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Pragnan Kancharla, B K Surapaneni, M Goldfinger, K Hennrick, David J Ozeri
Anti-neutrophil cytoplasmic antibodies (ANCA) play an important role in the pathogenesis of pauci-immune renal vasculitis. However, in 10% of the cases, ANCA are absent. We present a case of a 64-year-old man with a chronic untreated hepatitis C virus infection and Middle Eastern thalassemia who was ANCA-negative when he was hospitalized due to acute kidney injury and accounts for an uncommon presentation of renal vasculitis. The patient had earlier reported to have undergone local lobectomy and adjuvant chemotherapy (carboplatin/pemetrexed) for lung adenocarcinoma a month prior...
May 2018: Case Reports in Oncology
Andrzej Eljaszewicz, Katarzyna Kleina, Kamil Grubczak, Urszula Radzikowska, Paula Zembko, Paulina Kaczmarczyk, Marlena Tynecka, Karolina Dworzanczyk, Beata Naumnik, Marcin Moniuszko
IgA nephropathy (IgAN) is recognized as most frequent form of primary glomerulonephritis worldwide. IgAN is associated with renal degradation occurring due to irreversible pathological changes leading to glomerulosclerosis and interstitial fibrosis. It remains poorly understood whether and to what extent these changes are followed by the activation of regenerative mechanisms. Therefore, in this study we aimed to evaluate regenerative potential of IgAN patients by quantitating the frequencies of several stem cell types, namely circulating very small embryonic-like stem cells (VSELs), hematopoietic stem cells (HSCs), endothelial progenitor cells (EPCs) as well as different monocyte subsets with varying maturation and angiopoietic potential...
July 19, 2018: Stem Cell Reviews
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
Asif Noor, Leonard R Krilov, Vivette D'Agati, Manju Chandra
Infection-related glomerulonephritis results from glomerular immune complex deposition due to a variety of potential pathogens. Poststreptococcal glomerulonephritis is the best known example. We present a case of acute infection-related glomerulonephritis associated with disseminated gonococcal infection in a sexually active 13-year-old girl, the first report of such an association in the absence of endocarditis. The patient presented with features of acute disseminated gonococcal infection including fever, hypotension, tenosynovitis, polyarthralgias and petechiae...
July 18, 2018: BMJ Case Reports
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
Frederick Pfister, Kerstin Amann, Christoph Daniel, Monika Klewer, Anke Büttner, Maike Büttner-Herold
BACKGROUND: Thrombotic microangiopathy (TMA) is a microvascular pathology caused by several drugs used in cancer therapy. Agents targeting vascular endothelial growth factor (VEGF) have increasingly been used in therapy of advanced malignancies and have been found to induce renal TMA and proteinuria. However, histomorphological changes in human biopsies in this setting and the underlying mechanism are not yet fully understood. METHODS: Renal biopsies of 15 patients with anti-VEGF therapy (aVEGF) evaluated between 2013 and 2017 at a single centre were morphologically characterized using light microscopy, electron microscopy and immunohistochemistry (IgA, IgG, IgM, C1q, C3) and compared to cases with acute TMA caused by atypical haemolytic uramic syndrome or hypertension...
July 17, 2018: Histopathology
Aram Musaelyan, Sergey Lapin, Vladimir Nazarov, Olga Tkachenko, Boris Gilburd, Alexandra Mazing, Lilia Mikhailova, Yehuda Shoenfeld
Vimentin is a protein of intermediate filament family, which is expressed in all mesenchymal cells. Vimentin plays a key role in the physiology of the cell, cellular interactions and the functioning of the immune system. Post-translationally modified and native forms of vimentin are involved in the pathogenesis of inflammation and many autoimmune diseases: rheumatoid arthritis, sarcoidosis, systemic lupus erythematosus, antiphospholipid syndrome, Crohn's disease, ankylosing spondyloarthritis and idiopathic pulmonary fibrosis...
