Case Reports in Nephrology and Dialysis最新文献

{"title":"Kidney, Pituitary, Eyes, and Nose Involved in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: A Case Report and Literature Review.","authors":"Xiaonan Feng, Yinyin Yan, Na Tian, Lihua Wu","doi":"10.1159/000551212","DOIUrl":"10.1159/000551212","url":null,"abstract":"<p><strong>Introduction: </strong>Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a systemic autoimmune disease characterized by diverse clinical manifestations. Central diabetes insipidus resulting from pituitary involvement in AAV is exceedingly rare.</p><p><strong>Case presentation: </strong>This article presented a rare case of a young patient with a medical history of 8 years, who presented with sinusitis, pituitary microadenoma with central diabetes insipidus, acute renal injury, right abducens nerve paralysis (strabismus, diplopia), and most cases were not accompanied by an increase of ANCA titer.</p><p><strong>Conclusion: </strong>Our case showed that granulomatosis with polyangiitis (GPA) has a variety of clinical manifestations and rapid progression. The patient was diagnosed with GPA and treated with glucocorticoids combined with cyclophosphamide and desmopressin. Following treatment, his renal impairment, diabetes insipidus, and diplopia improved, achieving clinical remission. This case underscores the importance of timely diagnosis and treatment for the patient's prognosis.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"16 1","pages":"55-62"},"PeriodicalIF":1.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147940381","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":"Lumbar Inferior Vena Cava Cannulation for Haemodialysis: A Lifesaving Option in Paediatric Patients with Exhausted Vascular Access - A Case Series.","authors":"Bandula Samarasinghe, Ashani Ratnayake, Shenal Thalgahagoda, John Shelton, Nethmi Munasinghe, Uhanovitage A Isurindi","doi":"10.1159/000551235","DOIUrl":"10.1159/000551235","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) in children poses unique challenges, especially in resource-poor developing countries, with limited facilities for renal replacement therapy (RRT). We present three cases of children with end-stage renal disease from Sri Lanka in whom traditional access has been exhausted secondary to sepsis and thrombosis.</p><p><strong>Case presentations: </strong>Three patients were not candidates for peritoneal dialysis, and several attempts for tunnelled and non-tunnelled catheters limited the ability to continue RRT until the donor work-up for transplantation was completed. Therefore, surgical placement of a vascular catheter (vascath) to enter the inferior vena cava (IVC) directly was performed under general anaesthesia. Patient 1, a nine-year-old boy, successfully maintained dialysis through the IVC catheter until transplantation. Patient 2, a fourteen-year-old boy with extensive thrombosis, underwent successful cannulation with good outcomes at 4 months' follow-up. Patient 3, a twelve-year-old girl post-nephrectomy, initially dialysed successfully but later died due to cardiac failure unrelated to the access site. This procedure provided effective haemodialysis access, mitigating severe volume overload and hyperkalaemia. They also tolerated subsequent dialysis sessions well.</p><p><strong>Conclusion: </strong>This case series highlights the critical role of unconventional dialysis access methods in resource-constrained settings, where advanced interventional radiology options may be unavailable. While IVC cannulation for haemodialysis is more commonly described in adults, these are the first reported cases of vascath insertion into the IVC in paediatric patients. Additionally, these findings underscore the importance of innovative strategies to manage paediatric CKD in low-resource settings, pending definitive renal transplantation.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"16 1","pages":"46-54"},"PeriodicalIF":1.0,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147926409","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":"Relapsing Polymicrobial Peritoneal Dialysis-Associated Peritonitis Caused by Rare Non-Fermenting Gram-Negative Pathogens: A Case Report.","authors":"Ben Hammoud, Jan Schiefer, Peter R Mertens","doi":"10.1159/000551489","DOIUrl":"10.1159/000551489","url":null,"abstract":"<p><strong>Introduction: </strong>Peritoneal dialysis (PD)-associated peritonitis caused by rare non-fermenting Gram-negative organisms represents a diagnostic and therapeutic challenge, particularly in patients with prolonged antibiotic exposure and biofilm-associated catheter infections.