Vikas Srivastava, George Passaris, Rajiv Juneja, Mark Siddins, Jeffrey A J Barbara
{"title":"Bladder Rupture following Conversion to Enteric Drainage after Pancreatic Transplantation.","authors":"Vikas Srivastava, George Passaris, Rajiv Juneja, Mark Siddins, Jeffrey A J Barbara","doi":"10.1159/000336626","DOIUrl":"https://doi.org/10.1159/000336626","url":null,"abstract":"<p><p>Complications associated with bladder-drained pancreatic transplant are not uncommon and include urinary tract infections and reflux pancreatitis. Bladder rupture with peritoneal leak is a rare complication after pancreatic transplantation and can present as an acute abdomen with rapidly deteriorating renal function. We describe the first case of a urine leak into the peritoneal cavity occurring after conversion from bladder to enteric drainage. A high index of suspicion is required to diagnose such a complication.</p>","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"2 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000336626","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31088288","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}
Konstantin N Konstantinov, Alexis A Harris, Michael F Hartshorne, Antonios H Tzamaloukas
{"title":"Symptomatic anti-neutrophil cytoplasmic antibody-positive disease complicating subacute bacterial endocarditis: to treat or not to treat?","authors":"Konstantin N Konstantinov, Alexis A Harris, Michael F Hartshorne, Antonios H Tzamaloukas","doi":"10.1159/000339409","DOIUrl":"10.1159/000339409","url":null,"abstract":"<p><p>A 54-year-old man was diagnosed with Streptococcus mutans endocarditis of the mitral valve. Serological tests disclosed the presence of multiple autoantibodies including c-ANCA, anti-PR3 and anti-MPO. While the fever subsided with antibiotics, mental status and renal function deteriorated rapidly. Kidney biopsy revealed pauci-immune glomerulonephritis and acute eosinophilic interstitial nephritis. The abnormal clinical features improved rapidly after addition of corticosteroids and cyclophosphamide to the antibiotics. Immunosuppressive agents may be required in a fraction of the patients with infective endocarditis who develop ANCA and ANCA-mediated renal disease. Histological identification of the type of renal disease is imperative for the choice of the treatment.</p>","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"2 1","pages":"25-32"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4d/5b/cru-0002-0025.PMC3482086.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31086614","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}
{"title":"Severe proteinuria secondary to amyloidosis requiring bilateral renal artery embolization.","authors":"Chun-Tung Yeh, Hsiuo-Shan Tseng, Wen-Sheng Liu, Szu-Yuan Li, Wu Chang Yang, Yee-Yung Ng","doi":"10.1159/000339895","DOIUrl":"https://doi.org/10.1159/000339895","url":null,"abstract":"<p><p>In the case reported here, after prolonged medical therapy resistance, severe proteinuria subsided following bilateral renal artery embolization (RAE). Thereafter, respiratory distress, anasarca edema, muscle mass, and serum albumin level improved after regular hemodialysis. Although RAE is reported to be a safe and effective therapeutic procedure, it is rarely used for severe proteinuria with prolonged medical therapy resistance. The limited use of bilateral RAE for nephrological purposes may be partly related to its tendency to destroy renal function, which results in anuria and subsequent regular dialysis. However, delayed RAE could cause the patient to reach a life-threatening cachexic state and could increase the risk of morbidity and mortality due to severe proteinuria-induced hypoalbuminemia. Our case and selected previous reports reveal important information for physicians and patients while discussing prognoses and considering the pros and cons of bilateral RAE.</p>","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"2 1","pages":"78-82"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000339895","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31086510","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}
{"title":"A Japanese Family Suffering from Familial Juvenile Hyperuricemic Nephropathy due to a Rare Mutation of the Uromodulin Gene.","authors":"Mayuka Nakayama, Yasukiyo Mori, Noriyoshi Ota, Mami Ishida, Yayoi Shiotsu, Eiko Matsuoka, Hiroshi Kado, Ryo Ishida, Mayumi Nakata, Takashi Kitani, Keiichi Tamagaki, Chieko Sekita, Atsuo Taniguchi","doi":"10.1159/000337343","DOIUrl":"https://doi.org/10.1159/000337343","url":null,"abstract":"<p><p>We report the case of a Japanese family suffering from familial juvenile hyperuricemic nephropathy (FJHN) due to a rare missense mutation of the uromodulin (UMOD) gene. An 18-year-old male presented with gout, hyperuricemia, and stage 3 chronic kidney disease. Mostly, FJHN is caused by a mutation altering the cystine residue of UMOD/Tamm-Horsfall protein. However, in the present case, a T688C mutation was identified in exon 4, resulting in amino acid substitution with arginine replacing tryptophan at position 230 (Trp230Arg). This mutation was also found in his brother and father with the same phenotype, indicating autosomal dominant inheritance. The affected amino acid was conserved in 200 healthy Japanese controls. Therefore, mutation T688C most likely causes rare structural and/or functional abnormalities in UMOD/Tamm-Horsfall protein.</p>","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"2 1","pages":"15-9"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000337343","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31088291","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}
