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Case Reports in Nephrology and Dialysis

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https://www.readbyqxmd.com/read/29998126/postembolization-intratumoral-chronic-bleeding-without-the-classic-ct-feature-of-active-extravasation-in-tuberous-sclerosis-complex-related-renal-angiomyolipoma-two-case-reports
#1
Xixi Zhang, Ryohei Kuwatsuru, Hiroshi Toei, Daisuke Yashiro, Shingo Okada, Hitomi Kato
Two patients with tuberous sclerosis complex each had multiple bilateral renal angiomyolipomas. After undergoing embolization for a ruptured angiomyolipoma, patient 1 experienced long-lasting abdominal fullness; contrast-enhanced computed tomography (CECT) revealed a large chronic hematoma without contrast extravasation. Patient 2 underwent embolization for the largest right renal angiomyolipoma which contained a chronic hematoma. 2 weeks later, the symptom of abdominal fullness presented, and CECT revealed that the preexisting hematoma had enlarged without contrast extravasation...
May 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29998125/importance-of-ast-120-kremezin%C3%A2-adherence-in-a-chronic-kidney-disease-patient-with-diabetes
#2
Yasuhiko Tomino, Atsuko Hisada-Urita, Takuto Seki, Tomonari Watanabe, Reo Kanda, Toshimasa Takahashi
We report herein an adult case of chronic kidney disease (CKD) associated with diabetes. The patient had been treated with insulin injection for diabetes 10 years ago. At the time of his first visit to our division for further examinations, we diagnosed him as CKD: cause (C) diabetes; glomerular filtration rate (GFR) (G) G5 (estimated [e] GFR, 10.2 mL/min/1.73 m2 ; serum creatinine of 4.90 mg/dL); and albuminuria (A) A3 (2.62 g/gCr) by the Japanese Society of Nephrology (JSN) CGA classification. Because he had complained of severe constipation and kidney function, i...
May 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29928646/the-unpredictability-of-idiopathic-membranous-nephropathy-an-illustrative-case-report
#3
Murray L Levin, Shubhada Ahya
The case of a female patient with primary membranous nephropathy is presented. She was treated with corticosteroids and chlorambucil after conservative therapy had failed and went into remission for 5 years. Her nephrotic syndrome recurred but did not respond to the same regimen. She had another complete remission after treatment with corticosteroids and cyclosporine, but the nephrosis recurred after 7 years. Again, she failed to respond with retreatment of steroids plus cyclosporine. She was treated with alternate-day steroid plus mycophenolate and, once again, had a complete remission...
May 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29928645/bile-cast-nephropathy-the-unknown-dangers-of-online-shopping
#4
Andrea Fisler, Tobias Breidthardt, Nadine Schmidlin, Helmut Hopfer, Michael Dickenmann, Katrin K├Ânig, Patricia Hirt-Minkowski
Renal dysfunction in the setting of cholestatic liver disease is multifactorial but most often due to decreased kidney perfusion from intravascular volume depletion, acute tubular injury/necrosis, and hepatorenal syndrome. Drug-induced hepatotoxicity may be associated with a cholestatic injury pattern. We report a case of a 56-year-old man with a diagnosis of bile cast nephropathy, as a complication of drug-induced severe hyperbilirubinemia due to the abuse of intramuscular anabolic steroids bought on the internet to increase muscular mass for bodybuilding training...
May 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29928644/the-case-chronic-kidney-disease-unmasked-by-single-subject-research
#5
Benjamin Gollasch, Oskar Wischnewski, Birgit Rudolph, Yoland-Marie Anistan, Friedrich C Luft, Maik Gollasch
We present a 42-year-old man with a BMI of 32, who was referred because of proteinuria and decreased renal function. We were impressed by his markedly muscular physique. A renal biopsy was performed, which showed focal segmental glomerular sclerosis (FSGS). Is this patient merely an obese person with FSGS or is something else going on here? We performed extensive clinical and laboratory examinations, genetic testing, and anthropometric data monitoring over time. We transferred our methodology for routine FSGS mutation screening (Sanger sequencing) to the Ion Torrent PGM platform with a new custom-targeted NGS gene panel (Ion Ampliseq FSGS panel) and tested the performance of the system in two cohorts of patients with FSGS...
