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https://www.readbyqxmd.com/read/28884034/snakebite-induced-thrombotic-microangiopathy-leading-to-renal-cortical-necrosis
#1
Ying Mao Gn, Arvind Ponnusamy, Vikram Thimma
Renal complications from snakebite result in high mortality and morbidity. Acute kidney injury (AKI) occurs in 5-30% of cases. Renal manifestation could include acute tubular necrosis, cortical necrosis, interstitial nephritis, glomerulonephritis, and vasculitis. We present a case of thrombotic microangiopathy (TMA) resulting in renal cortical necrosis. Renal biopsy showed fibrin thrombi in glomeruli and arterioles with cortical necrosis. Our patient progressed to end-stage renal disease.
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28866833/voriconazole-induced-periostitis-deformans-serial-imaging-in-a-patient-with-anca-vasculitis
#2
S Cormican, N Adams, P O'Connell, A McErlean, D de Freitas
OBJECTIVES: A 61-year-old with acute granulomatosis and polyangiitis developed Aspergillus fumigatus pneumonia after admission to the intensive care unit with a small bowel perforation. This occurred after immunosuppression (intravenous methylprednisolone, intravenous cyclophosphamide, and plasmapheresis) for his initial presentation with stage 3 acute kidney injury. MATERIALS AND METHODS: The mycologist recommended long-term treatment with voriconazole after initial recovery...
September 2, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28661098/efficacy-of-cryofiltration-for-treatment-of-mixed-cryoglobulinemia-a-report-of-four-cases
#3
Yoshihiro Taniyama, Yoshihisa Nakatani, Toshiaki Matsuoka, Miyo Takahashi, Kazuyuki Shimizu, Sachiyo Yamamoto, Yuki Inoue, Sayoko Ohnishi, Norihiro Kobayashi, Yukihito Nakano, Masahiro Takami, Shuji Arima
Cryoglobulinemia can induce systemic vasculitis affecting various organs such as skin, peripheral nerves, and kidney. The disease can induce chronic organ failure and even be life-threatening. Cryofiltration has been applied for the treatment of cryoglobulinemic vasculitis. We have experienced four cases with mixed cryoglobulinemia showing severe and progressive clinical manifestations, including skin purpura, nephrotic syndrome, acute kidney injury, and peripheral neuropathy. Cryofiltration in conjunction with conventional pharmacological therapies appeared to be safe and effective...
June 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28640105/glomerulonephritis-and-granulomatous-vasculitis-in-kidney-as-a-complication-of-the-use-of-braf-and-mek-inhibitors-in-the-treatment-of-metastatic-melanoma-a-case-report
#4
Mehdi Maanaoui, Camille Saint-Jacques, Viviane Gnemmi, Marie Frimat, Arnaud Lionet, Marc Hazzan, Christian Noël, François Provot
RATIONALE: BRAF and MEK inhibitors have significantly improved the prognosis of metastatic melanoma, by inhibiting both the mitogen-activated protein kinase (MAP-kinase) pathway. They are associated with infrequent adverse kidney events. Most of these are related to the use of BRAF inhibitors and involve interstitial nephritis with acute tubular necrosis. PATIENT CONCERNS: We report a unique case of glomerulonephritis with renal granulomatous vasculitis in a patient diagnosed with metastatic melanoma treated with BRAF and MEK inhibitors...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28556523/cytomegalovirus-induced-polyarteritis-nodosa-in-a-liver-transplant-recipient
#5
K Abadeer, N Aslam, C Cortese, H M Wadei
Polyarteritis nodosa (PAN) is a necrotizing vasculitis that has been associated with viral infections, especially hepatitis B virus. We hereby report a case of tissue-invasive cytomegalovirus (CMV)-induced PAN in a liver transplant recipient presenting with acute kidney injury and active urinary sediment. Treatment directed against both PAN and CMV resulted in improvement in kidney function, normalization of urinary indices and resolution of the CMV infection. There was no recurrence of either PAN or CMV after a 3-year follow-up period...
