A deposition, and electron-dense deposit in the mesangial areas, all of which are consistent with Immunoglobulin A nephropathy...
September 25, 2018: CEN Case Reports
Keishi Morita, Takayuki Shibano, Kohei Maekawa, Masuji Hattori, Nobuyuki Hida, Shiro Nakamura, Yasuhiro Takeshima
Rituximab (RTX) is increasingly used for the treatment of refractory nephrotic syndrome due to its inhibitory effect on B cells which extends the period of remission, while lowering the dose of steroids needed for disease management. However, RTX can lead to various side effects, including Crohn's disease. Herein, we describe a case of a 15-year-old boy with refractory nephrotic syndrome diagnosed at age 9 years who developed Crohn's disease following RTX treatment. RTX was initiated in this patient at the age of 13 years 6 months due to occurrence of 12 relapses of nephrotic syndrome over a 4-year period, despite treatment using cyclosporine, steroid pulse therapy, and mycophenolate mofetil...
September 24, 2018: CEN Case Reports
Keiko Hashimoto, Takashi Sano, Yukari Honma, Maoko Ida, Hiroshi Tominaga, Aya Sawada, Tetsuya Abe, Haruka Takahashi, Yoshitaka Shimada, Takanori Masaki, Mariko Kamata, Shokichi Naito, Togo Aoyama, Yasuo Takeuchi, Masashi Akiya, Madoka Inukai, Norihiro Nakata
TAFRO syndrome (thrombocytopenia, anasarca, myelofibrosis, renal dysfunction, and organomegaly) is an atypical manifestation of multicentric Castleman's disease. Although overproduction of interleukin-6, vascular endothelial growth factor, and other cytokines may partially explain the pathophysiology of this rare syndrome, the precise mechanisms underlying the renal dysfunction associated with the condition remain unclear. Here, we describe a case of a 69-year-old male with TAFRO syndrome. He was treated with immunosuppressive agents and his renal function improved...
September 22, 2018: CEN Case Reports
M Kamran Azim, Aisha Mehnaz, Javeria Z Ahmed, Ghulam Mujtaba
Hypomagnesemia with secondary hypocalcemia is a rare autosomal-recessive disorder characterized by intense hypomagnesemia associated with hypocalcemia (HSH). Mutations in the TRPM6 gene, encoding the epithelial Mg2+ channel TRPM6, have been proven to be the molecular cause of this disease. This study identified causal mutations in a 2-month-old male patient of hypomagnesemia from a consanguineous marriage. Biochemical analyses indicated the diagnosis of HSH due to primary gastrointestinal loss of magnesium...
August 24, 2018: CEN Case Reports
Irena Franolić, Branka Bedenić, Nataša Beader, Amarela Lukić-Grlić, Slobodan Mihaljević, Luka Bielen, Gernot Zarfel, Tomislav Meštrović
Urinary tract infections after JJ stent insertion are among the most common complications, and the associated microorganisms carry more antibiotic resistance determinants than those found in urine prior to stent insertion. In line with the trends in healthcare epidemiology which implicate multi-resistant microorganisms in a plethora of healthcare-associated infections, prosthetic stent material also represents an ideal milieu for biofilm formation and subsequent infection development with resistant bacterial agents...
August 23, 2018: CEN Case Reports
(no author information available yet)
No abstract text is available yet for this article.
November 2018: CEN Case Reports
Javier Naranjo Muñoz, Carlos Narváez, Florentino Villanego, María Auxiliadora Mazuecos, Manuel Ceballos
No abstract text is available yet for this article.
November 2018: CEN Case Reports
Rida Salman, Mikhael G Sebaaly, Karl Asmar, Mohammad Nasserdine, Sami Bannoura, Nabil J Khoury
Renal cell carcinoma (RCC) is a tumor that usually metastasizes to lung, liver, bone and brain, but rarely to skeletal muscles. We report a case of an elderly man with a history of bilateral metachronous RCC for which he underwent curative bilateral nephrectomies and renal transplantation, was in remission, and presented with a large solitary skeletal muscle metastasis from the initial RCC, 3 years later.
November 2018: CEN Case Reports
Bassel Lakkis, Alissar El Chediak, Jana G Hashash, Sahar H Koubar
Spinal muscular atrophy (SMA) is a genetic neuromuscular disease characterized by progressive muscle weakness and atrophy. We report a case of a 36-year-old man with SMA type 3 who presented to our emergency department with epigastric pain and vomiting. He was found to have severe ketoacidosis on laboratory evaluation. The patient's symptoms and ketoacidosis resolved after dextrose infusion and a relatively small amount of sodium bicarbonate infusion. Given the severity of the ketosis that seemed inconsistent with moderate starvation alone, we postulate that there must have been other contributing factors besides moderate starvation that might explain the severity of acidosis in this particular patient...
November 2018: CEN Case Reports
Yannick Dieudonné, Laure Eprinchard, Emilie Léon, Pierre Oswald, Anne Gressel, Sophie Carre, Yves Dimitrov
30% of the patients suffering from hyperoxaluria type 1 are diagnosed only when they already had reached end-stage renal disease. We report the case of a 57-year-old woman with history of chronic kidney failure presenting with paraplegia due to spinal cord compression by thoracic mass-like lesions. Bone biopsy specimen obtained by decompressive laminectomy revealed calcium oxalate deposits. Once diagnosis of primary hyperoxaluria was confirmed, she underwent haemodialysis with incomplete improvement of her neurological disorders and was registered on the waiting list for transplantation...
