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uremic encephalopathy

Takaaki Mitsui, Miho Watanabe-Takahashi, Eiko Shimizu, Baihao Zhang, Satoru Funamoto, Shinji Yamasaki, Kiyotaka Nishikawa
Shiga toxin (Stx), a major virulence factor of enterohemorrhagic Escherichia coli (EHEC), can be classified into two subgroups, Stx1 and Stx2, each consisting of various closely related subtypes. Stx2 subtypes Stx2a and Stx2d are highly virulent and linked with serious human disorders, such as acute encephalopathy and hemolytic-uremic syndrome. Through affinity-based screening of a tetravalent peptide library, we previously developed peptide neutralizers of Stx2a in which the structure was optimized to bind to the B-subunit pentamer...
September 2016: Infection and Immunity
Kibriya Fidan, Yasar Kandur, Murat Ucar, Kivilcim Gucuyener, Oguz Soylemezoglu
Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological syndrome, composed of symptoms such as headache, seizures, visual disturbances, lethargy, confusion, stupor, focal neurologic findings and radiological findings of bilateral gray and white matter abnormalities suggestive of edema in the posterior regions of the cerebral hemispheres. PRES is associated with significant morbidity and mortality if it is not expeditiously recognized. Magnetic resonance image (MRI) represents the most sensitive imaging technique for recognizing PRES...
July 2016: Journal of Clinical Medicine Research
M de Mos, E J Hoorn, D Dippel, J van Bommel
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Hue Leu, Naotoshi Sugimoto, Masaki Shimizu, Tomoko Toma, Taizo Wada, Kunio Ohta, Akihiro Yachie
Shiga toxin (STX) is one of the main factors inducing hemorrhagic colitis and hemolytic-uremic syndrome (HUS) in infections with STX-producing Escherichia coli (STEC). Approximately 62% of patients with HUS showed symptoms of encephalopathy in the 2011 Japanese outbreak of STEC infections. At that time, we reported elevated serum concentrations of tumor necrosis factor (TNF)-α in patients with acute encephalopathy during the HUS phase. In the current study, we investigated whether TNF-α augments the effects of STX in glial cell lines and primary glial cells...
September 2016: International Immunopharmacology
Chirag Kamal Ahuja, Mukesh Kumar Yadav, Niranjan Khandelwal
No abstract text is available yet for this article.
April 26, 2016: Neurology
D M Kim, I H Lee, C J Song
BACKGROUND AND PURPOSE: Uremic encephalopathy is a metabolic disorder in patients with renal failure. The purpose of this study was to describe the MR imaging findings of uremic encephalopathy. MATERIALS AND METHODS: This study retrospectively reviewed MR imaging findings in 10 patients with clinically proved uremic encephalopathy between May 2005 and December 2014. Parameters evaluated were lesion location and appearance; MR signal intensity of the lesions on T1WI, T2WI, and T2 fluid-attenuated inversion recovery images; the presence or absence of restricted diffusion on diffusion-weighted images and apparent diffusion coefficient maps; and the reversibility of documented signal-intensity abnormalities on follow-up MR imaging...
September 2016: AJNR. American Journal of Neuroradiology
Manigandan Gopi, Aashish Arumugam
Myoclonic jerks are brief involuntary twitching of a muscle or a group of muscles. It is a medical sign and not a diagnosis of a disease. It occurs in number of secondary conditions like hepatic failure, renal failure, dyselectrolytaemia, etc in addition to the physiologic, epileptic, essential and psychogenic causes. Myoclonic jerks secondary to uraemia usually occur in the end stage renal failure and is resolved by renal replacement therapy. Here we report a case of uremic myoclonic jerk presented to our emergency department which occurred secondary to obstructive uropathy secondary to neurogenic bladder caused by old traumatic paraparesis and it was resolved by simple and timely intervention by bladder catheterization and it prevented the patient from going into uremic encephalopathy...
February 2016: Journal of Clinical and Diagnostic Research: JCDR
Masaki Shimizu, Natsumi Inoue, Mondo Kuroda, Mao Mizuta, Naotoshi Sugimoto, Hisashi Kaneda, Kazuhide Ohta, Akihiro Yachie
BACKGROUND: Angiopoietin (Ang)-1 and -2 play important roles in maintaining vascular homeostasis. This study aimed to assess the roles of angiopoietin (Ang)-1 and -2 and to investigate the clinical significance of their serum levels in patients with hemolytic uremic syndrome (HUS) induced by enterohemorrhagic Escherichia coli (EHEC). METHODS: Twenty patients with HUS and 15 healthy controls were studied. Serum Ang-1 and Ang-2 levels were quantified using enzyme-linked immunosorbent assay...