May 28, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28412927/widespread-subcutaneous-necrosis-in-spotted-fever-group-rickettsioses-from-the-coastal-belt-of-sri-lanka-a-case-report
#6
Nathasha Luke, Hasini Munasinghe, Lakshmi Balasooriya, Ranjan Premaratna
BACKGROUND: Spotted fever group rickettsioses (SFGR) transmitted mostly by ticks are increasingly discovered around the World and some of them are either re-emerging or emerging in Sri Lanka. Accidental human infections caused by these vector borne zoonotic diseases generally give rise to nonspecific acute febrile illnesses which can be complicated by multi organ involvement carrying high morbidity and mortality. Nonspecific clinical features and non-availability of early diagnostic facilities are known to result in delay in the diagnosis of rickettsial infections...
April 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28391344/is-there-a-role-for-tnf%C3%AE-blockade-in-anca-associated-vasculitis-and-glomerulonephritis
#7
Stephen P McAdoo, Charles D Pusey
Tumour necrosis factor alpha (TNFα) is a cytokine that is pivotal in the inflammatory response. Blockade of TNFα has been shown to be effective in a number of human autoimmune diseases, including rheumatoid arthritis, raising the question of whether this approach may be effective in inflammatory kidney disease, such as ANCA-associated vasculitis (AAV). In AAV, there is considerable evidence for the role of TNFα in the pathophysiology of disease, including increased expression of TNFα mRNA in leucocytes and in renal tissue...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28356675/thrombotic-microangiopathy-due-to-viperidae-bite-two-case-reports
#8
T Dineshkumar, J Dhanapriya, R Sakthirajan, K Thirumalvalavan, A A Kurien, T Balasubramaniyan, N Gopalakrishnan
Snake bite is mainly an occupational hazard and causes serious health problems in rural India. Acute kidney injury (AKI) occurs in 5-30% cases. Renal pathologic findings include acute tubular necrosis, cortical necrosis, interstitial nephritis, glomerulonephritis, and vasculitis. Thrombotic microangiopathy (TMA) occurrence after a snake bite is reported rarely. Here, we present two patients who developed TMA after viper bite treated with hemodialysis and plasmapheresis. Renal biopsy showed fibrin thrombi in glomeruli and arterioles with cortical necrosis...
March 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28348948/microscopic-polyangiitis-atypical-presentation-with-extensive-small-bowel-necrosis-diffuse-alveolar-hemorrhage-and-renal-failure
#9
Justin M Segraves, Vivek N Iyer
Microscopic polyangiitis is an uncommon systemic vasculitis of varying severity that is associated with myeloperoxidase (MPO) and perinuclear antineutrophil cytoplasmic (p-ANCA) antibodies. The most commonly affected organs are the lungs and kidneys. We report on a very unusual case of microscopic polyangiitis presenting with severe mesenteric ischemia in addition to diffuse alveolar hemorrhage and acute renal failure. The patient was initially diagnosed with acute pancreatitis at an outside facility given his severe abdominal pain and elevated pancreatic enzymes...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28289874/renal-vasculitis-presenting-with-acute-kidney-injury
#10
Javier Villacorta, Francisco Diaz-Crespo, Mercedes Acevedo, Teresa Cavero, Carmen Guerrero, Manuel Praga, Gema Fernandez-Juarez
Renal failure secondary to ANCA-associated vasculitis represents a clinical and therapeutic challenge. In this study, we aimed to assess the treatment response rates and long-term outcomes of vasculitis patients presenting with renal failure. This retrospective study included 151 patients with renal vasculitis from three hospitals who underwent a renal biopsy between 1997 and 2014. Patients with renal failure which required dialysis at the onset were compared to those presenting with more preserved renal function...
