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Membraneous Glomerulonephritis

Saskia Bolz, Andreas Totzeck, Kerstin Amann, Mark Stettner, Christoph Kleinschnitz, Tim Hagenacker
BACKGROUND: We present a patient fulfilling the electrophysiological criteria for definite chronic inflammatory demyelinating polyneuropathy (CIDP), antibody-positive myasthenia gravis (MG), and membranous glomerulonephritis (MGN) confirmed by biopsy. To our knowledge, this is the first case of the concomitant appearance of these three autoimmune diseases in a single patient. CASE REPRESENTATION: A 42-year-old Caucasian male presented with rapidly progressive gait disturbance, distal weakness of the lower extremities, ascending hypoesthesia, impaired fine motor skills, and beginning cranial nerve palsy showing dysarthrophonia, facial paralysis, and eye movement abnormalities and was diagnosed as rapid onset (atypical) CIDP...
August 14, 2018: BMC Neurology
Claudio Ponticelli, Rachele Escoli, Gabriella Moroni
Cyclophosphamide is a prodrug that is converted to inactive carboxy-cyclophosphamide, acrolein and phosphoramide mustard, an agent that adds alkyl groups to oxygen and nitrogen atoms of guanine, one of the four nitrogen bases that form the DNA nucleotides, causing DNA cross-links and introducing DNA breaks. These cytotoxic and mutagenic effects mainly occur in proliferating cells. Repair mechanisms may prevent DNA damage in quiescent cells, but they may be insufficient to contrast the side effects of cyclophosphamide if high doses of the drug are used...
August 11, 2018: Autoimmunity Reviews
Meherzad Kutky, Sarah Aloudat
Rationale: Late-onset systemic lupus erythematosus (SLE) represents a specific subgroup of SLE, and although there is no strict age cut-off, 50 years is commonly used as the minimum age for disease onset. In this report, we present a case of a 74-year-old male with late-onset SLE and biopsy-proven lupus nephritis (LN). Presenting concerns of the patient: A 74-year-old male was referred to the nephrology clinic with a rapidly rising creatinine from a baseline of 60 µmol/L to 176 µmol/L...
2018: Canadian Journal of Kidney Health and Disease
Mayerly Prada Rico, Carmen Inés Rodríguez Cuellar, Monica Fernandez Hernandez, Luz Stella González Chaparro, Olga Lucía Prado Agredo, Ricardo Gastelbondo Amaya
Introduction: Renal biopsy is the principal instrument to evaluate the diagnosis and prognosis of children with kidney disease. There are relatively few studies establishing epidemiology of its findings in the pediatric population. Methods: A descriptive study was conducted to describe characteristics of pediatric patients who had undergone a renal biopsy over the last 10 years in a national reference center, trying to accomplish an etiopathogenic approach of biopsy findings...
2018: International Journal of Nephrology
Eric J Dein, Monica Crespo-Bosque, Homa Timlin, Duvuru Geetha
Approximately one in four patients (23.3%) with inflammatory myositis including dermatomyositis can require evaluation for acute kidney injury. The main cause of kidney injury is acute tubular necrosis from medications or myoglobinuria, though clinicians should be aware of a wide variety of possible aetiologies. We present the case of a 44-year-old woman with stable anti-Jo1 dermatomyositis, who presented with acute kidney injury. During her hospital course, she was diagnosed with double-positive disease characterised by circulating anti-glomerular basement membrane antibody and myeloperoxidase antineutrophil cytoplasmic antibody and renal biopsy revealing crescentic glomerulonephritis with linear staining of capillary wall for IgG...
July 24, 2018: BMJ Case Reports
Chengwei Zhang, Lei Leng, Xiaoming Zhang, Yao Zhao, Zhaozheng Li
BACKGROUND: Membranous glomerulonephritis (MGN) is the most common cause of nephrotic syndrome in adult patients. Despite extensive evidences suggested that many immune-related genes could serve as effective biomarkers in MGN, the potential has not been sufficiently understood because of most previous studies have concentrated on individual gene and not the entire interaction network. METHODS: Here, we integrated multiple levels of data containing immune-related genes, MGN-related genes, protein-protein interaction (PPI) networks and gene expression profiling data to construct an immune or MGN-directed neighbor network (IOMDN network) and an MGN-related genes-directed network (MGND network)...
