Case reports in nephrology and urology最新文献_第3页

Rapidly progressive lupus nephritis with extremely high levels of antineutrophil cytoplasmic antibodies. 快速进展性狼疮性肾炎伴极高水平的抗中性粒细胞细胞质抗体。

Case reports in nephrology and urology Pub Date : 2014-01-29 eCollection Date: 2014-01-01 DOI: 10.1159/000358557

Katrin F Koenig, Stefan A Kalbermatter, Thomas Menter, Michael Mayr, Denes Kiss

{"title":"Rapidly progressive lupus nephritis with extremely high levels of antineutrophil cytoplasmic antibodies.","authors":"Katrin F Koenig, Stefan A Kalbermatter, Thomas Menter, Michael Mayr, Denes Kiss","doi":"10.1159/000358557","DOIUrl":"https://doi.org/10.1159/000358557","url":null,"abstract":"A 43-year-old woman, with a 3-month history of fatigue, anaemia and swollen lymph nodes, underwent biopsy of a lymph node, which revealed reactive lymphadenopathy. Due to an increased serum creatinine concentration and severe proteinuria, a kidney biopsy was performed, which revealed diffuse, segmental, proliferative, immune-complex glomerulonephritis with crescents. Electron microscopy showed tubulo-reticular structures within one endothelial cell. These were a typical clinical presentation and compatible histopathological findings for systemic lupus erythematosus; however, the anti-myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) level was extraordinarily high. In spite of treatment with intravenous cyclophosphamide and methylprednisolone pulse therapy, the patient's kidney function declined. Starting plasma exchange improved her renal function and removed MPO-ANCAs, which were suspected to play the major role in the pathogenesis of glomerulonephritis. These findings indicate that in addition to lupus nephritis, MPO-ANCAs may be involved in the pathogenesis of glomerulonephritis and that the coincidence of systemic lupus erythematosus and ANCA may be responsible for the severe clinical course in our patient. ","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"4 1","pages":"5-11"},"PeriodicalIF":0.0,"publicationDate":"2014-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000358557","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32157602","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: 7

Optimizing evaluation of split renal function in a living kidney donor using scintigraphy and calculation of the geometric mean: a case report. 利用闪烁显像和几何平均计算优化评价活体肾脏供者的分裂肾功能:1例报告。

Case reports in nephrology and urology Pub Date : 2014-01-10 eCollection Date: 2014-01-01 DOI: 10.1159/000358007

S Weinberger, M Bäder, C Scheurig-Münkler, S Hinz, J Neymeyer, K Miller, C Kempkensteffen

{"title":"Optimizing evaluation of split renal function in a living kidney donor using scintigraphy and calculation of the geometric mean: a case report.","authors":"S Weinberger, M Bäder, C Scheurig-Münkler, S Hinz, J Neymeyer, K Miller, C Kempkensteffen","doi":"10.1159/000358007","DOIUrl":"https://doi.org/10.1159/000358007","url":null,"abstract":"Within the evaluation process of living kidney donors, split renal function is usually evaluated by renal scintigraphy. Since split renal function measured by conventional posterior scans depends on the position of the kidney, actual suitable donors may be rejected because of an inaccurate examination technique. We report the case of a 28-year-old male living kidney donor. Due to a complex vascular anatomy of the right kidney, only his left kidney was considered eligible for transplantation. In conventional posterior Tc99m-mercapto-acetyltriglycine scintigraphy, the left kidney had a relative function of 60%. A second scintigraphy using anterior and posterior dimercaptosuccinic acid scans with calculation of the geometric mean showed an adapted relative function of the left kidney of 53%, now meeting the inclusion criteria for living kidney donation. This case shows that the geometric mean method using simultaneous anterior and posterior views obtained with a dual-head gamma camera can be a very helpful approach to determine split renal function of potential living kidney donors. Further investigation is necessary to prove the benefit of a general bilateral scan before living kidney donation. ","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"4 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2014-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000358007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32157601","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: 6

A case of water intoxication with prolonged hyponatremia caused by excessive water drinking and secondary SIADH. 水中毒伴长期低钠血症伴过量饮水继发SIADH 1例。

Case reports in nephrology and urology Pub Date : 2013-12-21 eCollection Date: 2013-07-01 DOI: 10.1159/000357667

Mari Yamashiro, Hajime Hasegawa, Akihiko Matsuda, Masanobu Kinoshita, Osamu Matsumura, Kazuo Isoda, Tetsuya Mitarai