{"title":"Balloon-assisted creation and maturation of an arteriovenous fistula in a patient with small-caliber vasculature.","authors":"Atsushi Kotoda, Tetsu Akimoto, Taro Sugase, Naoshi Miyamoto, Eiji Kusano","doi":"10.1159/000339501","DOIUrl":"10.1159/000339501","url":null,"abstract":"<p><p>The major problem associated with the creation of an arteriovenous fistula (AVF), which is the optimal form of vascular access for hemodialysis, is the fact that fistulas do not necessarily mature into a usable vascular access, requiring subsequent revision and construction of another access. The caliber of the vessels used for fistula creation is a pivotal factor predicting the presumable maturation of the constructed fistula, and veins less than 2.5 mm in diameter have poor outcomes. This report describes the balloon-assisted creation and maturation of an autogenous radial-cephalic AVF in a patient with a small-caliber vein and a radial artery measuring approximately 2 and 1.5 mm in diameter, respectively. The clinical impact of percutaneous radiological intervention for expediting the maturation of an autogenous AVF with small-caliber vessels is also discussed.</p>","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"2 1","pages":"65-71"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/4f/cru-0002-0065.PMC3482083.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31086620","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}
Soo Min Kim, Heejung Choi, Yoonjung Kim, Junam Shin, Hye Ryoun Jang, Jung Eun Lee, Wooseong Huh, Dae Joong Kim, Ha Young Oh, Yoon-Goo Kim
{"title":"Posterior Reversible Encephalopathy Syndrome during Recovery from Acute Kidney Injury after Hepatitis A Infection.","authors":"Soo Min Kim, Heejung Choi, Yoonjung Kim, Junam Shin, Hye Ryoun Jang, Jung Eun Lee, Wooseong Huh, Dae Joong Kim, Ha Young Oh, Yoon-Goo Kim","doi":"10.1159/000339253","DOIUrl":"https://doi.org/10.1159/000339253","url":null,"abstract":"<p><p>The patient was a 25-year-old healthy male who experienced fever, chills, and abdominal pain for 5 days prior to the hospital visit. He was diagnosed with acute hepatitis A, and at admission he presented with anuric acute kidney injury and hepatic encephalopathy. He received continuous renal replacement therapy followed by intermittent regular hemodialysis. His urine output increased to 1,610 ml/day after 31 days. On day 32, he suddenly developed a headache and visual disturbance and experienced three short convulsions, which were followed by postictal confusion and high fever. T2 and FLAIR MRI images of the brain revealed hyperintense signal alterations in bilateral subcortical regions of the temporoparietal and occipital lobes, consistent with posterior reversible encephalopathy syndrome. His mental status was fully recovered after 7 h of conservative treatment, including antihypertensive therapy. On hospital day 56, the renal function of the patient had recovered, and he was discharged without neurologic sequelae.</p>","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"2 1","pages":"33-7"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000339253","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31086615","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}
Patricia Hirt-Minkowski, Marten Trendelenburg, Isabel Gröschl, Andreas Fischer, Ingmar Heijnen, Jürg A Schifferli
{"title":"A trial of complement inhibition in a patient with cryoglobulin-induced glomerulonephritis.","authors":"Patricia Hirt-Minkowski, Marten Trendelenburg, Isabel Gröschl, Andreas Fischer, Ingmar Heijnen, Jürg A Schifferli","doi":"10.1159/000339403","DOIUrl":"https://doi.org/10.1159/000339403","url":null,"abstract":"<p><p>Cryoglobulinemia induces an immune complex-mediated glomerulonephritis that is characterized by the presence of large immune deposits, including complement C3 and C5b-9, marked macrophage influx and mesangial cell proliferation. The precise role of complement in cryoglobulin-induced glomerulonephritis in humans remains unclear, whereas in mice there has been evidence that complement activation might be a central factor favoring glomerular inflammation, particularly by the recruitment of neutrophils. We report on an exceptional case of cryoglobulin-induced glomerulonephritis in a patient with mixed essential cryoglobulinemia type II. The clinical features included relapsing proteinuria and renal function impairment that were controlled by plasmapheresis. Complement was low in plasma and two renal biopsies at 1-year interval showed prominent immunoglobulin and complement deposits, with unusual high numbers of neutrophils. In a 1-patient clinical trial, we tested whether the monoclonal anti-C5 antibody eculizumab would be sufficient to control renal function at the time of a relapse. Although during the initial weeks renal function was stabilized, slow increase in creatinine could not be controlled by this treatment, so that plasmapheresis was reinstituted. This result suggests that despite evidence for a role of complement in enhancing renal damage in this patient, other inflammatory processes dominated.</p>","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"2 1","pages":"38-45"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000339403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31086616","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}
