Clinical nephrology. Case studies最新文献

Minimal change disease in treatment-naïve hepatitis C virus infection: A case report and literature review. treatment-naïve丙型肝炎病毒感染的微小变化疾病：1例报告和文献复习。

Clinical nephrology. Case studies Pub Date : 2025-01-10 eCollection Date: 2025-01-01 DOI: 10.5414/CNCS111506

Juliano Alhaddad, Hazim Allos, Dimo Dimitrov, Claudia M Nader, Helmut G Rennke, Bertrand L Jaber

{"title":"Minimal change disease in treatment-naïve hepatitis C virus infection: A case report and literature review.","authors":"Juliano Alhaddad, Hazim Allos, Dimo Dimitrov, Claudia M Nader, Helmut G Rennke, Bertrand L Jaber","doi":"10.5414/CNCS111506","DOIUrl":"10.5414/CNCS111506","url":null,"abstract":"Minimal change disease (MCD) accounts for 10 - 15% of idiopathic nephrotic syndromes in adults. Chronic hepatitis C virus (HCV) infection is rarely ascribed as a cause of MCD and was previously associated with interferon-based therapy. MCD in treatment-naïve chronic HCV infection is extremely rare, with only 3 cases reported in the literature. We report on a 67-year-old woman presenting with acute nephrotic syndrome and severe acute kidney injury requiring short-term dialysis. She was initially treated empirically with glucocorticoids and underwent a kidney biopsy that revealed MCD with evidence of acute tubular necrosis and mild focal acute interstitial nephritis. An extensive work-up was only significant for the presence of anti-HCV antibody with an elevated HCV viral load of genotype 1b. Her kidney function recovered, and she was discharged on an oral prednisone course with a planned taper. 4.5 months later, her HCV infection was treated with ledipasvir and sofosbuvir, and she achieved sustained virological response. The nephrotic syndrome remained in remission 24 months after initial presentation. This is a unique case where sustained remission of both the nephrotic syndrome and the HCV infection were achieved with glucocorticoids and direct antiviral agents, respectively.","PeriodicalId":510898,"journal":{"name":"Clinical nephrology. Case studies","volume":"13 ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Significant response to tocilizumab in a case of immune deposits-related membranoproliferative glomerulonephritis and tubulointerstitial nephritis complicated by multicentric Castleman's disease. 托珠单抗对免疫沉积相关膜增殖性肾小球肾炎和小管间质性肾炎合并多中心Castleman病的疗效显著

Clinical nephrology. Case studies Pub Date : 2024-12-20 eCollection Date: 2024-01-01 DOI: 10.5414/CNCS111337

Hisashi Sugimoto, Naoki Sawa, Daisuke Ikuma, Yuki Oba, Hiroki Mizuno, Akinari Sekine, Masayuki Yamanouchi, Eiko Hasegawa, Tatsuya Suwabe, Takehiko Wada, Kei Kono, Keiichi Kinowaki, Kenichi Ohashi, Kazuho Honda, Yukiko Kanetsuna, Kensuke Joh, Yutaka Yamaguchi, Yoshifumi Ubara

{"title":"Significant response to tocilizumab in a case of immune deposits-related membranoproliferative glomerulonephritis and tubulointerstitial nephritis complicated by multicentric Castleman's disease.","authors":"Hisashi Sugimoto, Naoki Sawa, Daisuke Ikuma, Yuki Oba, Hiroki Mizuno, Akinari Sekine, Masayuki Yamanouchi, Eiko Hasegawa, Tatsuya Suwabe, Takehiko Wada, Kei Kono, Keiichi Kinowaki, Kenichi Ohashi, Kazuho Honda, Yukiko Kanetsuna, Kensuke Joh, Yutaka Yamaguchi, Yoshifumi Ubara","doi":"10.5414/CNCS111337","DOIUrl":"https://doi.org/10.5414/CNCS111337","url":null,"abstract":"A 47-year-old woman with a 12-year history of anemia and high C-reactive protein (CRP) levels was admitted to our hospital with worsening fatigue and night sweats. She had high levels of immunoglobulin G (IgG; 4182 mg/dL), IgA (630.6 mg/dL), and CRP (7.44 mg/dL); a low hemoglobin level (8.9 g/dL); urinary protein (11.83 g/day); and urinary sediment (20 - 29 red blood cells per high power field). On the basis of the clinical findings and biopsied lymph nodes, we diagnosed multicentric Castleman's disease (MCD). Light microscopy of kidney biopsy samples revealed various nephropathies, including membranoproliferative glomerulonephritis with crescentic formation and focal segmental sclerosis and tubulointerstitial nephritis. Immunofluorescence and electron microscopy revealed IgG-positive deposits in the subepithelial areas, mesangial areas, and tubular basement membrane. The patient's clinical findings including kidney disease improved after treatment with tocilizumab. MCD is considered to be caused by abnormally high levels of interleukin (IL)-6. Tocilizumab, an IL-6 receptor antagonist, was effective in this patient, indicating that the immune complex-related kidney findings were also related to MCD.","PeriodicalId":510898,"journal":{"name":"Clinical nephrology. Case studies","volume":"12 ","pages":"73-82"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142961047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment of emphysematous polycystic renal infection in patients with autosomal dominant polycystic kidney disease: Feasibility and limitations of percutaneous cyst drainage. 常染色体显性多囊肾病患者肺气肿性多囊肾感染的治疗：经皮囊肿引流术的可行性和局限性。