November 2018: CEN Case Reports
Chiharu Kinoshita, Pham Nguyen Quy, Masanori Honda
Splenic hemorrhage is a potentially life-threatening complication usually occurring after blunt trauma to the abdomen. Atraumatic splenic rupture (ASR) is an uncommon condition, and mostly results from pathology affecting the spleen, such as tumor infiltration or infection. Here, we report a case of atraumatic rupture of a normal spleen in a patient undergoing peritoneal dialysis, and review similar cases in the literature. The case involved a 58-year-old man with nephrotic syndrome who had been undergoing peritoneal dialysis for 1 year...
November 2018: CEN Case Reports
Taro Akihisa, Ayami Ino, Hiroto Egawa, Yoshihito Kotera, Shunichi Ariizumi, Akiko Oomori, Shingo Yamashita, Yusuke Yamamoto, Ken Tsuchiya, Masakazu Yamamoto, Kosaku Nitta, Toshio Mochizuki
Liver cysts are observed in 83% of cases of autosomal dominant polycystic kidney disease (ADPKD). Although not as prevalent as renal cyst infection, liver cyst infection is a serious complication that is sometimes difficult to treat. We report the case of a maintenance hemodialysis patient with ADPKD who received a living donor liver transplantation alone (LDLTA) due to refractory liver cyst infection. The patient was a 67-year-old Japanese man who developed fever and right-side abdominal pain, and liver cyst infection was suspected...
November 2018: CEN Case Reports
Ayumi Ishiwatari, Mariko Endo, Sachiko Wakai
Medium-vessel hemorrhage is a rare occurrence in ANCA-associated vasculitis, and has been previously described in only a few patients with microscopic polyangiitis. We report a case of renal hemorrhage in a patient with microscopic polyangiitis that was successfully managed by transcatheter arterial embolization of the active bleeding sites. The early clinical findings included necrotizing arteritis, as indicated by skin biopsy; rapidly progressive glomerulonephritis; mononeuritis multiplex; positive screening for myeloperoxidase-specific antineutrophil cytoplasmic antibody...
November 2018: CEN Case Reports
Wei Han, Tsutomu Sakurada, Rina Hachisuka, Sayaka Kuroya, Hirofumi Sumi, Shigeki Kojima, Takeshi Okamoto, Yugo Shibagaki, Yoko Tsuchihashi, Kenji Isahaya, Naoshi Sasaki, Yasuhiro Hasegawa
Thrombolytic therapy is an effective treatment for acute ischemic stroke and provides benefits and improvements that lead to better neurological outcomes. However, thrombolytic therapy with recombinant tissue plasminogen activator (r-tPA) in hemodialysis (HD) patients is limited because HD patients have a higher risk of bleeding. We report a case of a 75-year-old HD patient who presented with sudden aphasia during HD treatment. She was brought to the hospital for treatment for infarction. Following thrombolytic therapy, we achieved re-opening without complications...
November 2018: CEN Case Reports
Mari Okada, Koichi Kamei, Kentaro Matsuoka, Shuichi Ito
Acute rejection is a major cause of graft loss in patients with kidney transplantations. However, the appropriate timing for performing a biopsy is often difficult to gauge in a clinical settings. We encountered an 8-year-old boy in whom antibody mediated rejection (AMR) associated with de novo donor-specific antibody (DSA) developed shortly after an episode of type IA acute cellular rejection (ACR). He had received a preemptive ABO-compatible kidney transplantation due to bilateral renal hypoplasia. Type IA ACR developed 2 months after transplantation and was successfully treated with methylprednisolone pulse therapy (MPT) and gusperimus hydrochloride...
November 2018: CEN Case Reports
Yoichi Oshima, Tatsuya Suwabe, Yuji Marui, Noriko Hayami, Eiko Hasegawa, Masayuki Yamanouchi, Rikako Hiramatsu, Keiichi Sumida, Masahiro Kawada, Akinari Sekine, Hiroki Mizuno, Masahiko Oguro, Junichi Hoshino, Naoki Sawa, Yasuo Ishii, Takeshi Fujii, Kenichi Ohashi, Kenmei Takaichi, Yoshifumi Ubara
A 29-year-old woman with past medical history of hypertension was referred to our hospital for the evaluation of kidney dysfunction (serum creatinine 1.0 mg/dL), proteinuria (0.54 g/gCre), and microscopic hematuria. Renal biopsy before the first pregnancy was supportive for benign nephrosclerosis with no evidence of vasculitis. After her second pregnancy and delivery when she was 32 years old, she developed proteinuria of 3.2 g/gCre, hematuria, and elevated serum creatinine level of 2.6 mg/dL. Second renal biopsy revealed necrotizing glomerulonephritis and her serum MPO-ANCA was positive, leading to the diagnosis of MPA/renal-limited vasculitis (RLV)...
November 2018: CEN Case Reports
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