</p><p><strong>Case presentation: </strong>We report the case of a 44-year-old male PD patient who developed relapsing polymicrobial PD-associated peritonitis involving <i>Elizabethkingia miricola</i>, <i>Brevundimonas diminuta</i>, <i>Stenotrophomonas maltophilia</i>, and <i>Staphylococcus haemolyticus</i>. Despite repeated susceptibility-guided intraperitoneal antibiotic therapy, inflammatory markers and dialyzate leukocytosis persisted. Multiple cultures consistently identified rare non-fermenting Gram-negative pathogens. Following prolonged discussion, the PD catheter was removed, and the patient transitioned to hemodialysis, followed by targeted oral antimicrobial therapy. Clinical and laboratory resolution occurred within 3 weeks after catheter removal.</p><p><strong>Conclusion: </strong>Rare environmental non-fermenting Gram-negative pathogens should be recognized as clinically relevant causes of relapsing PD-associated peritonitis. Persistent or polymicrobial infections should prompt early consideration of catheter removal in accordance with current ISPD recommendations.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"16 1","pages":"63-68"},"PeriodicalIF":1.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013783","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":"MGRS or MGUS? Diagnostic Dilemma of ANCA-Associated Pauci-Immune Crescentic Glomerulonephritis with Monoclonal Gammopathy: A Case Report.","authors":"Yanqin Qiu, Dingguo Chen, Shengkun Yang, Hui Fan, Qiongdan Hu, Qiong Zhang","doi":"10.1159/000550114","DOIUrl":"10.1159/000550114","url":null,"abstract":"<p><strong>Introduction: </strong>Monoclonal gammopathy of undetermined significance (MGUS) is the most common plasma cell dyscrasia, defined by clonal monoclonal immunoglobulin (MIg) in serum and/or urine in the absence of end-organ damage caused by plasma cell proliferation. By contrast, monoclonal gammopathy of renal significance (MGRS) encompasses a spectrum of kidney disorders directly or indirectly driven by MIg, with clinical phenotypes ranging from insidious proteinuria to rapidly progressive glomerulonephritis. The diagnostic ambiguity arising when MGUS coexists with renal dysfunction remains a major clinical challenge. Here, we report a rare case of a patient initially suspected to have MGRS complicated by pauci-immune crescentic glomerulonephritis (PICGN). However, this diagnosis was ultimately excluded by the absence of MIg deposits in renal tissue on histopathological examination.</p><p><strong>Case presentation: </strong>We describe a female with concurrent PICGN and MGUS, presented with acute kidney injury, proteinuria, and hematuria, with renal biopsy revealing type III crescentic glomerulonephritis and immunofluorescence showing weak positivity for κ and λ MIg deposits. Despite initial suspicion of MGRS, immuno-electron microscopy did not confirm monoclonal light chain deposition, leading to a final diagnosis of PICGN and MGUS.</p><p><strong>Conclusions: </strong>This case underscores the importance of integrating serological, histopathological, and advanced imaging techniques to distinguish between autoimmune and plasma cell dyscrasias in renal pathology. It also emphasizes the limitations of immunofluorescence alone in diagnosing MGRS and the necessity of immuno-electron microscopy for definitive exclusion. This report calls for further research into the pathophysiological interactions between ANCA-associated vasculitis and monoclonal gammopathies, particularly in cases with overlapping renal injury features.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"16 1","pages":"24-34"},"PeriodicalIF":0.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12851614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084471","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":"Latex-Contaminated Kidney Graft as a Source of Perioperative Anaphylaxis: A Case Report.","authors":"Elodie Faure, Mane Andreassian, Ahmad Mroue, Ophélie Le Monnier, Benoit Plaud, Benjamin Deniau","doi":"10.1159/000549587","DOIUrl":"10.1159/000549587","url":null,"abstract":"<p><strong>Introduction: </strong>Latex allergy is a leading cause of perioperative anaphylaxis, yet the risk of graft-mediated exposure during solid organ transplantation is poorly characterised.</p><p><strong>Case presentation: </strong>We report the case of a 45-year-old man with end-stage renal disease and confirmed latex allergy who underwent kidney transplantation with a graft that had been handled with latex gloves during procurement. Following multidisciplinary discussion, the graft was repeatedly rinsed with preservation solution to reduce antigenic load. The operating theatre was prepared as latex-free, and the anaesthesia team implemented enhanced readiness for anaphylaxis. The surgery and perioperative course were uneventful, and the patient was extubated in theatre and transferred to intensive care without complication.