Clinical nephrology. Case studies Pub Date : 2024-12-20 eCollection Date: 2024-01-01 DOI: 10.5414/CNCS111450

Hisashi Sugimoto, Tatsuya Suwabe, Shigekazu Kurihara, Yuki Oba, Daisuke Ikuma, Hiroki Mizuno, Akinari Sekine, Masayuki Yamanouchi, Katsuyuki Miki, Takayoshi Yokoyama, Yuki Nakamura, Yasuo Ishii, Takehiko Wada, Naoki Sawa, Yoshifumi Ubara

{"title":"Treatment of emphysematous polycystic renal infection in patients with autosomal dominant polycystic kidney disease: Feasibility and limitations of percutaneous cyst drainage.","authors":"Hisashi Sugimoto, Tatsuya Suwabe, Shigekazu Kurihara, Yuki Oba, Daisuke Ikuma, Hiroki Mizuno, Akinari Sekine, Masayuki Yamanouchi, Katsuyuki Miki, Takayoshi Yokoyama, Yuki Nakamura, Yasuo Ishii, Takehiko Wada, Naoki Sawa, Yoshifumi Ubara","doi":"10.5414/CNCS111450","DOIUrl":"https://doi.org/10.5414/CNCS111450","url":null,"abstract":"Emphysematous polycystic renal infection (EPRI) has a poor prognosis with conservative management, and early surgical nephrectomy has been recommended. However, percutaneous cyst drainage may be a possible treatment option. We experienced 6 patients with autosomal dominant polycystic kidney disease (ADPKD) presenting with EPRI. Three patients developed EPRI after renal transarterial embolization (TAE), and the other 3 developed EPRI independently of renal TAE. Two of the patients had only one cyst with gas formation, and the causative organism was sensitive to antibiotics; these patients were cured by cyst drainage and antibiotic therapy. However, in 3 patients with severe renal enlargement and gas formation in multiple cysts, the causative organism was antibiotic resistant and cyst drainage was not effective, so surgical nephrectomy was performed and the disease effectively treated. Surgical nephrectomy should be considered in patients with multiple cysts with gas formation and severe renal enlargement.","PeriodicalId":510898,"journal":{"name":"Clinical nephrology. Case studies","volume":"12 ","pages":"83-89"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142961049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pediatric double-seropositive anti-glomerular basement membrane antibody disease: A case report and literature review. 小儿抗肾小球基底膜抗体双阳性病：病例报告和文献综述。

Clinical nephrology. Case studies Pub Date : 2024-11-14 eCollection Date: 2024-01-01 DOI: 10.5414/CNCS111439

Nadia Echcharii, Soukaina Essadiqi, Nabila Chekhlabi, Rajaa Tissir, Halima Hadri, Abire Allaoui, Nezha Dini