May 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29850462/transcatheter-arterial-embolization-therapy-for-huge-renal-cysts-two-case-reports
#6
Naoya Toriu, Junichi Hoshino, Saeko Kobori, Sun Watanabe, Masahiko Oguro, Yoichi Oshima, Rikako Hiramatsu, Hiroki Mizuno, Daisuke Ikuma, Akinari Sekine, Noriko Hayami, Keiichi Sumida, Masayuki Yamanouchi, Eiko Hasegawa, Naoki Sawa, Kenmei Takaichi, Motoko Yanagita, Takuya Fujimaru, Eisei Sohara, Shinichi Uchida, Yoshifumi Ubara
We encountered 2 patients with symptomatic huge simple renal cysts. In case 1, 4,000 mL of cyst fluid was drained via a catheter, but intracystic bleeding occurred immediately afterwards. Transcatheter arterial embolization (TAE) was performed, after which the bleeding stopped, and cyst drainage was repeated successfully. After 2 years, the total cyst volume was reduced from 11,775 mL to 75.4 mL. In case 2, TAE was performed prophylactically before drainage. Subsequently, 9,400 mL of fluid was removed from multiple cysts...
January 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29850461/accidental-insertion-of-a-peritoneal-dialysis-catheter-in-the-urinary-bladder
#7
Shivraj Riar, Mohammed Abdulhadi, Christine Day, Bhanu Prasad
Percutaneous insertion of a peritoneal dialysis (PD) catheter has inherent risks of complications, more so if done "blind" (without fluoroscopy and ultrasound guidance). Despite the perceived disadvantages, there are very few reported cases of mechanical complications after PD catheter insertion. We present an 81-year-old man who underwent percutaneous insertion of dual-cuffed coiled Tenckhoff PD catheter under local anesthesia by a trained nephrologist. The procedure was uneventful, and the patient was discharged 45 min later in a stable state...
January 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29850460/proliferative-glomerulonephritis-with-monoclonal-immunoglobulin-g-lambda-deposits-report-of-the-first-pediatric-case
#8
Jose Torrealba, Jyothsna Gattineni, Allen R Hendricks
Proliferative glomerulonephritis with monoclonal immunoglobulin G deposits (PGNMID) is a recently described, uncommon renal disorder which is considered a monoclonal gammopathy of renal significance. Although some patients will have a detectable monoclonal spike, overt hematologic malignancy is found in only a minority. Most patients with PGNMID are over the age of 50 years, and to our knowledge no cases have been reported in children or adolescents. Renal biopsy shows variable histologic patterns by light microscopy, with membranoproliferative and membranous patterns being most common...
January 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29692992/tolvaptan-for-primary-aldosteronism-and-autosomal-dominant-polycystic-kidney-disease-a-case-report
#9
Kyohei Kunizawa, Junichi Hoshino, Hiroki Mizuno, Tatsuya Suwabe, Keiichi Sumida, Masahiro Kawada, Masayuki Yamanouchi, Akinari Sekine, Noriko Hayami, Rikako Hiramatsu, Eiko Hasegawa, Naoki Sawa, Kenmei Takaichi, Shigeru Shibata, Yoshifumi Ubara
A 59-year-old Japanese woman was admitted for evaluation of muscle weakness. Autosomal dominant polycystic kidney disease had been diagnosed at the age of 47 years, followed by primary aldosteronism at 53 years. At the age of 58, tolvaptan was started (60 mg/day) to treat her renal disease. After 8 months of tolvaptan therapy, hypokalemia-related muscle weakness became prominent, and hypertension became refractory. Finally, treatment with low-dose tolvaptan (30 mg/day) and high-dose spironolactone (100 mg/day) normalized serum potassium and the blood pressure...
January 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29692991/rapid-and-complete-remission-of-class-iv-lupus-nephritis-with-massive-wire-loop-lesions
#10
Tomo Suzuki, Ryutaro Matsumura, Hiroshi Kitamura, Yugo Shibagaki
Class IV lupus nephritis (LN) often has a poorer prognosis than other classes. However, class IV LN has various phenotypes, including not only segmental and global types but also others. We present the case of a 29-year-old woman with class IV-G LN who had an early response to glucocorticoid monotherapy. In addition, multiple lung nodules such as miliary tuberculosis (TB) were detected on computed tomography. All cultures of sputum, gastric fluid, and bone marrow were negative. A kidney biopsy revealed diffuse endocapillary proliferative glomerulonephritis with marked subendothelial deposition...