July 12, 2018: Autoimmunity Reviews
Stamatis Karakonstantis, Despoina Galani, Dafni Korela, Sofia Pitsigavdaki, Ifigeneia Kassotaki, Despoina Arna, Dimitrios Xydakis
Background: IgA glomerulonephritis may present with hematuria, flank pain, and fever. This clinical presentation may be easily confused with acute pyelonephritis. Case Report: We present the case of a 25-year-old female with a typical clinical presentation for acute pyelonephritis (high fever, left flank pain, left costovertebral angle tenderness, hematuria, elevated inflammatory markers, and a hypoenhancing region in the left kidney on contrast-enhanced computed tomography)...
2018: Case Reports in Medicine
Manoj Gopal Madakshira, Amanjit Bal, ShivaPrakash, Manish Rathi, Rajesh Vijayvergiya
Candida parapsilosis is a rare cause of endocarditis, which is seen to affect the native valves in patients who are known intravenous drug abusers or following contamination during surgery for prosthetic valves. We discuss a unique constellation of autopsy findings in a 35-year-old chronic opium abuser who presented with left-sided weakness followed by low-grade fever. He was diagnosed to have C. parapsilosis native valve endocarditis with septic emboli involving the myocardial vessels, left middle cerebral artery, spleen, and common iliac artery...
June 7, 2018: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Liv A Amos, Frank Y Ma, Greg H Tesch, John T Liles, David G Breckenridge, David J Nikolic-Paterson, Yingjie Han
Activation of p38 mitogen-activated protein kinase (MAPK) and c-Jun amino terminal kinase (JNK) is prominent in human crescentic glomerulonephritis. p38 and JNK inhibitors suppress crescentic disease in animal models; however, the upstream mechanisms inducing activation of these kinases in crescentic glomerulonephritis are unknown. We investigated the hypothesis that apoptosis signal-regulating kinase 1 (ASK1/MAP3K5) promote p38/JNK activation and renal injury in models of nephrotoxic serum nephritis (NTN); acute glomerular injury in SD rats, and crescentic disease in WKY rats...
July 11, 2018: Journal of Cellular and Molecular Medicine
Jiqiu Wen, Wei Wang, Feng Xu, Jinsong Chen, Mingchao Zhang, Dongrui Cheng, Xuefeng Ni, Xue Li, Zhihong Liu
BACKGROUND: We present a case series of 5 patients with proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) of renal allografts to better define its natural history, presenting characteristics, pathological features and treatment outcome. RESULTS: These 5 patients presented 5 to 19 months post-kidney transplantation for complaints of serum creatinine (Scr) elevation, proteinuria or hematuria. Membranoproliferative glomerulonephritis (MPGN) pattern was the most frequently observed histological manifestation...
July 11, 2018: BMC Nephrology
Sandra Beyer, Stephanie Schwalm, Josef Pfeilschifter, Andrea Huwiler
BACKGROUND/AIMS: Sphingosine 1-phosphate (S1P) is considered as a key molecule regulating various cell functions including cell growth and death. It is produced by two sphingosine kinases (SK) denoted as SK-1 and SK-2. Whereas SK-1 has been extensively studied and has been appointed a role in promoting cell growth, the function of SK-2 is controversial, and both pro-proliferative and pro-apoptotic functions have been suggested. In this study we investigated whether renal mesangial cells isolated from transgenic mice overexpressing the human Sphk2 gene (hSK2-tg) showed an altered cell response towards growth-inducing and apoptotic stimuli...
July 10, 2018: Cellular Physiology and Biochemistry
Muhammad Omar, Vasantha Gali, Arvin Santos, Mark Huber, Nishant Parmar
Dysproteinemia is excessive production of immunoglobulins from clonal proliferation of plasma or B cells. Cryoglobulins are a special group of immunoglobulins that precipitate below 37 degrees C. Type 1 cryoglobulinemia consists mostly of IgM and IgG that infrequently leads to glomerulonephritis. In these situations, an underlying malignancy is even rare with only 21 cases described so far with only four having chronic lymphocytic leukemia (CLL). We present a case of a 68-year-old male admitted with hypertension and kidney dysfunction who upon work up was found to have CLL...