Andrea Ranghino, Michela Tamagnone, Maria Messina, Antonella Barreca, Luigi Biancone, Bruno Basolo, Giuseppe Paolo Segoloni, Gianna Mazzucco
{"title":"A case of recurrent proliferative glomerulonephritis with monoclonal IgG deposits after kidney transplant treated with plasmapheresis.","authors":"Andrea Ranghino, Michela Tamagnone, Maria Messina, Antonella Barreca, Luigi Biancone, Bruno Basolo, Giuseppe Paolo Segoloni, Gianna Mazzucco","doi":"10.1159/000339405","DOIUrl":"https://doi.org/10.1159/000339405","url":null,"abstract":"<p><p>Proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) is a rare and recently identified disease with a poor prognosis irrespective of the treatment. Recently, the possibility of recurrent or de novo PGNMID after kidney transplantation has been reported, which is associated with a better prognosis compared to PGNMID on native kidneys. Nevertheless, at present, due to the very few cases of recurrent PGNMID diagnosed, there is no proven effective treatment. Here, we report a case of recurrent PGNMID successfully treated with plasmapheresis, steroids and mycophenolate mofetil. Our report suggests that plasmapheresis might be a valid therapeutic option to treat recurrent PGNMID.</p>","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"2 1","pages":"46-52"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000339405","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31086617","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}
{"title":"Successful treatment of adult IgA nephropathy with nephrotic-level proteinuria by combination therapy including long-term coadministration of mizoribine.","authors":"Hideo Okonogi, Tetsuya Kawamura, Nanae Matsuo, Yasuto Takahashi, Izumi Yamamoto, Hiraku Yoshida, Kentaro Koike, Takashi Yokoo, Kensuke Joh, Yasunori Utsunomiya, Kazushige Hanaoka, Tatsuo Hosoya","doi":"10.1159/000339401","DOIUrl":"https://doi.org/10.1159/000339401","url":null,"abstract":"<p><p>A 41-year-old male patient was admitted to our hospital due to massive proteinuria and hematuria. His 24-hour urinary protein excretion and the number of urinary erythrocytes were 3.91 g/day and 50-99/high-power field, respectively. A renal biopsy showed a severe pathological pattern of immunoglobulin A nephropathy (IgAN) that involved marked endocapillary proliferation and segmental sclerosis (Oxford-MEST score: M0, E1, S1, T0). Because he had nephrotic-level proteinuria with severe pathological findings, which are tonsillectomy and corticosteroid pulse therapy-resistant characteristics, he received mizoribine for a long period as part of the combination therapy using corticosteroid, tonsillectomy, dipyridamole, warfarin and renin-angiotensin-aldosterone system blockers. Twelve months after the beginning of treatment, his urinary findings were normal. In this report, we describe the pathological findings and successful treatment course, and discuss the potential effects of long-term coadministration of mizoribine for adult IgAN treatment.</p>","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"2 1","pages":"53-8"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000339401","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31086618","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}
{"title":"Successful treatment of cryoglobulinaemia with rituximab.","authors":"M Choudhry, N Rao, R Juneja","doi":"10.1159/000339400","DOIUrl":"https://doi.org/10.1159/000339400","url":null,"abstract":"<p><p>Cryoglobulinaemia is a systemic inflammatory condition characterised by immune complex-mediated small-to-medium-sized vasculitis. It has a wide variety of presentations ranging from bruising, neuropathy, and hepatosplenomegaly to acute renal failure. Mixed cryoglobulinaemia is the most common type and is strongly associated with hepatitis C. Management approaches include use of cyclophosphamide, prednisolone, and plasmapheresis, with differing views on alternative treatments in resistant cases. Rituximab has emerged as an attractive option in resistant cases on account of its potent immunosuppressive effects on B cells. We describe a case of type 2 mixed cryoglobulinaemia in association with non-Hodgkin's lymphoma resistant to standard treatments which responded well to rituximab. This case is remarkable as mixed cryoglobulinaemia associated with non-Hodgkin's lymphoma presenting with nephritis is unusual, and, contrary to the high rate of recurrence in lymphoma-related cryoglobulinaemia, our patient has not shown any recurrence over 24 months. This highlights an alternative treatment modality which can be used in patients not responsive to existing managements for this condition with benefits of minimal side effects and no oncogenetic potential.</p>","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"2 1","pages":"72-7"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000339400","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31086621","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}