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Clinical Nephrology. Case Studies

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https://www.readbyqxmd.com/read/29951351/malignant-renal-epithelioid-angiomyolipoma-with-tfe3-gene-amplification-mimicking-renal-carcinoma
#1
Haili Wang, Haiyu Zhan, Zhigang Yao, Qingwei Liu
Malignant renal epithelioid angiomyolipoma (EAML) is an extremely rare disease with a poor prognosis, and currently there are no uniform criteria for its biological behavior. Here, we present a case of malignant renal EAML with TFE3 gene amplification in a 53-year-old woman. Four months after surgery, unenhanced computed tomography scans showed recurrence as well as metastasis in the abdomen and lung. The patient succumbed to rapid neoplastic progression of the disease 6 months later.
2018: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29845002/rituximab-for-retroperitoneal-fibrosis-due-to-igg4-related-disease-a-case-report-and-literature-review
#2
Mohammad Almeqdadi, Mohammed Al-Dulaimi, Aleksandr Perepletchikov, Kevin Tomera, Bertrand L Jaber
Retroperitoneal fibrosis (RPF) is a progressive fibroinflammatory disease that can be complicated by urinary obstruction. RPF can be the only manifestation of IgG4-related disease (IgG4-RD). Treatment of IgG4-related RPF is challenging and mostly consists of long-term glucocorticoids leading to significant side effects and treatment intolerance. Recent exploration of the role of rituximab as a B-cell depleting therapy in the treatment of IgG4-RD provides therapeutic potential as a well-tolerated alternative to glucocorticoids...
2018: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29457800/comment-to-focal-segmental-glomerulosclerosis-associated-with-mitochondrial-disease-by-lim-et-al-in-clin-nephrol-case-stud-2017-5-20-25
#3
COMMENT
https://www.readbyqxmd.com/read/29456923/response-to-the-letter-to-the-editor-by-finsterer-and-zarrouk-mahjoub-in-clin-nephrol-case-stud-2018-6-1
#4
Kenneth Lim, David Steele, Andrew Fenves, Ravi Thadhani, Eliot Heher, Amel Karaa
Not available.
2018: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29350220/nephrotic-syndrome-in-primary-myelofibrosis-with-renal-extramedullary-hematopoiesis-and-glomerulopathy-in-the-jak-inhibitor-era
#5
Rachele Del Sordo, Rachele Brugnano, Carla Covarelli, Gioia Fiorucci, Franca Falzetti, Giorgio Barbatelli, Emidio Nunzi, Angelo Sidoni
Primary myelofibrosis (PMF) is an uncommon form of myeloproliferative neoplasm (MPN) characterized by a proliferation of predominantly megakaryocytes and granulocytes in the bone marrow that, in fully-developed disease, is associated with reactive deposition of fibrous connective tissue, extramedullary hematopoiesis (EMH), and splenomegaly. Kidney involvement is rare and clinically presents with proteinuria, nephrotic syndrome, and renal insufficiency. Renal damage can be due to EMH and glomerulopathy. Renal EMH presents three patterns: infiltration of the interstitium with possible renal failure caused by functional damage of parenchyma and vessels, infiltration of capsule and pericapsular adipose tissue, and sclerosing mass-like lesions that can cause hydronephrosis and hydroureter with obstructive uropathy and renal failure...
2017: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29318105/a-case-of-tumor-lysis-syndrome-and-acute-renal-failure-associated-with-elotuzumab-treatment-in-multiple-myeloma
#6
Douglas K Atchison, H David Humes
Renal dysfunction is a common comorbidity of multiple myeloma. However, tumor lysis syndrome is a rare cause of renal dysfunction in multiple myeloma. Elotuzumab is a newly US FDA-approved monoclonal antibody used in the treatment of refractory multiple myeloma. To our knowledge, elotuzumab has not been associated with a case of tumor lysis syndrome. We present the case of a patient who developed clinical tumor lysis syndrome 1 week after treatment with elotuzumab accompanied by renal failure with hyperphosphatemia, hyperkalemia, and profound hyperuricemia...
2017: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29098140/mpgn-and-mixed-cryoglobulinemia-in-a-patient-with-hepatitis-c-new-treatment-implications-and-renal-outcomes
#7
Shannon B Palombo, Eric C Wendel, Laura R Kidd, Farshid Yazdi, Mihran V Naljayan
. INTRODUCTION: The association of hepatitis C virus (HCV), cryoglobulinemia, and membranoproliferative glomerulonephritis (MPGN) is well known. Treatment of underlying HCV infection has greatly improved in recent years with the introduction of direct-acting antivirals (DAA), which have demonstrated curative sustained viral response (SVR) rates for select viral genotypes with the added benefit of less drug side effects. However, a mainstay of newer DAAs is sofosbuvir, which is contraindicated in patients with severe renal impairment...