June 2017: Rheumatology International
https://www.readbyqxmd.com/read/28210912/inhibitory-effects-of-emodin-thymol-and-astragalin-on-leptospira-interrogans-induced-inflammatory-response-in-the-uterine-and-endometrium-epithelial-cells-of-mice
#11
Wenlong Zhang, Xiaojie Lu, Wei Wang, Zhuang Ding, Yunhe Fu, Xiaofei Zhou, Naisheng Zhang, Yongguo Cao
Leptospirosis is a systemic infection that causes, among others, acute kidney injury, acute liver disease, muscle pain, vasculitis, bleeding disorders, and reproductive loss. In an effort to reduce uterine inflammatory responses induced by Leptospira, we evaluated the anti-inflammation effects of emodin, thymol, and astragalin in a mouse model. Our results showed that treatment with emodin, thymol, and astragalin alleviated uterine inflammation induced by leptospira infection via suppression of pro-inflammatory cytokine expression and prevented tissue damage...
April 2017: Inflammation
https://www.readbyqxmd.com/read/28149647/hepatitis-c-and-kidney-disease-a-narrative-review
#12
REVIEW
Rashad S Barsoum, Emad A William, Soha S Khalil
Hepatitis-C (HCV) infection can induce kidney injury, mostly due to formation of immune-complexes and cryoglobulins, and possibly to a direct cytopathic effect. It may cause acute kidney injury (AKI) as a part of systemic vasculitis, and augments the risk of AKI due to other etiologies. It is responsible for mesangiocapillary or membranous glomerulonephritis, and accelerates the progression of chronic kidney disease due to other causes. HCV infection increases cardiovascular and liver-related mortality in patients on regular dialysis...
March 2017: Journal of Advanced Research
https://www.readbyqxmd.com/read/28132051/anca-associated-vasculitis-secondary-to-levamisole-adultered-cocaine-with-associated-membranous-nephropathy-a-case-series
#13
David Collister, Christie Sathianathan, Krista Ryz, Martin Karpinski, Keevin Bernstein, Ian W Gibson
BACKGROUND: Cocaine is a risk factor for acute kidney injury and chronic kidney disease with progression to end-stage renal disease. Levamisole is an adulterant that is added to cocaine to enhance its euphoric effects. Levamisole-adulterated cocaine (LAC) is associated with the distinct clinical syndromes of agranulocytosis, leukocytoclastic vasculitis, cocaine-induced midline destructive lesions (CIMDL), and ANCA-associated vasculitis (AAV) with pauci-immune necrotizing glomerulonephritis...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/27917269/ecstasy-mdma-and-its-effects-on-kidneys-and-their-treatment-a-review
#14
REVIEW
Feyza Bora, Fatih Yılmaz, Taner Bora
Ecstasy (MDMA; 3,4-methylenedioxymethylamphetamine) is an illicit drug that has been increasingly abused by young people. Its effects include euphoria, enhanced sociability and heightened mental awareness. These come about via the increase of serotonin in both the central nervous system and the sympathetic nervous system. Despite the drug's prevalent abuse, serious or adverse effects are rare. Due to personal pharmacokinetics, effects from the same dosage vary according to the individual. Fatal instances may include acute hyponatremia, hyperthermia (>42 °C), disseminated intravascular coagulation (DIC) resulting from hyperthermia affecting the kidneys, and non-traumatic rhabdomyolysis...
November 2016: Iranian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/27915351/the-role-of-nephrologist-in-the-intensive-care-unit
#15
Zoltán H Endre
Participation by nephrologists is needed in most intensive care units, even when such units are 'closed'. This participation should assist with diagnosis and management of intrinsic and complex renal diseases such as vasculitis, complex metabolic and electrolyte disorders including hyponatremia, and acute kidney injury (AKI) with and without underlying chronic kidney disease (CKD). Early nephrologist involvement will also facilitate transition to continuing care and follow-up after an episode of AKI, but may also assist in avoiding dialysis where treatment is futile...