{"title":"Pediatric double-seropositive anti-glomerular basement membrane antibody disease: A case report and literature review.","authors":"Nadia Echcharii, Soukaina Essadiqi, Nabila Chekhlabi, Rajaa Tissir, Halima Hadri, Abire Allaoui, Nezha Dini","doi":"10.5414/CNCS111439","DOIUrl":"10.5414/CNCS111439","url":null,"abstract":"Introduction: Glomerular basement membrane (GBM) disease is a severe and exceedingly rare disorder characterized by the presence of circulating antibodies targeting the non-collagen NC1 domain of the α3 chain of collagen type IV in glomerular and alveolar basement membranes. It typically presents as rapidly progressive glomerulonephritis (RPGN), often accompanied by pulmonary hemorrhage. The occurrence of double-seropositivity for anti-GBM antibody and anti-neutrophil cytoplasmic antibody (ANCA), primarily with myeloperoxidase specificity (MPO-ANCA), is particularly uncommon in pediatric cases.Case presentation: A 9-year-old boy was admitted to the pediatric ward exhibiting macroscopic hematuria, proteinuria, and acute kidney injury, with a gradual decline in kidney function. Pulmonary function remained normal. Circulating anti-GBM antibodies and ANCA, specifically targeting myeloperoxidase (MPO), were detected. Diagnosis was confirmed via percutaneous renal biopsy, which revealed circular glomerular crescents in 9 out of 16 glomeruli. Immunofluorescence examination exhibited a linear staining pattern of the capillary wall for IgG. Treatment involved 5 boluses of methylprednisolone, followed by prolonged oral prednisone, 11 plasma exchange sessions, and initiation of rituximab due to a moderate response to therapy. Subsequently, the patient's condition significantly improved, with normalized renal function observed 24 months post treatment.Conclusion: Despite limited literature on pediatric anti-GBM and double-positive disease, it is imperative to consider these diagnoses in pediatric patients presenting with RPGN. This article offers a comprehensive summary of the main characteristics of this disease in children and emphasizes therapeutic approaches through a review of identified cases in individuals under 18 years of age.","PeriodicalId":510898,"journal":{"name":"Clinical nephrology. Case studies","volume":"12 ","pages":"60-72"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Examine m.3243A>G carriers prospectively and comprehensively, treat them symptomatically, and avoid mitochondrion-toxic drugs. 前瞻性地全面检查 m.3243A>G 携带者，对其进行对症治疗，避免使用线粒体毒性药物。

Clinical nephrology. Case studies Pub Date : 2024-10-30 eCollection Date: 2024-01-01 DOI: 10.5414/CNCS111564

Josef Finsterer

引用次数: 0

Diet-induced hyperoxaluria: A case based mini-review. 饮食诱发的高草酸尿症：基于病例的微型综述。

Clinical nephrology. Case studies Pub Date : 2024-10-02 eCollection Date: 2024-01-01 DOI: 10.5414/CNCS111505

Aman Pal, Emmanuel Aydin-Ghormoz, Andrea Lightle, Geovani Faddoul

{"title":"Diet-induced hyperoxaluria: A case based mini-review.","authors":"Aman Pal, Emmanuel Aydin-Ghormoz, Andrea Lightle, Geovani Faddoul","doi":"10.5414/CNCS111505","DOIUrl":"10.5414/CNCS111505","url":null,"abstract":"Introduction: Oxalate nephropathy (ON) is a rare condition involving the precipitation of calcium oxalate crystals within the nephrons. Primary hyperoxaluria involves enzymatic defects in the metabolism of glyoxylate, while secondary hyperoxaluria includes dietary and malabsorption-related etiologies.Case presentation: We discuss the case of a White male in his 80s who presented to the hospital with acute kidney injury on chronic kidney disease stage 4 in the setting of a new antibiotic prescription. Creatinine had increased to 4.2 mg/dL from a baseline of 2.2 mg/dL, with no etiology identified on urinalysis or renal ultrasound. Renal biopsy then revealed an acute tubular injury with intraluminal calcium oxalate crystals deposits, confirming a diagnosis of ON.Discussion: A detailed history revealed an excessive dietary intake of oxalate-rich foods, including nuts, and daily ingestion of 2 g of vitamin C. The patient was counselled on adjusting his diet and stopping vitamin C supplementation, which led his creatinine to return close to baseline 2 months post-discharge.Conclusion: Thorough history-taking enables early recognition and timely interventions to possibly avoid hyperoxaluria from progressing to end-stage kidney disease (ESRD).","PeriodicalId":510898,"journal":{"name":"Clinical nephrology. Case studies","volume":"12 ","pages":"52-57"},"PeriodicalIF":0.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A rare case of alirocumab (PCSK9 inhibitor)-associated acute interstitial nephritis. 一例罕见的阿利库单抗（PCSK9 抑制剂）相关急性间质性肾炎病例。

Clinical nephrology. Case studies Pub Date : 2024-09-16 eCollection Date: 2024-01-01 DOI: 10.5414/CNCS111443

Nazia Habib, Chase Yuan, Andrea Lightle, Mauricio Monrroy, Swati Mehta

引用次数: 0

Renal and cardiac biopsy findings in an adolescent patient with the 3243A>G mitochondrial DNA mutation: Favorable renal prognosis post renal transplantation from the mother. 一名线粒体 DNA 3243A>G 突变的青少年患者的肾脏和心脏活检结果：母亲肾移植后肾脏预后良好。

Clinical nephrology. Case studies Pub Date : 2024-06-25 eCollection Date: 2024-01-01 DOI: 10.5414/CNCS111422

Hisashi Kamido, Shigekazu Kurihara, Yuki Oba, Masayuki Yamanouchi, Tatsuya Suwabe, Katsuyuki Miki, Yuki Nakamura, Yasuo Ishi, Kei Kono, Kenichi Ohashi, Naoki Sawa, Yoshifumi Ubara