January 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29692990/membranous-nephropathy-like-apolipoprotein-e-deposition-disease-with-apolipoprotein-e-toyonaka-ser197cys-and-a-homozygous-apolipoprotein-e2-2
#11
Megumu Fukunaga, Kiyotaka Nagahama, Michiko Aoki, Akira Shimizu, Shigeo Hara, Akira Matsunaga, Eri Muso, Takao Saito
A 20-year-old female student underwent renal biopsy because of chance proteinuria and hematuria. Histological study revealed a membranous nephropathy-like appearance by light microscopy. But immunoglobulins and complements were negative in the glomerulus by immunofluorescence study. On the other hand, plasma apolipoprotein E (ApoE) concentration was elevated to more than 2 times the normal range, and the phenotype, genotype, and DNA sequence studies of her ApoE showed homozygous ApoE2/2 and a heterozygous novel missense mutation called ApoE Toyonaka (Ser197Cys)...
January 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29692989/the-convergence-of-vasculopathy-and-vasculitis-computer-mapping-analysis-of-2-renal-biopsies-in-a-patient-with-both-systemic-sclerosis-and-anca-related-vasculitis
#12
Jia Xu, Milan Rosen, Christina I Luffman, Charles Law, Anita Laloo, Seymour Rosen, Beverly E Faulkner-Jones
Scleroderma vasculopathy and ANCA (antineutrophil cytoplasmic antibodies)-associated glomerulonephritis have rarely been reported to occur simultaneously in one patient. Herein, we report a patient who presented with a classic constellation of clinical and laboratory findings of systemic scleroderma and was subsequently found to be positive for p-ANCA. Two renal biopsies, performed 5 months apart, demonstrated typical changes of the two entities in both acute and "healed" phases, which were analyzed by computer mapping techniques...
January 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29594148/c3-glomerulopathy-and-atypical-hemolytic-uremic-syndrome-two-important-manifestations-of-complement-system-dysfunction
#13
Ravneet Bajwa, John A DePalma, Taimoor Khan, Anmol Cheema, Sheila A Kalathil, Mohammad A Hossain, Attiya Haroon, Anne Madhurima, Min Zheng, Ali Nayer, Arif Asif
The advances in our understanding of the alternative pathway have emphasized that uncontrolled hyperactivity of this pathway causes 2 distinct disorders that adversely impact the kidney. In the so-called atypical hemolytic uremic syndrome (aHUS), renal dysfunction occurs along with thrombocytopenia, anemia, and target organ injury to multiple organs, most commonly the kidney. On the other hand, in the so-termed C3 glomerulopathy, kidney involvement is not associated with thrombocytopenia, anemia, or other system involvement...
January 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29594147/oxcarbazepine-therapy-for-complete-central-diabetes-insipidus
#14
Basmah Abdallah, Spencer Hodgins, Daniel Landry, Michael O'shea, Gregory Braden
Oxcarbazepine and carbamazepine cause hyponatremia by unknown mechanisms. We describe a patient with complete central diabetes insipidus and seizures who developed worsening hyponatremia when her dose of oxcarbazepine was increased. The patient maintained a normal serum sodium level and has had appropriately concentrated urine for 5 years on just oxcarbazepine, despite undetectable antidiuretic hormone (ADH) levels. This suggests that oxcarbazepine (or one of its metabolites) may stimulate collecting tubule V2 receptor-G protein complex independent of ADH, resulting in increased renal tubular water reabsorption...
January 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29594146/early-conversion-from-tacrolimus-to-belatacept-in-a-highly-sensitized-renal-allograft-recipient-with-calcineurin-inhibitor-induced-de-novo-post-transplant-hemolytic-uremic-syndrome
#15
Vasishta S Tatapudi, Bonnie E Lonze, Ming Wu, Robert A Montgomery
Background: Kidney transplantation is the first-line therapy for patients with end-stage renal disease since it offers greater long-term survival and improved quality of life when compared to dialysis. The advent of calcineurin inhibitor (CNI)-based maintenance immunosuppression has led to a clinically significant decline in the rate of acute rejection and better short-term graft survival rates. However, these gains have not translated into improvement in long-term graft survival. CNI-related nephrotoxicity and metabolic side effects are thought to be partly responsible for this...