{"title":"A case of water intoxication with prolonged hyponatremia caused by excessive water drinking and secondary SIADH.","authors":"Mari Yamashiro, Hajime Hasegawa, Akihiko Matsuda, Masanobu Kinoshita, Osamu Matsumura, Kazuo Isoda, Tetsuya Mitarai","doi":"10.1159/000357667","DOIUrl":"https://doi.org/10.1159/000357667","url":null,"abstract":"Water intoxication is a life-threatening disorder accompanied by brain function impairment due to severe dilutional hyponatremia. We treated a 22-year-old man without psychotic illness who had been put in a detention facility. He drank 6 liters of water over a 3-hour period at the facility as a game's penalty, and he showed progressive psychiatric and neurological signs including restlessness, peculiar behavior and convulsions. On his admission, 15 h after the discontinuation of the water drinking, he was in a coma, showing intermittent convulsions and remarkable hyponatremia (120 mmol/l). Because his laboratory tests showed hypertonic urine and normal sodium excretion, the diagnosis of secondary development of syndrome of inappropriate secretion of antidiuretic hormone (SIADH) was strongly suggested and later confirmed by the suppression of the renin-aldosterone system and the inappropriately elevated secretion of ADH. Saline infusion and an initial administration of furosemide in addition to dexamethasone as treatments for the patient's brain edema successfully improved his laboratory data and clinical signs by the 3rd hospital day, and he was returned to the facility without physical or psychiatric abnormalities on the 6th day. The secondary SIADH might have been due to the prolonged emesis, recurrent convulsions and rapid elevation of intracranial pressure.","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"3 2","pages":"147-52"},"PeriodicalIF":0.0,"publicationDate":"2013-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000357667","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32154281","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: 9

An unusual prostate-specific antigen decrease in an advanced castration-resistant prostate cancer patient with intracerebral hemorrhage subsequently treated with luteinizing hormone-releasing hormone antagonist. 一个不寻常的前列腺特异性抗原减少晚期去势抵抗前列腺癌患者脑出血后治疗黄体生成素释放激素拮抗剂。

Case reports in nephrology and urology Pub Date : 2013-12-17 eCollection Date: 2013-07-01 DOI: 10.1159/000357668

Kouji Izumi, Atsushi Mizokami, Mikio Namiki

引用次数: 0

A case of atypical hemolytic uremic syndrome successfully treated with eculizumab. 异珠单抗成功治疗非典型溶血性尿毒症综合征1例。

Case reports in nephrology and urology Pub Date : 2013-12-14 eCollection Date: 2013-07-01 DOI: 10.1159/000357520

B Thajudeen, A Sussman, E Bracamonte

{"title":"A case of atypical hemolytic uremic syndrome successfully treated with eculizumab.","authors":"B Thajudeen, A Sussman, E Bracamonte","doi":"10.1159/000357520","DOIUrl":"https://doi.org/10.1159/000357520","url":null,"abstract":"Atypical hemolytic uremic syndrome (aHUS) is a rare thrombotic microangiopathy (TMA) characterized by the triad of hemolytic anemia, thrombocytopenia, and acute renal failure. Eculizumab, a monoclonal complement C5 antibody which prevents the induction of the terminal complement cascade, has recently emerged as a therapeutic option for aHUS. We report a case of aHUS successfully treated with eculizumab. A 51-year-old male was admitted to the hospital following a mechanical fall. His past medical history was significant for rheumatic valve disease and mitral valve replacement; he was on warfarin for anticoagulation. A computed tomography scan of the head revealed a right-sided subdural hematoma due to coagulopathy resulting from a supratherapeutic international normalized ratio (INR). Following treatment with prothrombin complex concentrate to reverse the INR, urine output dropped and his serum creatinine subsequently increased to 247.52 μmol/l from the admission value of 70.72 μmol/l. Laboratory evaluation was remarkable for hemolytic anemia, thrombocytopenia, elevated lactate dehydrogenase (LDH), low haptoglobin, and low complement C3. A renal biopsy was consistent with TMA, favoring a diagnosis of aHUS. Treatment with eculizumab was initiated which resulted in the stabilization of his hemoglobin, platelets, and LDH. Hemodialysis was terminated after 2.5 months due to improvement in urine output and solute clearance. The interaction between thrombin and complement pathway might be responsible for the pathogenesis of aHUS in this case. Eculizumab is an effective therapeutic agent in the treatment of aHUS. Early targeting of the complement system may modify disease progression and thus treat aHUS more effectively. ","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"3 2","pages":"139-46"},"PeriodicalIF":0.0,"publicationDate":"2013-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000357520","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32154280","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: 16

Glomerulopathy with homozygous apolipoprotein e2: a report of three cases and review of the literature. 纯合子载脂蛋白e2肾小球病:附3例报告及文献复习。

Case reports in nephrology and urology Pub Date : 2013-11-28 eCollection Date: 2013-07-01 DOI: 10.1159/000356849

Kunio Kawanishi, Anri Sawada, Ayami Ochi, Takahito Moriyama, Michihiro Mitobe, Toshio Mochizuki, Kazuho Honda, Hideaki Oda, Toshio Nishikawa, Kosaku Nitta

引用次数: 13

Delayed development of pulmonary hemorrhage in a patient with positive circulating anti-neutrophil cytoplasmic antibody: a clinical dilemma. 循环抗中性粒细胞细胞质抗体阳性患者肺出血的延迟发展:一个临床困境。