July 24, 2018: Journal of Translational Medicine
Naoki Takahashi, Kazuya Tsuji, Hiroyuki Tamiya, Tsutomu Shinohara, Naoto Kuroda, Eiji Takeuchi
Nivolumab, an anti-programmed death-1 immune checkpoint inhibitor (ICI), is now widely used to treat numerous cancers. Although most adverse effects related to ICIs are controllable, fulminant immune-related adverse events can occur. A 74-year-old patient with non-small-cell lung cancer was treated with nivolumab as a second-line treatment. After 8 cycles, acute kidney injury with macroscopic hematuria appeared, followed by diffuse ground-glass opacities with hemoptysis. Since the clinical course suggested Goodpasture's disease, methylprednisolone pulse therapy and plasma exchange were started...
August 2018: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Debasis Pore, Emily Huang, Dina Dejanovic, Neetha Parameswaran, Michael B Cheung, Neetu Gupta
Genetic deletion of the Src family tyrosine kinase Lyn in mice recapitulates human systemic lupus erythematosus, characterized by hyperactive BCR signaling, splenomegaly, autoantibody generation, and glomerulonephritis. However, the molecular regulators of autoimmunity in Lyn-deficient mice and in human lupus remain poorly characterized. In this study, we report that conditional deletion of the membrane-cytoskeleton linker protein ezrin in B cells of Lyn-deficient mice (double knockout [DKO] mice) ameliorates B cell activation and lupus pathogenesis...
July 18, 2018: Journal of Immunology: Official Journal of the American Association of Immunologists
Hala Kfoury, Mohammed Mubarak, Abd Assalam Qannus, Malak Alshareef, Jwaher Alharbi, Hadeel Alghurair, Alanoud Bin Omair, Najd Alshamlan, Lama Raddaoui, Hisham Alkhalidi
AIM: To identify the underlying diseases with TRI-positive kidney biopsies, and describe the histological pattern and spectrum of TRI-positive kidney biopsies. METHODS: A retrospective analysis of all patients' chart that underwent renal biopsy at King Saud University Medical City between 2012 and 2017 was done. Kidney biopsies that indicated a positive result for tubuloreticular inclusions (TRI's) on electron microscopy were reviewed and the underlying disease and histological pattern was extracted...
July 18, 2018: Ultrastructural Pathology
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
Shohei Tachibana, Masayuki Iyoda, Kei Matsumoto, Yukihiro Wada, Taihei Suzuki, Ken Iseri, Nobuhiro Kanazawa, Takanori Shibata
Background: Since recombinant human soluble thrombomodulin (RH-TM) has anti-inflammatory properties through neutralizing high-mobility group box 1 protein (HMGB1), the protective effects of RH-TM were examined in anti-glomerular basement membrane (GBM) glomerulonephritis (GN) in Wistar-Kyoto rats. Methods: Rats were injected with nephrotoxic serum (NTS) to induce anti-GBM GN on Day 0, and were given either RH-TM or vehicle from Day 0 to Day 6. Rats were sacrificed 7 days after NTS injection...
July 5, 2018: Nephrology, Dialysis, Transplantation
Md Abdul Masum, Osamu Ichii, Yaser Hosny Ali Elewa, Teppei Nakamura, Yuki Otani, Marina Hosotani, Yasuhiro Kon
This study evaluated endothelial cells and podocytes, both being primary components of the glomerular filtration barrier, in the progression of membranoproliferative glomerulonephritis (MPGN) using modified scanning electron microscopy (mSEM) analysis. BXSB/MpJ-Yaa model mice exhibited autoimmune-mediated MPGN characterised by elevated serum autoantibody levels, albuminuria, renal dysfunctional parameters, and decreased glomerular endothelial fenestrations (EF) and podocyte foot process (PFP) effacement with immune cell infiltration...
July 6, 2018: Scientific Reports
Muhammad M Javaid, Priyanka Khatri, Srinivas Subramanian
Renal involvement is the most common extrahepatic manifestation of chronic hepatitis B virus (HBV) infection. While membranous nephropathy is the most frequent, the association with focal segmental glomerulosclerosis (FSGS) is not as strong, and only a few cases have been described in the literature. In particular, the tip variant FSGS is extremely rare and to our knowledge has not previously been described in association with chronic HBV infection. The management of such cases can be challenging. Immunosuppression may lead to enhanced viral replication and flare-up of the hepatic disease...