February 2018: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Dominick Santoriello, Nanda K Pullela, Kalpana A Uday, Shawn Dhupar, Jai Radhakrishnan, Vivette D D'Agati, Glen S Markowitz
No abstract text is available yet for this article.
July 2018: KI Reports
Choli Hartono, Miriam Chung, Alan S Perlman, James M Chevalier, David Serur, Surya V Seshan, Thangamani Muthukumar
Introduction: IgA nephropathy is the most common glomerulonephritis in the world. We conducted a pilot trial (NCT01103778) to test the effect of bortezomib in patients with IgA nephropathy and significant proteinuria. Methods: We treated 8 consecutive subjects from July 2011 until March 2016 with 4 doses of bortezomib. All subjects had biopsy-proven IgA nephropathy and proteinuria of greater than 1 g per day. They were given 4 doses of bortezomib i.v. at 1.3 mg/m2 of body surface area per dose...
July 2018: KI Reports
James M Williams, Manoj Parimi, Jamie Sutherell
Although the role of ANCA in infective endocarditis is unclear, Bartonella henselae has been implicated as the culprit in cases of PR3-ANCA positive subacute bacterial endocarditis (SBE) with glomerulonephritis. In this case, a Coombs-positive autoimmune hemolytic anemia and glomerulonephritis accompanied a PR3-ANCA positive SBE caused by Bartonella henselae .
July 2018: Clinical Case Reports
Keiko Tanaka, Hitoshi Sugiyama, Toshio Yamanari, Koki Mise, Hiroshi Morinaga, Masashi Kitagawa, Akifumi Onishi, Ayu Ogawa-Akiyama, Katsuyuki Tanabe, Jun Eguchi, Yasukazu Ohmoto, Kenichi Shikata, Jun Wada
AIM: Trefoil factor 3 (TFF3) is a small peptide that is involved in mucosal protection. TFF3 is widely expressed in multiple tissues including kidney tissue. Previous studies have reported that the levels of urinary TFF3 are significantly increased in patients with chronic kidney disease. The aim of this study is to detect the TFF3 mRNA in kidney and elucidate the relationship between renal TFF3 mRNA and tubulointerstitial fibrosis in IgA nephropathy (IgAN). METHODS: We investigated the renal mRNA expression of TFF3 by real time PCR analysis in biopsy specimens from patients with IgAN, other glomerulonephritis (OGN), and minor glomerular abnormalities (MGA)...
July 10, 2018: Nephrology
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
Tomomichi Kasagi, Hironobu Nobata, Kaori Ikeda, Shogo Banno, Yasuhiko Ito
BACKGROUND: Recurrence of glomerulonephritis is an important risk factor for renal graft dysfunction. Cryoglobulinemia is known as a relatively rare cause of renal failure, and doctors are usually hesitant to perform transplantation on a recipient with cryoglobulinemia because of the risk for graft loss. We present a case of renal transplantation on a patient with organ manifestations of type II cryoglobulinemia. CASE PRESENTATION: At the age of 44 years, the patient developed acute kidney injury and purpura on the lower extremities with type II cryoglobulinemia after interferon therapy for hepatitis C virus...
July 9, 2018: BMC Nephrology
A Richard Kitching, Maliha A Alikhan
Crescentic glomerulonephritis, a complication of severe immune glomerular injury, is the pathological correlate of rapidly progressive glomerulonephritis, mediated by both humoral and cellular effectors. In the current issue of the JCI, Chen et al. have implicated Bowman's capsule in functionally isolating potentially immune effectors, specifically antigen-specific CD8+ T lymphocytes, from podocytes. They suggest that, in crescentic glomerulonephritis, immune-mediated glomerular endothelial injury results in inside-out injury to the glomerulus, with subsequent leukocyte migration through a weakened or ruptured Bowman's capsule, resulting in outside-in injury...
July 9, 2018: Journal of Clinical Investigation
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