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Kidney biopsy and bleeding

Q A Hill, L C Harrison, A D Padmakumar, R G Owen, K R Prasad, G F Lucas, P Tachtatzis
OBJECTIVE AND IMPORTANCE: Transplantation-mediated alloimmune thrombocytopenia (TMAT) occurs when leukocytes transferred in a donor organ from a patient with immune thrombocytopenia (ITP), mount a response against recipient platelets. We present the first fatal case of TMAT following liver transplantation and review its aetiology and treatment. CLINICAL PRESENTATION: The liver donor had ITP and died from an intracranial haemorrhage. The recipient platelet count fell to 2 × 10(9)/l on post-operative day 2...
October 21, 2016: Hematology (Amsterdam, Netherlands)
Sentaro Imamura, Shintaro Narita, Ryuta Nishikomori, Hiroshi Tsuruta, Kazuyuki Numakura, Atsushi Maeno, Mitsuru Saito, Takamitsu Inoue, Norihiko Tsuchiya, Hiroshi Nanjo, Toshio Heike, Shigeru Satoh, Tomonori Habuchi
BACKGROUND: Secondary bladder amyloidosis is an extremely rare disease, resulting from a chronic systematic inflammatory disorder associated with amyloid deposits. Although uncommon in Japan, familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease characterized by recurrent episodes of fever of short duration and serositis and is frequently associated with systemic amyloidosis. Here, we present a case of a Japanese patient complaining of fever and macroscopic hematuria after a living donor renal transplantation...
October 19, 2016: BMC Research Notes
Stephanie Preuss, Claudius Kuechle, Stefan Wagenpfeil, Christoph Schmaderer, Lutz Renders, Uwe Heemann, Konrad Stock
The aim of this retrospective single-center study was to examine ultrasound-detected complications after diagnostic parenchymal renal biopsies. After 471 ultrasound-guided kidney biopsies (225 native kidneys and 246 renal allografts), ultrasound revealed hematomas (21.9%), arterio-venous fistulas (8.9%), active bleeding (1.1%) and hematuria (0.4%). Only 0.8% of all patients required invasive intervention such as coiling (n = 3) and surgical procedures (n = 1). Three episodes of bleeding (0.6%) were solved with manual compression...
October 13, 2016: Ultrasound in Medicine & Biology
Hamid Tavakkoli, Mehdi Zobeiri, Mansour Salesi, Mohammad Hossein Sanei
Wegener's granulomatosis is an uncommon inflammatory disease that manifests as vasculitis, granulomatosis, and necrosis. It usually involves the upper and lower respiratory tracts and kidneys. Although it may essentially involve any organ, gastrointestinal (GI) involvement is notably uncommon. A 20-year-old male patient presented with epigastric pain, vomiting, hematemesis, and melena. On physical examination, he was pale. There was no abdominal tenderness or organomegaly. Upper GI endoscopy revealed dark blue-colored infiltrative lesions in prepyloric area...
July 2016: Middle East Journal of Digestive Diseases
K Sunil Raviraj, P Miglani, A Garg, P K Agarwal
Mucormycosis, is an emerging fungal infection in immunocompromised and diabetic individuals, usually affects rhino-orbito-cerebral, cutaneous and pulmonary regions. But mucormycosis in immunocompetent environment is rare and occurrence of gastric mucormycosis is unusual. We report a case of 19 year old female, with no pre-existing co-morbidities, presented with fever, dysentery, vomiting, and melena for 4 days. On evaluation she was found to have pancytopenia, acute kidney injury, hemolytic anemia, coagulopathy and hepatic derangement and treated with hemodialysis, plasmapheresis along with antibiotics and packed cell RBC transfusion...
October 2015: Journal of the Association of Physicians of India
Gilda Diaz-Fuentes, Bharat Bajantri, Muhammad Adrish
BACKGROUND: Bronchoscopy with transbronchial and endobronchial biopsy and transbronchial needle aspiration is an important diagnostic tool in the pulmonologist's armamentarium. Safety in patients with pulmonary hypertension is controversial and many bronchoscopists consider this as a contraindication for the procedure. OBJECTIVES: To evaluate safety of bronchoscopy in patients with echocardiographic pulmonary hypertension and to compare with patients without it...
2016: Respiration; International Review of Thoracic Diseases
Arkadiusz Lubas, Anna Wojtecka, Jerzy Smoszna, Piotr Koziński, Emilia Frankowska, Stanisław Niemczyk
PURPOSE: Renal biopsy-related arteriovenous fistula (RB-AVF), although usually asymptomatic, may sometimes result in serious clinical implications. The aim of the study was to prospectively evaluate the incidence of RB-AVF in native kidneys, together with the assessment of hemodynamic characteristics and the impact of the histopathological results of biopsy. METHODS: The study included 138 patients (age 46.2 ± 15.2; 70 F, 68 M), who underwent percutaneous renal biopsy (PRB) of the native kidney...
