Case reports in nephrology and urology最新文献_第8页

Bilateral nephrectomy as a rescue therapy for hemodialyzed patient with malignant hypertension - case report. 双侧肾切除术抢救血液透析合并恶性高血压1例。

Case reports in nephrology and urology Pub Date : 2012-01-01 Epub Date: 2012-02-17 DOI: 10.1159/000336621

Lucian Stefan Macsim, Paweł Stróżecki, Ilona Miśkowiec-Wiśniewska, Anna Kardymowicz, Jacek Manitius

引用次数: 7

Steroid-responsive nephrotic syndrome and bilateral renal artery stenosis: a possible role for Angiotensin-mediated podocyte injury. 类固醇反应性肾病综合征和双侧肾动脉狭窄:血管紧张素介导的足细胞损伤的可能作用。

Case reports in nephrology and urology Pub Date : 2012-01-01 Epub Date: 2012-06-05 DOI: 10.1159/000339407

Rahul Bhardwaj, Imran Dosani, Barbara A Clark

{"title":"Steroid-responsive nephrotic syndrome and bilateral renal artery stenosis: a possible role for Angiotensin-mediated podocyte injury.","authors":"Rahul Bhardwaj, Imran Dosani, Barbara A Clark","doi":"10.1159/000339407","DOIUrl":"https://doi.org/10.1159/000339407","url":null,"abstract":"Nephrotic syndrome (NS) associated with renal artery stenosis is not widely recognized or investigated as a cause of the NS. The mechanisms are incompletely understood, but have largely focused on hemodynamic factors resulting in hyperfiltration injury-induced focal and segmental glomerulosclerosis (FSGS) in the nonstenosed kidney with sparing of the stenotic kidney protected from hemodynamic stress. However, separation of hemodynamic from circulating factors (such as angiotensin II) as the cause of the nephrosis remains difficult. We report a patient presenting with NS who was incidentally discovered to have high-grade bilateral renal artery stenosis from fibromuscular dysplasia. Kidney biopsy revealed FSGS. Proteinuria in our patient did not initially respond to angiotensin-converting enzyme inhibition (ACEI) and correction of stenoses with angioplasties. There was prompt response to steroid treatment. A brief relapse several months later (without associated hypertension) responded to ACEI alone. This is the first reported case of an association between fibromuscular dysplasia and steroid-responsive nephrotic syndrome due to FSGS. This may shed insight into the nature of podocyte injury in patients with high angiotensin states and suggest a possible role for activated renin-angiotensin-aldosterone system (RAAS) triggering an immune-mediated injury, rather than hemodynamic insult. Furthermore the lack of initial response to angioplasty and ACEI suggests that RAAS-activated injury may in some cases require more aggressive immune modulatory therapy with steroids over and above angiotensin inhibition alone. This case also highlights the importance of being aware of possible occult renovascular disease contributing to idiopathic NS with FSGS even when hypertension is only modest.","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"2 1","pages":"59-64"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000339407","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31086619","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: 2

Massive colchicine overdose with recovery. 过量服用秋水仙碱后恢复。

Case reports in nephrology and urology Pub Date : 2012-01-01 Epub Date: 2012-04-11 DOI: 10.1159/000338269

Ioulia Iosfina, James Lan, Carson Chin, Ronald Werb, Adeera Levin

{"title":"Massive colchicine overdose with recovery.","authors":"Ioulia Iosfina, James Lan, Carson Chin, Ronald Werb, Adeera Levin","doi":"10.1159/000338269","DOIUrl":"https://doi.org/10.1159/000338269","url":null,"abstract":"Colchicine is an active alkaloid that is commonly used for treatment of multiple diseases including gout, primary biliary cirrhosis and familial Mediterranean fever. Less commonly, it has been implicated in several fatal overdoses. Deaths from colchicine overdoses are usually due to multi-organ failure, whether directly from colchicine toxicity or due to ensuing sepsis. We report an extreme case of colchicine ingestion (1.38 mg/kg), which is the largest reported non-fatal colchicine overdose. The patient was a 47-year-old First Nations woman with a history of depression and no other comorbidities. Ingestion was intentional and initial presentation was within 2 h of ingestion, at which point she had normal clinical and laboratory parameters. Early implementation of a targeted therapeutic strategy directed at the predicted multi-organ failure which included aggressive use of a GI decontamination protocol, timely supportive measures including ventilator support and renal replacement therapy, as well as the utilization of broad-spectrum antibiotics and G-CSF for sepsis and leucopenia management, resulted in successful support and discharge of this patient off dialysis.","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"2 1","pages":"20-4"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000338269","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31088292","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

Thyroid storm masked by hemodialysis and glucocorticoid therapy in a patient with rheumatoid arthritis. 类风湿性关节炎患者的甲状腺风暴被血液透析和糖皮质激素治疗掩盖。

Case reports in nephrology and urology Pub Date : 2012-01-01 Epub Date: 2012-02-16 DOI: 10.1159/000336624