January 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29594145/exit-site-infection-due-to-mycobacterium-chelonae-in-an-elderly-patient-on-peritoneal-dialysis
#16
Arata Hibi, Takahisa Kasugai, Keisuke Kamiya, Chiharu Ito, Satoru Kominato, Toshiyuki Miura, Katsushi Koyama
Nontuberculous mycobacteria (NTM) are rarely isolated from peritoneal dialysis (PD)-associated catheter infections. However, NTM infection is usually difficult to treat and leads to catheter loss. Prompt diagnosis is essential for appropriate treatment. A 70-year-old Japanese man who had been on PD for 2 years and with a medical history of 2 episodes of exit site infections (ESIs) due to methicillin-resistant Staphylococcus aureus was admitted to the hospital due to suspected ESI recurrence. However, Gram staining of the pus revealed no gram-positive cocci...
January 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29594144/an-unexpected-case-of-scurvy-in-a-peritoneal-dialysis-patient
#17
Raymonda El Khoury, Mitchell Warren, Saba Ali, James L Pirkle
This case describes an obese adult male peritoneal dialysis patient who presented with a pruritic follicular rash. Nutrient deficiency was not suspected initially in this case because there was no history of protein-calorie malnutrition, but the patient reported a diet devoid of fruits and vegetables and had not been taking his dialysis vitamin as prescribed. Skin biopsy showed follicular hyperkeratosis with fragmented hair shafts and corkscrew hairs consistent with scurvy. After supplementation with ascorbic acid 500 mg twice daily for 2 weeks, the rash resolved completely...
September 2017: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29594143/a-case-of-crescentic-glomerulonephritis-complicated-with-hypocomplementemic-urticarial-vasculitis-syndrome-and-anca-associated-vasculitis
#18
Marenao Tanaka, Norihito Moniwa, Tomohiro Mita, Toshiyuki Tobisawa, Tamaki Matsumoto, Atsushi Mochizuki, Tomohisa Yamashita, Toshiyuki Yano, Masato Furuhashi, Tetsuji Miura
Systemic urticaria in a 64-year-old woman was diagnosed as leukocytoclastic vasculitis by a punch biopsy of the skin. Her physical findings improved after prescription of prednisolone at a dose of 20 mg/day, but the skin rash relapsed with renal dysfunction, proteinuria, and hematuria when the dose of prednisolone was reduced over a period of 9 months to 1 mg/day. She was admitted to our institute for further examination, when urinary protein and plasma creatinine levels were 0.8 g/day and 1.7 mg/dL, respectively...
September 2017: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29594142/rare-bacteria-infecting-the-heart-and-affecting-the-kidney-of-a-young-child
#19
Gurinder Kumar, Alyaa Saeed Al Ali, Namrata Gulzar Bhatti
Rare bacteria can lead to infective endocarditis, which may lead to renal involvement as severe glomerulonephritis. We report our experience of a 12-year-old child who presented with infective endocarditis and blood culture-grown Gemella morbillorum - a rarely reported bacteria. The clinical picture was further complicated with severe glomerulonephritis. Renal biopsy was suggestive of crescentic glomerulonephritis. The child was managed with antibiotics, steroids, and plasmapheresis and responded well to the treatment...
September 2017: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29457022/a-case-report-of-compound-heterozygous-cyp24a1-mutations-leading-to-nephrolithiasis-successfully-treated-with-ketoconazole
#20
Emma Davidson Peiris, Raghav Wusirika
CYP24A1 is an enzyme that inactivates vitamin D. Loss-of-function mutations in this enzyme are rare but have been linked with idiopathic infantile hypercalcemia as well as adult-onset nephrocalcinosis and nephrolithiasis. Genetic testing for this mutation should be considered in the presence of calciuria, elevated serum calcium, elevated 1,25-dihydroxyvitamin D, and suppressed parathyroid hormone. We present a case with these lab findings as well as an elevated 25-hydroxyvitamin D/24,25-dihydroxyvitamin D ratio in whom compound heterozygous CYP24A1 mutations were found...
September 2017: Case Reports in Nephrology and Dialysis
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