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CEN Case Reports

Javier Naranjo Muñoz, Carlos Narváez, Florentino Villanego, María Auxiliadora Mazuecos, Manuel Ceballos
No abstract text is available yet for this article.
August 29, 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
Hiroki Yamaguchi, Hisaki Shimada, Kazuhiro Yoshita, Yutaka Tsubata, Kouzou Ikarashi, Tetsuo Morioka, Noriko Saito, Shinji Sakai, Ichiei Narita
Hypermagnesemia is generally considered an exceptional iatrogenic condition usually caused by magnesium-containing cathartics. In particular, this condition often develops when magnesium-containing cathartics are administered to elderly patients with renal insufficiency or bowel movement dysfunction. Although magnesium oxide (MgO) is widely prescribed as a laxative, serum magnesium concentration has not been examined in most cases. In this report, we present the cases of four elderly patients with constipation and symptomatic hypermagnesemia caused by MgO ingestion, one of which had a lethal course...
August 22, 2018: CEN Case Reports
B Sangeetha Lakshmi, S V Padmavathi Devi, N Rukumangadha, V Sarat Chandra, N Praveen, R Ram, V Siva Kumar
No abstract text is available yet for this article.
August 21, 2018: CEN Case Reports
Chieko Kawakita, Masaru Kinomura, Yoshie Gon, Chika Okita, Katsuyoshi Katayama, Mana Nishikawa, Noriaki Shimada, Kenji Notohara, Masaki Fukushima, Kenichiro Asano
A 40-year-old male was hospitalized with renal impairment and severe hypercalcemia. His concentration of serum IgG4 was high, but serum whole PTH, 1-25(OH)2 vitamin D3 and PTHrP were not elevated. Computed tomography showed swelling of the bilateral lacrimal glands and systemic lymphadenopathy. The histological findings of lacrimal gland biopsy fulfilled the diagnostic criteria of IgG4-related ophthalmic disease (IgG4ROD). Bone scintigraphy showed increased ectopic uptake in the stomach, heart, lungs, and kidneys...
August 14, 2018: CEN Case Reports
Osamu Motoyama, Ken Sakai, Kikuo Iitaka
A 35-year-old woman with membranoproliferative glomerulonephritis type I had quintuplet gestation after induced ovulation. Her serum creatinine level and estimated glomerular filtration rate were 0.86 mg/dL and 61.5 mL/min/1.73 m2 before pregnancy. Blood pressure was normal and urinary protein to creatinine ratio was 0.2 g/gCr. Prednisolone 10 mg on alternate-day administration was continued during pregnancy. At 10 weeks of gestation transvaginal selective embryo reduction was performed and five embryos were reduced to twins...
August 12, 2018: CEN Case Reports
China Nagano, Kandai Nozu, Tomohiko Yamamura, Shogo Minamikawa, Junya Fujimura, Nana Sakakibara, Keita Nakanishi, Tomoko Horinouchi, Yoichi Iwafuchi, Sentaro Kusuhara, Wataru Matsumiya, Norishige Yoshikawa, Kazumoto Iijima
Transforming growth factor beta-induced (TGFBI)-associated corneal dystrophies are a group of inherited progressive corneal diseases. One of these TGFBI-associated corneal dystrophies is Avellino corneal dystrophy, an autosomal dominant corneal dystrophy characterized by multiple asymmetric stromal opacities that potentially impair vision. Recently, a case with corneal dystrophy complicated by nephropathy possessing a pathogenic variant of the TGFBI gene was reported for the first time. Here, we report the second case with the same condition and the same mutation in the TGFBI gene...
August 7, 2018: CEN Case Reports
Akihiro Tsuchimoto, Yuta Matsukuma, Kenji Ueki, Takehiro Nishiki, Atsushi Doi, Yasuhiro Okabe, Masafumi Nakamura, Kazuhiko Tsuruya, Toshiaki Nakano, Takanari Kitazono, Kosuke Masutani
Thrombotic microangiopathy (TMA) develops from various etiologies, and it is often difficult to distinguish the etiology of TMA in kidney transplantation. Antiphospholipid syndrome (APS) is one of the differential diagnoses for TMA that may cause acute loss of graft function or fatal thrombotic complications. This report details a 66-year-old male patient with polycythemia after ABO-incompatible kidney transplantation. Antibody screening tests were negative before transplant. Despite administration of an adequate desensitization therapy including plasmapheresis and rituximab, he developed acute graft dysfunction on postoperative day 112 and graft biopsy revealed prominent microvascular inflammation in the glomerular capillaries without immunoglobulin deposits...
August 2, 2018: CEN Case Reports
Akari Takeji, Kazunori Yamada, Dai Inoue, Ichiro Mizushima, Satoshi Hara, Kiyoaki Ito, Hiroshi Fujii, Kenichi Nakajima, Kazuaki Mizutomi, Masakazu Yamagishi, Mitsuhiro Kawano
A 73-year-old Japanese woman was diagnosed with type 1 autoimmune pancreatitis (AIP) without kidney lesions. She was treated with prednisolone (PSL) 30 mg/day, and her AIP symptoms promptly improved, after which the PSL dose was gradually tapered to 5 mg/day. Her renal function had remained normal (serum creatinine 0.7 mg/dL) until 1 year before the current admission without any imaging abnormalities in the kidney. However, during this past year her renal function gradually declined (serum creatinine 1...
July 30, 2018: CEN Case Reports
Fumiko Katsuragawa, Kiyotaka Nagahama, Shotaro Naito, Yukio Tsuura, Megumi Otani, Takaaki Koide, Sakino Nishiyama, Tomoki Yanagi, Azuma Nanamatsu, Shota Aki, Makoto Aoyagi, Hiroyuki Tanaka, Tatemitsu Rai, Shinichi Uchida
Patients with an indwelling tunneled dialysis catheter (TDC) for hemodialysis access are at a high risk of developing methicillin-resistant Staphylococcus aureus (MRSA) infection. MRSA bacteremia complications rarely include infected aneurysm. Here, we report the first case of an infected thoracic aneurysm associated with TDC-related MRSA bacteremia. An 86-year-old Japanese male with a TDC for hemodialysis access developed TDC-related MRSA bacteremia. Intravenous vancomycin was initiated, and the TDC was removed on day 3...
July 9, 2018: CEN Case Reports
Akiko Mii, Akira Shimizu, Daisuke Takada, Shuichi Tsuruoka
A 71-year-old woman presented with massive proteinuria and microhematuria. Renal biopsy showed diffuse global membranoproliferative and endocapillary proliferative lesions with leukocytic infiltration and an irregular duplication of the glomerular basement membrane on light microscopy. Immunofluorescence study showed granular deposits of monoclonal immunoglobulin G3 (IgG3) kappa, C3, and C1q in the glomeruli. Electron microscopy revealed unique structurally organized microlamellar electron-dense deposits. There was no evidence of systemic diseases such as paraproteinemia, cryoglobulinemia, or systemic lupus erythematosus...
July 9, 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.
July 5, 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...
July 5, 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...
June 29, 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...
June 29, 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...
June 28, 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...
June 27, 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...
June 12, 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...
June 12, 2018: CEN Case Reports
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