{"title":"Renal and cardiac biopsy findings in an adolescent patient with the 3243A>G mitochondrial DNA mutation: Favorable renal prognosis post renal transplantation from the mother.","authors":"Hisashi Kamido, Shigekazu Kurihara, Yuki Oba, Masayuki Yamanouchi, Tatsuya Suwabe, Katsuyuki Miki, Yuki Nakamura, Yasuo Ishi, Kei Kono, Kenichi Ohashi, Naoki Sawa, Yoshifumi Ubara","doi":"10.5414/CNCS111422","DOIUrl":"10.5414/CNCS111422","url":null,"abstract":"We investigated the pathogenesis of a perihilar variant of focal segmental glomerulosclerosis detected by kidney biopsy in a 16-year-old male. The disease was refractory to steroid therapy, and at the second kidney biopsy, abnormal mitochondrial proliferation was newly observed in the podocytes. The patient also developed late-onset hearing loss and had a family history of diabetes, and genetic testing confirmed the mitochondrial DNA mutation 3243A>G (48%). Eight months after hemodialysis was started, encephalopathy occurred presumably due to rapid dehydration. After changing dialysis into continuous ambulatory peritoneal dialysis, encephalopathy was resolved, but the patient developed myocardial hypertrophy, probably because of the myocardial overreaction to congestion. A myocardial biopsy showed mitochondrial proliferation in the myocardium. After renal transplantation from his mother with a heteroplasmy of 4%, the cardiomyopathy improved, and the renal function has remained stable for 4 years. We speculated that the abnormal mitochondrial morphology in the kidney and heart may be characteristic of mitochondrial genetic disease, and renal transplantation from the mother with a low heteroplasmy was considered desirable for mitochondrial nephropathy with poor prognosis.","PeriodicalId":510898,"journal":{"name":"Clinical nephrology. Case studies","volume":"12 ","pages":"42-47"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11218049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of acquired thrombotic thrombocytopenic purpura following near-drowning. 一例溺水后获得性血栓性血小板减少性紫癜。

Clinical nephrology. Case studies Pub Date : 2024-05-03 eCollection Date: 2024-01-01 DOI: 10.5414/CNCS111301

Natnicha Leelaviwat, Shanti Parkash, Sharma Prabhakar

引用次数: 0

A pediatric case of atypical hemolytic uremic syndrome (aHUS): Could any infection play a triggering role? 一例非典型溶血性尿毒症（aHUS）儿科病例：任何感染都可能是诱因吗？

Clinical nephrology. Case studies Pub Date : 2024-04-05 eCollection Date: 2024-01-01 DOI: 10.5414/CNCS111209

Nikolaos Gkiourtzis, Paraskevi Panagopoulou, Kyriaki Papadopoulou-Legbelou, Sofia Chantavaridou, Despoina Tramma

{"title":"A pediatric case of atypical hemolytic uremic syndrome (aHUS): Could any infection play a triggering role?","authors":"Nikolaos Gkiourtzis, Paraskevi Panagopoulou, Kyriaki Papadopoulou-Legbelou, Sofia Chantavaridou, Despoina Tramma","doi":"10.5414/CNCS111209","DOIUrl":"https://doi.org/10.5414/CNCS111209","url":null,"abstract":"A 12-year-old boy was transferred to our pediatric department from a rural hospital for fever, cough, and vomiting associated with thrombocytopenia, non-immune hemolytic anemia, and acute kidney injury, leading to the diagnosis of hemolytic uremic syndrome (HUS). A nasopharyngeal swab and a lower respiratory sample detected Influenza A by polymerase chain reaction (PCR). The patient was treated with oseltamivir and intravenous fluids in addition to fresh frozen plasma (FFP). Enteropathogenic Escherichia coli (EPEC) was detected in a stool sample by PCR. Serum antibodies for Mycoplasma pneumoniae (IgM and IgG) and Helicobacter pylori (IgA and IgG) were increased. Further work-up revealed elevated serum C5b-9 suggesting a simultaneous viral and bacterial infection-mediated complement overactivation leading to the diagnosis of atypical HUS (aHUS). An association between aHUS and influenza A is reported in the literature, but the correlation of EPEC, Mycoplasma pneumoniae, and Helicobacter pylori with aHUS is not well-established. Fresh frozen plasma was administered for a total of 3 days, followed by clinical and laboratory improvement. The patient has remained asymptomatic until the latest follow-up, 5 months after discharge. This case demonstrates the potential triggering role of different pathogens in aHUS pathogenesis to raise awareness in the pediatric community.","PeriodicalId":510898,"journal":{"name":"Clinical nephrology. Case studies","volume":"12 ","pages":"32-35"},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11002780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0