</p><p><strong>Conclusion: </strong>This case underscores the potential for graft-mediated anaphylaxis due to latex contamination during procurement. Systematic latex avoidance from organ retrieval to implantation, along with communication between procurement and implant teams, is crucial to mitigate risk in sensitised recipients.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"16 1","pages":"20-23"},"PeriodicalIF":0.9,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12788838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951376","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":"Dual-Genetic Etiology in an Atypical Dent Disease Phenotype Which Combines Features of Focal Segmental Glomerulosclerosis and Ellis-Van Creveld-Like Syndrome: A Case Report.","authors":"Dorella Del Prete, Monica Ceol, Alessandra Giannella, Giulio Ceolotto, Elena Sgrò, Giovanna Priante, Marny Fedrigo, Franca Anglani, Federico Nalesso","doi":"10.1159/000549650","DOIUrl":"10.1159/000549650","url":null,"abstract":"<p><strong>Introduction: </strong>Dent disease (DD) is an X-linked recessive renal disorder characterized by features of incomplete Fanconi syndrome. DD varies in clinical presentation, manifesting with proteinuria alone or in combination with nephrocalcinosis/nephrolithiasis, and with or without chronic kidney disease, posing a challenge to clinical diagnosis. The genetic basis of DD is not completely known; about 25-35% of DD cases lack mutations in the disease-causing <i>CLCN5</i> and <i>OCRL</i> genes. This case report represents a rare example of a patient initially suspected of having DD, but through whole exome sequencing (WES) was found to harbor pathogenic variants in the <i>WT1</i> and <i>EVC2</i> genes, suggesting a dual-genetic etiology mimicking DD.</p><p><strong>Case presentation: </strong>We describe a young man with a renal phenotype resembling DD associated with nephrotic syndrome, focal segmental glomerulosclerosis (FSGS), tubular microcysts, and a significant family history of kidney disease. Also present was an extrarenal phenotype with short stature, narrow chest, recurrent upper respiratory tract infections, teeth anomalies and hypertension. We identified in the <i>WT1</i> gene the heterozygous ultrarare missense variant (NM_024426.6:c.1088C>T p.Thr363Met), classified as a variant of uncertain significance, and in the <i>EVC2</i> gene the heterozygous nonsense variant (NM_147127.5:c.2833C>T p.Arg945Ter), classified as pathogenic. The clinical phenotype combines WT1-related FSGS with a rare tubular phenotype of Ellis-van Creveld-like syndrome (EVC).</p><p><strong>Conclusions: </strong>This case report provides insights into the phenotypic complexity of hereditary nephropathies and the diagnostic challenge posed by overlapping glomerular and tubular presentations. WES enabled us to expand our knowledge of the genetics of kidney diseases in adults and to reclassify the patient's nephropathy.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"16 1","pages":"1-9"},"PeriodicalIF":1.0,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12755895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145888555","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 Case of Hyperinsulinemic Hypoglycaemia Associated with Atypical Fanconi Renal Tubulopathy Syndrome Caused by an HNF4A Variant.","authors":"Sarai Garriga-Edo, Lydia Peris-Serra, Héctor Ríos Duro, Marina Giralt, Noelia Díaz-Troyano, Roser Ferrer, María Antolín Mate, Belén Pérez Dueñas, María Clemente","doi":"10.1159/000549545","DOIUrl":"10.1159/000549545","url":null,"abstract":"<p><strong>Introduction: </strong>This case illustrates the challenges in the diagnosis of a rare disease with an intricate orientation. The definitive genetic diagnosis was carried out after establishing crucial correlations between the preliminary clinical indications and the laboratory findings.</p><p><strong>Case presentation: </strong>The initial presentation was myoclonic jerks. This was a direct consequence of hyperinsulinaemic hypoglycaemia (HH), and not a phenotypic characteristic described in previous case reports. Linking this to glycaemia led to the evaluation of response to fasting, where inadequate insulin suppression resulted in hypoketotic hypoglycaemia. The diagnosis of chronic kidney dysfunction associated with atypical Fanconi renal tubulopathy syndrome type 4 (FRTS4) was indicated on the basis of a decreased estimated glomerular filtration rate, nephrocalcinosis, millimetric lithiasis, rickets, and complex proximal tubulopathy. This indicated atypical FRTS4 as associated with HH and necessitated further molecular genetic testing.