March 5, 2016: Clinical and Experimental Nephrology
Yuji Shiga, Yuhei Kanaya, Ryuhei Kono, Shinichi Takeshima, Yutaka Shimoe, Masaru Kuriyama
We report the case of a 73-year-old woman presenting with hypersomnia and loss of appetite. She suffered from diabetic nephropathy without receiving dialysis, in addition to hypertension, which was well controlled without marked fluctuation. There were no objective neurological findings. Her laboratory findings showed renal failure with 3.7 mg/dl of serum creatinine and decreased serum sodium and potassium. Brain magnetic resonance imaging (MRI) showed posterior reversible encephalopathy syndrome (PRES) with vasogenic edema, which was distributed in the dorsal midbrain, medial thalamus, and hypothalamus...
2016: Rinshō Shinkeigaku, Clinical Neurology
Jee-Eun Yoon, Ji Sun Kim, Jeong-Ho Park, Kyung-Bok Lee, Hakjae Roh, Sung Tae Park, Jin Whan Cho, Moo-young Ahn
Uremic encephalopathy with bilateral basal ganglia lesions has been reported as an acute neurometabolic disease which shows reversible clinical course and brain imaging features. The exact nature and pathophysiology have not been well established. We encountered two patients who showed a relapsing and aggravating course and an atypical phenotype including parkinsonism with paroxysmal dystonic head tremor and acute onset monoparesis of the lower extremity. They also showed unusual radiological findings which revealed combined lesions in the basal ganglia and cortex, persistent hemorrhagic transformation, and focal ischemic lesion in the internal capsule...
April 2016: Metabolic Brain Disease
Naotoshi Sugimoto, Hue Leu, Natsumi Inoue, Masaki Shimizu, Tomoko Toma, Mondo Kuroda, Takekatsu Saito, Taizo Wada, Akihiro Yachie
BACKGROUND: In 2011, there was an outbreak of Shiga toxin-producing Escherichia coli (STEC) infections in Japan. Approximately 62 % of patients with hemolytic-uremic syndrome also showed symptoms of encephalopathy. To determine the mechanisms of onset for encephalopathy during STEC infections, we conducted an in vitro study with glial cell lines and primary glial cells. RESULTS: Shiga toxin 2 (Stx-2) in combination with lipopolysaccharide (LPS), or LPS alone activates nuclear factor-κB (NF-κB) signaling in glial cells...
2015: Journal of Biomedical Science
İlkay Çamlıdağ, Yang-Je Cho, Mina Park, Seung Koo Lee
Posterior reversible encephalopathy syndrome (PRES) is usually a reversible clinical and radiological entity associated with typical features on brain MR or CT imaging. However, the not-so-uncommon atypical radiological presentations of the condition are also present and they may go unrecognised as they are confused with other conditions. Here, we report a very rare case of atypical, unilateral PRES in a 49-year-old uremic, post-transplant female patient who presented with seizures. Initial MRI showed high-grade occlusion of the left middle cerebral artery (MCA) and lesions suggestive of subacute infarction in the ipsilateral frontotemporoparietal lobe...
September 2015: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Eriko Morishita
"Microangiopathic hemolytic anemia (MAHA)" is now used to designate any hemolytic anemia related to RBC fragmentation, occurring in association with small vessel disease. In DIC, RBC fragmentation is thought to result from the deposition of fibrin or platelets within the microvasculature. The term "thrombotic microangiopathy (TMA)" is also used to describe syndromes characterized by MAHA, thrombocytopenia, and thrombotic lesions in small blood vessels. The most prominent diagnoses associated with TMA are thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS)...
July 2015: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Hideki Mizuno, Keiji Minouchi, Shou Aoyama, Yoshinobu Hinoue
We report a case of a woman in her twenties with enterohemorrhagic Escherichia coli O111-induced hemolytic-uremic syndrome who developed acute encephalopathy on day 5 of admission. She recovered after treatment with steroid pulse therapy, plasmapheresis, and recombinant thrombomodulin, without any adverse sequelae. We report this interesting case and provide a summary of the recent outbreak of enterohemorrhagic Escherichia coli O111.