Case reports in nephrology and urology Pub Date : 2013-10-02 eCollection Date: 2013-01-01 DOI: 10.1159/000355509

Toshimi Imai, Shin-Ichi Takeda, Kazuo Kawaguchi, Yuko Chaki, Yoshiyuki Morishita, Tetsu Akimoto, Shigeaki Muto, Eiji Kusano

{"title":"Delayed development of pulmonary hemorrhage in a patient with positive circulating anti-neutrophil cytoplasmic antibody: a clinical dilemma.","authors":"Toshimi Imai, Shin-Ichi Takeda, Kazuo Kawaguchi, Yuko Chaki, Yoshiyuki Morishita, Tetsu Akimoto, Shigeaki Muto, Eiji Kusano","doi":"10.1159/000355509","DOIUrl":"https://doi.org/10.1159/000355509","url":null,"abstract":"Detection of circulating anti-neutrophil cytoplasmic antibody (ANCA) provides a powerful clue in the diagnosis of vasculitis, but the clinical interpretation of the results is difficult in some cases. Here, we describe the case of a 65-year-old man who underwent hemodialysis due to focal segmental glomerulosclerosis and abruptly developed hemoptysis 14 years after a renal biopsy. At the time of the biopsy, computed tomography (CT) showed interstitial shadows in the lungs and pleural thickening, indicating pneumoconiosis that was accompanied by tuberculosis. Circulating myeloperoxidase-ANCA (10.5-32.5 U/ml) was subsequently noted, but the significance of this observation was unclear due to the preexisting disorders in the lungs and kidneys. Potent immunosuppressive therapies were avoided because of the pulmonary lesions and decreased renal function. There were few changes noted on follow-up CT, but infiltrative shadows emerged in the bilateral lungs, consistent with hemoptysis. The hemorrhagic shadows completely disappeared shortly after initiation of steroid therapy, with normalization of the serum ANCA level. Herein, we report this case, with an emphasis on the clinical dilemma faced in deciding the appropriate treatment. The findings in the case provide deep insights into clinical management of ANCA-positive patients. ","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":" ","pages":"121-7"},"PeriodicalIF":0.0,"publicationDate":"2013-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000355509","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40269460","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: 1

Generalized subcutaneous emphysema caused by injection of air into the penis for autoerotic purposes. 为自慰而向阴茎内注射空气所引起的全身皮下肺气肿。

Case reports in nephrology and urology Pub Date : 2013-09-25 eCollection Date: 2013-01-01 DOI: 10.1159/000355514

Y Ural, N Muthen, U Engelmann, S Wille

引用次数: 4

A case of podocytic infolding glomerulopathy with focal segmental glomerulosclerosis. 足细胞病合并局灶节段性肾小球硬化1例。

Case reports in nephrology and urology Pub Date : 2013-08-08 eCollection Date: 2013-01-01 DOI: 10.1159/000354591

Akira Iguchi, Ayako Sohma, Hajime Yamazaki, Tomoyuki Ito, Takako Saeki, Yumi Ito, Naohumi Imai, Yutaka Osawa, Ichiei Narita

{"title":"A case of podocytic infolding glomerulopathy with focal segmental glomerulosclerosis.","authors":"Akira Iguchi, Ayako Sohma, Hajime Yamazaki, Tomoyuki Ito, Takako Saeki, Yumi Ito, Naohumi Imai, Yutaka Osawa, Ichiei Narita","doi":"10.1159/000354591","DOIUrl":"https://doi.org/10.1159/000354591","url":null,"abstract":"Podocytic infolding glomerulopathy (PIG) has been proposed as a new disease entity. A 14-year-old girl underwent renal biopsy at our institution because of a chance finding of proteinuria. Light microscopic findings revealed a minor glomerular abnormality, but under a higher magnification, after periodic acid methenamine silver staining, a bubbling appearance in the glomerular basement membrane (GBM) was observed. An electron microscopic examination revealed microspheres in the GBM, which were sparse but global. The patient was diagnosed as having PIG. After 3 years, her urinary protein had increased and a second biopsy was performed, showing focal segmental glomerulosclerosis in addition to a lesser degree of podocytic infolding than at the first biopsy. This is the first report of a case complicated by a different type of glomerulonephritis after being diagnosed as PIG. A few cases of PIG are complicated by focal segmental glomerulosclerosis, suggesting several mechanisms for the disorder. ","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"3 2","pages":"110-6"},"PeriodicalIF":0.0,"publicationDate":"2013-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000354591","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31725549","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: 13

Intussusception presenting with malignant hypertension and lethargy. 肠套叠表现为恶性高血压和嗜睡。

Case reports in nephrology and urology Pub Date : 2013-07-17 Print Date: 2013-07-01 DOI: 10.1159/000353849

Andra de Vries, Nilou Ashtiani, Nazanin Ahmadi, Roel Bakx, Annelies Walrave-Bij de Vaate, Arend Bökenkamp

引用次数: 0