2017: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29043149/pre-b-acute-lymphoblastic-leukemia-with-t-1-19-in-an-adult-initially-presenting-as-hematuria-and-bilateral-renal-enlargement-a-case-report-and-literature-review
#8
Jian Wu, Xiao-Ling Pi, Zhi-Bin Ye
Although pre-B acute lymphoblastic leukemia (ALL) is the most common type of renal leukemic infiltration; the renal infiltration with leukemia cells as the initial manifestation of leukemia is very rare. Translocation (1;19)(q23;p13) is one of the most common chromosomal abnormalities in patients with ALL and is observed in 5 - 6% of children with pre-B ALL. However, the incidence of t(1;19) in adults is lower, not exceeding 3%, and the prognosis of adult patients is usually poor. Herein, we report a 52-year-old female patient with pre-B ALL who initially presented as bilateral renal enlargement...
2017: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29043148/membranoproliferative-glomerulonephritis-associated-with-rosai-dorfman-disease
#9
Keisuke Sugimoto, Satoshi Ueda, Mitsuru Okada, Tsukasa Takemura
Rosai-Dorfman disease is also known as sinus histiocytosis with massive lymphadenopathy. Extranodal Rosai-Dorfman disease has been reported in ~ 43% of cases; the most frequent extranodal sites - skin, soft tissue, bone, respiratory tract, and eye - are usually involved in association with lymphadenopathy. Lack of lymph node involvement is rare, especially when patients manifest renal disease. Here, we describe a patient who developed membranoproliferative glomerulonephritis when lymphadenopathy was absent...
2017: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29043147/a-case-report-of-paraproteinemia-associated-pauci-immune-glomerulonephritis-a-new-form-of-monoclonal-gammopathy-of-renal-significance
#10
Robert Rope, Neeraja Kambham, Neiha Arora
BACKGROUND: Renal disease associated with paraproteinemias is classically predicated upon pathologic paraprotein deposition in the kidney. However, growing evidence suggests that paraproteins may be able to systemically activate complement or neutrophils to drive renal damage. This may provide an alternative pathologic mechanism for renal injury in rare cases. CASE REPORT: We report a case of a patient with crescentic pauci-immune glomerulonephritis presenting with rapidly progressive renal failure, polyarthropathy, and a purpuric rash in association with a monoclonal immunoglobulin G κ-light-chain producing multiple myeloma...
2017: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29043146/calciphylaxis-in-a-nondialysis-patient-treated-with-sodium-thiosulfate-and-high-dose-of-oxygen
#11
Anawin Sanguankeo, Natanong Thamcharoen, Sikarin Upala
BACKGROUND: Calciphylaxis in a nondialysis patient is a rare condition and is characterized by calcific deposition in tissue. We present a case of calciphylaxis in a nondialysis patient who was diagnosed by clinical presentation and skin biopsy and was treated with sodium thiosulfate with improvement of skin lesions. CASE: A 43-year-old female with type 2 diabetes and atrial fibrillation taking oral anticoagulation medication presented with reddish drainage from the right buttock...
2017: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29043145/anca-associated-pauci-immune-glomerulonephritis-in-a-patient-with-bacterial-endocarditis-a-challenging-clinical-dilemma
#12
Andrea Cervi, Dylan Kelly, Iakovina Alexopoulou, Nader Khalidi
PURPOSE: We report the case of a 59-year-old man with chronic hepatitis B and C infection presenting with acute kidney injury and enterococcus faecalis-infective endocarditis (IE). An elevated proteinase-3 (PR3)-ANCA and pauci-immune glomerulonephritis (GN) on renal biopsy were discovered, corresponding to ANCA-mediated GN. We conducted a literature review to assess the role of ANCA in IE and treatment implications. METHODS: On systematic review of the literature, we found five previous cases whereby IE caused by streptococcus and bartonella species were related to ANCA vasculitis-associated GN...
2017: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29043144/plasmapheresis-for-treatment-of-immune-complex-mediated-glomerulonephritis-in-infective-endocarditis-a-case-report-and-literature-review
#13
Meredith Halpin, Olga Kozyreva, Vanesa Bijol, Bertrand L Jaber
We report the case of a 57-year-old man who presented with subacute bacterial endocarditis secondary to Streptococcus mutans complicated by biopsy-proven immune complex-mediated glomerulonephritis (ICGN). Despite initial treatment with antibiotics and a short course of corticosteroids, the kidney function further deteriorated, and plasmapheresis was introduced as third-line therapy to remove circulating immune complexes. Following 7 treatment sessions, the patient recovered kidney function. We discuss the potential merit of plasmapheresis for patients with subacute bacterial endocarditis who develop ICGN...
2017: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29043143/focal-segmental-glomerulosclerosis-associated-with-mitochondrial-disease
#14
Kenneth Lim, David Steele, Andrew Fenves, Ravi Thadhani, Eliot Heher, Amel Karaa
Primary mitochondrial diseases (MD) are complex, heterogeneous inherited diseases caused by mutations in either the mitochondrial or nuclear DNA. Glomerular diseases in MD have been reported with tRNA mutation m.3243A>G causing a syndrome of mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS). We describe here a case of focal segmental glomerulosclerosis (FSGS) associated with a new tRNA mutation site. A 34-year-old man with a history of living related kidney transplantation, diabetes, hearing loss, and developmental delay presented to the outpatient clinic with complaints of new behavioral difficulties, worsening symptoms, and brain involvement on imaging...