Yohei Sasaki, Yoshio Shimizu, Junichiro Nakata, Toshiaki Kameda, Masahiro Muto, Isao Ohsawa, Hiroaki Io, Chieko Hamada, Satoshi Horikoshi, Yasuhiko Tomino

{"title":"Thyroid storm masked by hemodialysis and glucocorticoid therapy in a patient with rheumatoid arthritis.","authors":"Yohei Sasaki, Yoshio Shimizu, Junichiro Nakata, Toshiaki Kameda, Masahiro Muto, Isao Ohsawa, Hiroaki Io, Chieko Hamada, Satoshi Horikoshi, Yasuhiko Tomino","doi":"10.1159/000336624","DOIUrl":"https://doi.org/10.1159/000336624","url":null,"abstract":"Thyroid function test values are generally at low levels in patients with end-stage kidney disease. Life-threatening thyrotoxicosis or thyroid storm is rare, especially in hemodialysis (HD) patients, and is characterized by multisystem involvement and a high mortality rate if not immediately recognized and treated. Here, we report a female patient with severe symptomatic thyroid storm, receiving long-term HD and glucocorticoid therapy. Methimazole at a dose of 15 mg per day, β-adrenergic blockade and HD succeeded in controlling the patient's condition by gradually adjusting the target dry weight for hyperthyroidism-induced weight loss. When she was discharged from the hospital, her dry weight was reduced from 47.2 to 39.2 kg. The management of patients with severe symptomatic thyroid storm on HD represents a rare scenario. It is essential to initiate the available treatments as early as possible to reduce its mortality.","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"2 1","pages":"6-10"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000336624","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31088289","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: 4

Spontaneous renal hemorrhage in hemodialysis patients. 血液透析患者自发性肾出血。

Case reports in nephrology and urology Pub Date : 2011-07-01 Epub Date: 2011-08-08 DOI: 10.1159/000330192

Takashi Kawahara, Kimiko Kawahara, Hiroki Ito, Satoshi Yamaguchi, Hiroshi Mitsuhashi, Kazuhide Makiyama, Hiroji Uemura, Masashi Sakai, Yoshinobu Kubota

引用次数: 14

Three cases of gastric antral vascular ectasia in chronic renal failure. 慢性肾衰竭胃正中血管扩张3例。

Case reports in nephrology and urology Pub Date : 2011-07-01 Epub Date: 2011-10-03 DOI: 10.1159/000332832

Akira Iguchi, Junichiro James Kazama, Masamichi Komatsu, Yoshikatsu Kaneko, Noriaki Iino, Shin Goto, Ichiei Narita

引用次数: 12

Immune Complex-Mediated Complement Activation in a Patient with IgG4-Related Tubulointerstitial Nephritis. 免疫复合物介导的补体激活在igg4相关小管间质性肾炎患者中的作用

Case reports in nephrology and urology Pub Date : 2011-07-01 Epub Date: 2011-08-18 DOI: 10.1159/000330664

Seiji Nagamachi, Isao Ohsawa, Nobuyuki Sato, Masaya Ishii, Gaku Kusaba, Takashi Kobayashi, Yukihiko Takeda, Satoshi Horikoshi, Hiroyuki Ohi, Misao Matsushita, Yasuhiko Tomino

{"title":"Immune Complex-Mediated Complement Activation in a Patient with IgG4-Related Tubulointerstitial Nephritis.","authors":"Seiji Nagamachi, Isao Ohsawa, Nobuyuki Sato, Masaya Ishii, Gaku Kusaba, Takashi Kobayashi, Yukihiko Takeda, Satoshi Horikoshi, Hiroyuki Ohi, Misao Matsushita, Yasuhiko Tomino","doi":"10.1159/000330664","DOIUrl":"https://doi.org/10.1159/000330664","url":null,"abstract":"A 59-year-old man was diagnosed with IgG4-related tubulointerstitial nephritis. His symptoms as well as laboratory and imaging findings were improved after initiation of steroid therapy. Serologically, he showed hypocomplementemia (C3 23 mg/dl, C4 <2 mg/dl, CH50 <7 U/ml) with high levels of IgG (IgG4 1,970 mg/dl) and immune complexes (C1q assay 8.1 μg/ml) and a low level of C1q (<2.0 mg/dl). Histologically, he also showed linear depositions of IgG, IgM, C3, C4d, C1q, membrane attack complex and all IgG subclasses (IgG1, IgG2, IgG3 and IgG4) along the tubular basement membrane, as well as granular depositions of these components in the renal interstitium. However, mannose-binding lectin and L-ficolin were not detected in these tissues. Homogeneous electron-dense deposits were observed by electron microscopy in the tubular basement membrane. It appears that the immune complexes might activate the classical pathway of the complement in both blood and local tissues in a patient with IgG4-related tubulointerstitial nephritis.","PeriodicalId":89663,"journal":{"name":"Case reports in nephrology and urology","volume":"1 1","pages":"7-14"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000330664","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31088286","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: 10