2017: Blood Purification
https://www.readbyqxmd.com/read/27914701/il-2-anti-il-2-complexes-ameliorate-lupus-nephritis-by-expansion-of-cd4-cd25-foxp3-regulatory-t%C3%A2-cells
#16
Ji-Jing Yan, Jae-Ghi Lee, Joon Young Jang, Tai Yeon Koo, Curie Ahn, Jaeseok Yang
Adoptive transfer of regulatory T cells (Tregs) can delay disease progression and reduce mortality in lupus-prone mice. Here, we tested whether complex (IL-2C) consisting of IL-2 and anti-IL-2 monoclonal antibody (JES6-1) ameliorates lupus nephritis by expanding Tregs as an alternative to problematic Treg infusion therapy. IL-2C treatment of NZB/W F1 mice induced an effective and sustained expansion of CD4(+)CD25(+)Foxp3(+) Tregs in both the kidneys and spleen along with decreased renal infiltration of T cells, B cells, and innate immune cells...
March 2017: Kidney International
https://www.readbyqxmd.com/read/27900940/acute-kidney-injury-in-allopurinol-induced-dress-syndrome-a-case-report-of-concurrent-tubulointerstitial-nephritis-and-kidney-limited-necrotizing-vasculitis%C3%A2
#17
Anthony J Esposito, Ryan C Murphy, Mirna N Toukatly, Osama W Amro, Bryan R Kestenbaum, Behzad Najafian
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare but potentially fatal adverse drug reaction with variable renal involvement. We report the case of a man who presented with allopurinol-induced DRESS and acute kidney injury (AKI) requiring hemodialysis. Kidney biopsy revealed eosinophilic tubulointerstitial nephritis and necrotizing vasculitis of the intralobular arteries without systemic markers of vasculitis. After cyclophosphamide and glucocorticoids, his symptoms and AKI resolved. To our knowledge, this is the first case of kidney-limited necrotizing vasculitis, questioning whether a biopsy should be routinely performed in patients with DRESS accompanied by severe AKI...
November 30, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27801920/hydralazine-induced-anca-vasculitis-in-the-setting-of-acute-clostridium-difficile-infection
#18
Somwail Rasla, Amr El Meligy, Dragos F Cucu
We report a rare case of Hydralazine-induced ANCA associated glomerulonephritis with alveolar hemorrhage in the setting of acute Clostridium Difficile Infection. A 71-year-old Caucasian woman with hypertension, who was being treated with hydralazine 25 mg twice a day for six years, presented to the hospital with diarrhea, nausea, vomiting and anemia. She had acute kidney injury and urinalysis showed proteinuria, dysmorphic RBCs, and rare RBC cast. She was found to have Clostridium difficile colitis which was successfully treated...
November 1, 2016: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/27596627/biopsy-proven-kidney-diseases-in-the-elderly-clinical-characteristics-renal-histopathological-spectrum-and-prognostic-factors
#19
Yue Chen, Ping Li, Chunli Cui, Aihong Yuan, Kun Zhang, Chen Yu
Objective To explore the clinical characteristics, renal histopathological spectrum and prognostic factors of biopsy-proven kidney diseases in the elderly. Methods A retrospective observational study was conducted in elderly patients who had received renal biopsies. Demographic, clinical and pathological data at the time of the biopsy were collected from the medical records. Follow-up records and prognostic factors were studied. Results The elderly (≥60 years) accounted for 74 of 434 (17.1%) native renal biopsies that were performed in a 9-year period...
October 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/27433990/outcomes-of-elderly-patients-with-anti-neutrophil-cytoplasmic-autoantibody-associated-vasculitis-treated-with-immunosuppressive-therapy
#20
Parminder K Judge, Michael E Reschen, Richard Haynes, Edward J Sharples
BACKGROUND/AIMS: Anti-neutrophil cytoplasmic autoantibody-associated vasculitis (AAV) is a cause of biopsy-proven acute kidney injury, more common in the elderly. Treatment requires immunosuppression, which can have significant toxic effects. The aim of this study was to assess whether morbidity and mortality that are associated with immunosuppression for AAV varied with age. METHODS: A retrospective review of 232 patients given induction therapy with prednisolone and cyclophosphamide was conducted...
2016: Nephron
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