May 2018: Saudi Journal of Kidney Diseases and Transplantation
Parnaz Daneshpajouhnejad, Erfan Behzadi, Sanaz Amoushahi, Ahmadreza Aghabozorgi, Aida Farmani, Sayed-Mohsen Hosseini, Diana Taheri
Native kidney biopsy reports in previous studies that are mostly originated in Western countries show various results in different parts of the world. In this study, we aimed to determine the prevalence of renal biopsy disorders in Iran and compare it with that of other studies in the world. This cross-sectional study evaluated consecutive native kidney biopsies performed in four centers in Isfahan, Iran, from 2009 to 2014. We also reviewed other relevant studies in Iran and the world. Overall, 1547 renal biopsies were reviewed; 493 cases were excluded (transplant or re-biopsy cases) and 1054 cases (43...
May 2018: Saudi Journal of Kidney Diseases and Transplantation
Yassir Zajjari, Taoufiq Aatif, Hassani Kawtar, Sanaa Benbria, Dina Montasser, Driss El Kabbaj
The reported causes of nephrotic syndrome (NS) varies between different countries. In this retrospective study, we aimed to evaluate the underlying causes of NS in adult patients who underwent renal biopsy in a region of Morocco and we also determined the distribution of histopathological diagnoses with regard to the age subgroups and genders from January 2007 to December 2016. Patients were divided into four groups according to age at the time of renal biopsy. A total of the 257 patients with NS were included in this study...
May 2018: Saudi Journal of Kidney Diseases and Transplantation
Farahnaz Noroozinia, Khadijeh Makhdoomi, Hamid Behnamfard, Sedra Mohammadi, Sina Dindarian, Mahdi Bagheri, Hozan Mohammadi
Renal cell carcinoma (RCC) comprises 2%-3% of all visceral and 80%-85% of all adult kidney malignancies. Nephrectomy is the treatment of choice for renal tumors. The accurate pathological evaluation of nonneoplastic renal parenchyma in nephrectomy specimens is important for subsequent management. Eighty-two patients with RCC who underwent surgery at Imam Khomeini Hospital, Urmia, Iran, from April 2006 to February 2015 were studied. Paraffin blocks of the hospital archives were stained by hematoxylin and eosin (H and E) and periodic acid-Schiff staining...
May 2018: Saudi Journal of Kidney Diseases and Transplantation
Izumi Yamamoto, Takafumi Yamakawa, Ai Katsuma, Mayuko Kawabe, Haruki Katsumata, Aki Mafune Hamada, Yasuyuki Nakada, Akimitsu Kobayashi, Hiroyasu Yamamoto, Takashi Yokoo
The extent of recurrence of original kidney disease after kidney transplantation has been underestimated for several reasons. First, the duration of observation varies among studies. Second, the criteria used to schedule protocol and episode biopsies differ among institutions. And third, diagnostic modalities used for early detection of recurrent original kidney disease also vary. Thus, rates of graft loss attributable to a recurrence of original kidney disease vary among institutions and are often underestimated...
July 2018: Nephrology
Marisa Doher, Natália Borges Cardin, Alexandre W S de Souza, Gianna Mastroianni Kirsztajn
No abstract text is available yet for this article.
June 29, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
P J Koshy, R Parthsarathy, M Mathew, R Prabakaran, S Kuruvilla, G Abraham
The adult population above the age of 60 years has significantly increased in India, with a life expectancy of 68.4 years in 2016. Data regarding the renal histopathology in these patients are scarce though the number of native kidney biopsies done in this subset of population is increasing. The present study is a retrospective analysis of 231 biopsies from a total of 700 biopsies, from patients above 60 years of age (M = 65.8%; F = 34.2%) with a mean age of 64 ± 6.03 years. The indications for kidney biopsy included nephrotic syndrome (NS) (30...
May 2018: Indian Journal of Nephrology
Martin-Walter Welker, Nina Weiler, Wolf Otto Bechstein, Eva Herrmann, Christoph Betz, Mark Schöffauer, Stefan Zeuzem, Christoph Sarrazin, Kerstin Amann, Oliver Jung
AIMS: Chronic kidney disease (CKD) is a common complication after liver transplantation (LT). The etiology of CKD is broad and may only be assessed accurately by renal histology. The current study aimed to analyze the safety of renal biopsy in daily clinical practice as well as its usefulness regarding management of CKD after LT. METHODS: We performed a retrospective analysis of clinical data and renal biopsies obtained from patients with severe renal impairment (overt proteinuria, progressive deterioration of renal function) after LT with respect to safety, etiology of renal disease, and therapeutic consequences...
June 26, 2018: Journal of Nephrology
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