October 2016: International Urology and Nephrology
Talal Alfaadhel, Daniel Cattran
BACKGROUND: Idiopathic membranous nephropathy (IMN) is a common cause of nephrotic syndrome (NS) in adults in Western countries. In 2012, the KDIGO (Kidney Disease: Improving Global Outcomes) working group published guidelines for the management of glomerulonephritis, thus providing a template for the treatment of this condition. While being aware of the impact of the clinicians' acumen and that patients may choose a different therapeutic option due to the risks of specific drugs and also of the evolving guidelines, this review details our approach to the management of patients with IMN in a Western center (Toronto)...
September 2015: Kidney Diseases
Jing Xu, Xiaofan Hu, Jingyuan Xie, Nan Chen
BACKGROUND: Membranous nephropathy (MN) is the most common cause of nephrotic syndrome (NS) in adults, accounting for about 20.0% of all NS cases. With an increasing prevalence, especially in the elderly, it has received great attention in Asia. SUMMARY: Recently, the prevalence of idiopathic MN (IMN) has significantly increased among the elderly people in Asia and other places in the world. Although the exact mechanism of IMN remains unveiled, the identification of new antigens such as PLA2R and THSD7A has greatly enhanced our understanding of its pathogenesis...
September 2015: Kidney Diseases
Luca Visconti, Valeria Cernaro, Carlo Alberto Ricciardi, Viviana Lacava, Vincenzo Pellicanò, Antonio Lacquaniti, Michele Buemi, Domenico Santoro
Renal biopsy was performed for the first time more than one century ago, but its clinical use was routinely introduced in the 1950s. It is still an essential tool for diagnosis and choice of treatment of several primary or secondary kidney diseases. Moreover, it may help to know the expected time of end stage renal disease. The indications are represented by nephritic and/or nephrotic syndrome and rapidly progressive acute renal failure of unknown origin. Nowadays, it is performed mainly by nephrologists and radiologists using a 14-18 gauges needle with automated spring-loaded biopsy device, under real-time ultrasound guidance...
July 6, 2016: World Journal of Nephrology
Burcin Ekser, Richard S Mangus, Chandrashekhar A Kubal, Jonathan A Fridell, John A Powelson, Santosh Nagaraju, Plamen Mihaylov, Carrie L Phillips, Romil Saxena, William C Goggins
BACKGROUND: Enteric hyperoxaluria (EH) occurs with a rate of 5-24% in patients with inflammatory bowel disease, ileal resection and modern bariatric surgery. The excessive absorption of calcium oxalate causes chronic kidney disease (CKD) in patients with EH. In the literature, a single experience was reported in combined intestine-kidney transplantation (CIKTx) in patients with CKD due to EH. METHODS: After a report of 2 successful cases of CIKTx in patients with EH and CKD, one was performed at our center in a 59-year-old Caucasian female who developed intestinal failure with total parenteral nutrition (TPN) dependence after a complication post-bariatric surgery...
2016: American Journal of Nephrology
Jeanette Finderup, Laura Peschardt, Mette Rubin Sander, Mette Ulf Nielsen
BACKGROUND: Guidelines for care before, during and after a kidney biopsy vary nationally and internationally. A literature search has shown few studies about the care before, during and after a kidney biopsy and we found one study from the patients' perspective. OBJECTIVES: The aim of the study is to gain knowledge about patients' experiences before, during and after a kidney biopsy. METHODS: A qualitative study with a phenomenological and hermeneutic approach using 'observiews' of seven patients before, during and after a kidney biopsy...
September 2016: Journal of Renal Care
Victoria Bîrluţiu, Elena Cristina Rezi, Rares Mircea Bîrluţiu, Ioan Sorin Zaharie
BACKGROUND: Wegener's granulomatosis is a systemic vasculitis of the small- and medium-sized vessels, produced by the action of ANCA, which involves the respiratory tract, kidneys, and eyes, with a potential for lethal evolution in the first year after diagnosis. Its association with chronic lymphocytic leukemia is rarely described in the literature, and it may be difficult to diagnose and to treat this association. CASE PRESENTATION: We present the case of a 73-year-old Caucasian patient, a rare case in which Wegener's granulomatosis is associated in a patient with chronic lymphocytic leukemia, who is admitted in the Infectious Disease Department for fever, diplopia, headache, purulent and hemorrhagic nasal secretions, intense asthenia, and weight loss...