July 2015: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
H Ozcan, A Yucel, U Z Avşar, E Cankaya, N Yucel, H Gözübüyük, F Eren, M Keles, B Aydınlı
BACKGROUND: Cognitive impairment, anxiety and depression are important problems for patients with chronic kidney failure. Cognitive impairment, anxiety, and depression may be related to various factors, such as complications of hemo/peritoneal dialysis, uremic encephalopathy, psychosocial burden of the disease, and various comorbidities in patients with chronic kidney failure. Successful kidney transplantation (KT) improves kidney, endocrine, metabolic, and vascular systems, mental functions, and the quality of life of the patients...
June 2015: Transplantation Proceedings
G Imataka, K Wake, M Suzuki, H Yamanouchi, O Arisaka
We reported a case of a 22-months child with hemolytic uremic syndrome associated with encephalopathy. As the cause of this case, the involvements of verotoxin 1 and 2 caused by O157: the H7 strain of the enterohemorrhagic Escherichia coli and rotavirus were presumed. We administered brain hypothermic therapy and steroid pulse therapy in the intensive care unit, but we were not able to save his life and the child died on the 6th day from the onset.
May 2015: European Review for Medical and Pharmacological Sciences
Pradyumna Gadewar, Sourya Acharya, Praveen Khairkar, Samarth Shukla, S N Mahajan
AIM: To study Electroencephalogram (EEG) in different stages of chronic kidney disease (CKD). MATERIALS AND METHODS: This observational study was carried out in the Department of Medicine, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha conducted over a period of 24 months, spanning from August 2011 to August 2013. Eighty three cases of CKD at different stages were studied. EEG was done in all the subjects and the various EEG dynamics like morphometric waveform patterns, symmetricity, amplitude were recorded and compared with the different stages of CKD...
March 2015: Journal of Clinical and Diagnostic Research: JCDR
Mondo Kuroda, Masaki Shimizu, Natsumi Inoue, Iku Ikeno, Hiroyasu Nakagawa, Ayano Yokoi, Yo Niida, Michio Konishi, Hisashi Kaneda, Noboru Igarashi, Junya Yamahana, Hiromichi Taneichi, Hirokazu Kanegane, Mika Ito, Shigeru Saito, Kengo Furuichi, Takashi Wada, Masaru Nakagawa, Hitoshi Yokoyama, Akihiro Yachie
Tau protein levels in cerebrospinal fluid (CSF) and serum are elevated in patients with various central nervous system diseases. We investigated whether serum tau protein levels are useful for predicting and assessing disease activity of acute encephalopathy (AE) in enterohemorrhagic Escherichia coli (EHEC) O111-induced hemolytic uremic syndrome (HUS; EHEC encephalopathy). Serum samples were obtained from 14 patients with EHEC O111/HUS, 20 patients with non-EHEC-related AE, and 20 age- and sex-matched healthy controls...
June 2015: Neurochemistry International
Merin Iype Chandanathil, Subramanya Upadhya, Sharmila Upadhya, Gopalakrishna Bhat
In chronic renal failure there is a gradual retention of substances in the tissues and body fluids, called as uremic retention toxins, which can bring about a number of biochemical activities in the body. Chronic renal insufficiency also leads to progressive behavioural conflict. Uremic toxins can affect both the central and the peripheral nervous system. Uremic encephalopathy is also associated with problems in cognition and memory. To study the psychomotor functional disorders in rats with progressive chronic renal failure surgical nephrectomy was done by resection method...
April 2015: Cognitive Neurodynamics
M Ito, A Shiozaki, M Shimizu, S Saito
A food-poisoning outbreak due to enterohemorrhagic Escherichia coli (EHEC) occurred in Toyama, Japan. The case of a 26-year-old pregnant woman with hemolytic-uremic syndrome who developed acute encephalopathy due to EHEC infection after eating raw meat is presented herein. On day 2 following admission, a cesarean section was performed because of a non-reassuring fetal status. Fecal bacterial culture confirmed an O111/O157 superinfection. Intensive care therapies including continuous hemodiafiltration and plasma exchange were performed...
May 2015: International Journal of Infectious Diseases: IJID
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