2017: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29043142/costimulation-pathway-blockade-in-kidney-transplant-recipients-with-de-novo-rheumatoid-arthritis
#15
Mohamed Sheta, Samy Riad, Udayakumar Deepak, Naim Issa, Mark Birkenbach, Hassan N Ibrahim, Aleksandra Kukla
The best approach to treatment of de-novo rheumatoid arthritis in solid organ transplant recipients on typical immunosuppression is not well established. The use of biologics targeting specific cell types, cytokines, and immunological pathways has been gaining interest in the treatment of both, auto- and alloimmunity. We present a case of de-novo rheumatoid arthritis in a kidney transplant recipient 10 years post-transplant while receiving cyclosporine, mycophenolate mofetil, and also prednisone. Initial presentation included features of polymyalgia rheumatica and nephrotic range proteinuria...
2017: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29043141/antineutrophil-cytoplasmic-antibody-positive-pauci-immune-glomerulonephritis-associated-with-mantle-cell-lymphoma
#16
Kana N Miyata, Nazia A Siddiqi, Lawrence P Kiss, Nikolas B Harbord, James F Winchester
Renal involvement in non-Hodgkin lymphoma, especially mantle cell lymphoma (MCL) is rare. A 77-year-old man presented with acute kidney injury (AKI), which rapidly progressed to dialysis dependence. Kidney biopsy revealed patchy B-cell lymphocytic aggregates in the interstitium, which were positive for cyclin D1, consistent with atypical CD5-negative MCL as confirmed by the detection of translocation t(11;14) by FISH. Crescents were noted in 3 of 26 glomeruli; while PR-3 antineutrophil cytoplasmic antibody (ANCA) positivity and negative immunofluorescence suggested an additional pauci-immune (rapidly progressive) glomerulonephritis pattern of injury...
2017: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29043140/warfarin-related-nephropathy-in-a-patient-with-renal-pelvic-cancer
#17
Yuki Nagasako, Akiko Fujii, Satoshi Furuse, Katsunori Saito, Naobumi Mise
An 83-year-old Japanese man had a history of chronic heart failure due to bradycardia-tachycardia syndrome. He was admitted to our hospital because of macrohematuria and acute kidney injury (AKI), which were detected by an urologist at an outpatient visit. He had a history of recurrent macrohematuria and transurethral resection of bladder tumors twice in the preceding 2 years. He had been on warfarin for 12 years, with a stable international normalized ratio (INR) that was usually less than 2.1. Urinalysis revealed numerous red blood cells (RBCs) and mild proteinuria without RBC casts...
2017: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29043139/primary-renal-lymphoma-an-unusual-finding-following-radical-nephrectomy
#18
Cody M Rissman, Lawrence M Dagrosa, Jason R Pettus, Jessica L Dillon, Einar F Sverrisson
Secondary kidney involvement by disseminated non-Hodgkin's lymphoma (NHL) is quite common and is estimated to approach 30 - 60% in NHL patients. However, primary renal lymphoma is exceedingly rare and estimated to make up less than 1% of all kidney masses. We report a case of primary renal NHL presenting with profound hypercalcemia and renal failure recalcitrant to medical management, ultimately treated with urgent radical nephrectomy. To our knowledge, this is the first report of primary renal lymphoma presenting in this acute fashion...
2017: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29043138/coexistence-of-atypical-hemolytic-uremic-syndrome-and-crescentic-iga-nephropathy-treated-with-eculizumab-a-case-report
#19
Daisuke Matsumura, Atsushi Tanaka, Tsukasa Nakamura, Eiichi Sato, Koichi Node
Rapid progression to end-stage renal disease has been reported in a minority of patients with immunoglobulin A (IgA) nephropathy. In particular, crescentic IgA nephropathy has a poor prognosis in patients with a higher initial serum creatinine level. The complement system plays an important role in the pathogenesis of crescentic IgA nephropathy. Atypical hemolytic uremic syndrome (aHUS), which is characterized by thrombotic microangiopathy, is distinct from Shigatoxin-induced HUS and thrombotic thrombocytopenic purpura...
2016: Clinical nephrology. Case studies
https://www.readbyqxmd.com/read/29043137/tenofovir-and-kidney-transplantation-case-report
#20
Yuri Battaglia, Elena Cojocaru, Silvia Forcellini, Luigi Russo, Domenico Russo
BACKGROUND: Hepatitis B viral infection (HBV) has been regarded as a contraindication for kidney transplantation because of the high risk of viral activation induced by immunosuppressive therapy. Anti-retroviral drugs have changed the prognosis of patients with hepatitis B viral infection (HBV+) who are candidates for renal transplant; indeed, therapy with antiretroviral drugs may ensure lower rates of morbidity and mortality compared to traditional therapies. Entecavir is the first-line antiviral therapy recommended for the treatment of HBV+ kidney-transplanted patients...
2016: Clinical Nephrology. Case Studies
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