2016: World Journal of Surgical Oncology
Aruna Prasanna, Ranga Migara Weerakkody, Eranga Sanjeewa Wijewickrama, Mohammed Rezni Nizam Cassim, Mandika Wijeyarathne
BACKGROUND: Percutaneous renal biopsy is a valuable procedure in the management of and prognostication for patients with renal disease. Complications, although rare, occur with renal biopsies. Arteriovenous fistulas and heavy bleeding are notable complications. In this report, we describe simple suturing of the biopsy tract for salvage of a graft destined for a nephrectomy due to a profusely bleeding arteriovenous fistula. CASE PRESENTATION: A 20-year-old Sri Lankan man with end-stage renal disease due to steroid-resistant nephrotic syndrome underwent a renal transplant...
2016: Journal of Medical Case Reports
José Miguel Lloris-Carsí, David García-Cerdá, Beatriz Prieto-Moure, Carlos Barrios, Antonio B Martín-Ballester, Dolores Cejalvo-Lapeña
BACKGROUND: Renal injuries are relatively frequent in abdominal trauma. In some cases, adhesives and sealants can be used to repair and preserve injured organs. This paper describes the behaviour of three biomaterials - TachoSil®, GelitaSpon®, and a new elastic cyanoacrylate (CyA), Adhflex® - in standardized experimental renal injuries. METHODS: Ninety male Wistar rats (300-350 g) were used. A Stiefel Biopsy Punch (8 mm diameter, 3 mm depth) was used to create injuries to the anterior kidney to evaluate wound healing...
2016: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
Alesa Y Courson, John R Lee, Meredith J Aull, Jennifer H Lee, Sandip Kapur, Jennifer K McDermott
Surgical stress, corticosteroids, and mycophenolate may contribute to gastrointestinal ulcers/bleeding after kidney transplantation. Prophylactic acid suppression with H2RAs or PPIs is often utilized after transplantation, although unclear if truly indicated after early corticosteroid withdrawal (CSWD). PPIs have been associated with increased risks of Clostridium difficile infection (CDI), pneumonia, and acute rejection. This retrospective cohort study investigated benefits and risks of prolonged PPI use following kidney transplantation and included 286 kidney recipients undergoing CSWD within five d of transplant who were maintained on tacrolimus and mycophenolate mofetil/sodium...
June 2016: Clinical Transplantation
Hui-Chun Wang, Yu-Bin Wang, Xiao-Hong Chen, Lan-Lan Cui
A 48-year-old woman presented with a 50-day history of irregular vaginal bleeding and lower abdominal pain. Ultrasound indicated an extremely large occupying lesion in the pelvic cavity that was highly suggestive of malignancy. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) was performed to further assess the nature of pelvic abnormality. PET/CT images demonstrated a diffusely lobulated mass ranging from cervix up to the inferior pole of kidneys with mild FDG uptake. Simultaneously, multiple nodules in bilateral lungs and a hypodense lesion in the right ventricle were shown without FDG-avidity...
March 2016: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Benjamin L Laskin, Harsharan K Singh, Ulf H Beier, Taylor Moatz, Susan L Furth, Nancy Bunin, David Witte, Jens Goebel, Stella M Davies, Christopher Dandoy, Sonata Jodele, Volker Nickeleit
BACKGROUND: After hematopoietic cell transplantation (HCT), polyoma-BK virus is associated with hemorrhagic cystitis and also with polyomavirus nephropathy (PVN). However, the true burden of post-HCT PVN is unknown because kidney biopsies are avoided due to their bleeding risk. The novel, noninvasive urinary PV-Haufen test detects PVN in kidney transplant recipients with greater than 95% positive/negative predictive values. We hypothesized that the detection of PV-Haufen in voided urine samples-a positive PV-Haufen test-was also clinically significant after HCT...
October 2016: Transplantation
Jathin Bandari, Thomas W Fuller, Robert M Turner Іі, Louis A D'Agostino
INTRODUCTION: Percutaneous renal biopsy (PRB) is a safe and effective modality for sampling kidney tissue. In limited circumstances, alternative methods for kidney biopsy may be indicated. Historical contraindications for PRB such as bleeding diathesis, morbid obesity and solitary kidney have been called into question in the literature. We present a review of the literature on PRB and the risks and benefits associated with alternatives. MATERIALS AND METHODS: A review of the literature was performed through MEDLINE and PubMed...
February 2016: Canadian Journal of Urology
Matthew F Blum, Vincent Y Ma, Anthony M Betbadal, Robert A Bonomo, Rajeeva R Raju, Clifford D Packer
We report a case of Trousseau's syndrome with cholangiocarcinoma complicated by a fatal pulmonary embolism after liver biopsy. A 69-year-old man who presented with right upper quadrant pain was found to have portal vein thrombosis and nonspecific liver hypodensities after imaging by computerized tomography. Following four days of anticoagulation, heparin was held for percutaneous liver biopsy. After the biopsy, he developed acute hepatic failure, acute kidney injury, lactic acidemia, and expired. Autopsy revealed intrahepatic cholangiocarcinoma and a pulmonary embolism...
March 2016: Clinical Medicine & Research
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