</p><p><strong>Conclusion: </strong>The patient was identified as a carrier of the c.187C>T (p.Arg63Trp) variant in the <i>HNF4A</i> gene, which is a heterozygous missense variant classified as pathogenic. This entity is rare, and the published literature reporting <i>HNF4A</i> gene variants associated with atypical FRTS and HH is limited. It is therefore important to report such cases to contribute to the growing body of evidence and help identify pathogenic HNF4A variants and their implications.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"16 1","pages":"10-19"},"PeriodicalIF":1.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12757114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899211","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":"Adaptive Hemodiafiltration Strategies in a Full-Term Pregnancy with End-Stage Kidney Disease: A Case Report.","authors":"Masato Sakai, Erika Hishida, Manabu Ogura, Takahiro Masuda, Manabu Ogoyama, Toshimi Imai, Tetsu Akimoto, Hiroshi Satonaka, Hironori Takahashi, Hiroyuki Fujiwara, Daisuke Nagata","doi":"10.1159/000549586","DOIUrl":"10.1159/000549586","url":null,"abstract":"<p><strong>Introduction: </strong>Managing pregnancy in patients with end-stage kidney disease (ESKD) undergoing dialysis is challenging, with hypoalbuminemia significantly increasing risks to both maternal and neonatal outcomes. Intensive hemodialysis regimens are recommended; however, individualized and adaptive dialysis strategies, such as sequential online hemodiafiltration (OL-HDF) and intermittent HDF (i-HDF), may be required to optimize care in complex cases.</p><p><strong>Case presentation: </strong>We report the case of a 27-year-old Japanese woman with ESKD who transitioned from OL-HDF to i-HDF during pregnancy due to progressive hypoalbuminemia at 30 + 5 weeks of gestation. Dry weight adjustments were guided by human atrial natriuretic peptide (hANP) levels, blood pressure measurements, and bioimpedance analysis. i-HDF reduced albumin loss compared to OL-HDF, stabilized maternal hemodynamics, and enabled term delivery at 39 + 1 weeks with a healthy neonate weighing 2,774 g. Bioimpedance analysis and hANP-guided adjustments allowed for precise fluid management, resulting in a total gestational weight gain of 6.4 kg. The patient developed superimposed preeclampsia during labor, which was successfully managed.</p><p><strong>Conclusion: </strong>This case demonstrates that sequential OL-HDF and i-HDF can effectively address hypoalbuminemia and fluid imbalances, contributing to successful maternal and neonatal outcomes in ESKD pregnancies.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"15 1","pages":"278-285"},"PeriodicalIF":0.9,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12700590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755392","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":"Peritoneal Dialysis-Associated Peritonitis Caused by Lautropia Mirabilis and Concurrent Viral Infection: A Case Report.","authors":"Cunhong Deng, Junjie Chen, Jun Liu, Wei Zhang, Hao Zhang, Zhi Li","doi":"10.1159/000549422","DOIUrl":"10.1159/000549422","url":null,"abstract":"<p><strong>Introduction: </strong><i>Lautropia mirabilis</i> is a rare cause of peritonitis associated with peritoneal dialysis-associated peritonitis (PDAP). We report the first documented case of PDAP caused by coinfection with <i>L. mirabilis, cytomegalovirus</i> (CMV), and Epstein-Barr virus (EBV).</p><p><strong>Case presentation: </strong>A 67-year-old woman with end-stage renal disease secondary to polycystic kidney disease, on continuous ambulatory peritoneal dialysis for 3 years, developed PDAP. Initial peritoneal dialysis effluent (PDE) culture grew <i>Streptococcus salivarius</i>, and symptoms resolved with treatment. However, she was readmitted 2 days later with recurrent PDAP. Despite 18 days of empirical antibiotic therapy and repeated negative PDE cultures, the patient's symptoms persisted. Upon her transfer to our hospital, PDE white blood cell (WBC) count was 110 × 10⁶/L. Targeted next-generation sequencing (tNGS) of the PDE performed on day one detected <i>L. mirabilis</i> (16,929 reads), CMV (944 reads), and EBV (285 reads). Therapy with intravenous moxifloxacin, intraperitoneal gentamicin, and oral ganciclovir led to rapid WBC decline and clinical improvement within 48 h. After 1 week of inpatient monitoring, the patient was discharged with a 2-week course of oral moxifloxacin. At the 2-week follow-up, the patient was asymptomatic with normal PDE WBC counts.</p><p><strong>Conclusion: </strong>Conventional culture methods may fail to detect uncommon pathogens, such as <i>L. mirabilis</i>. Culture-negative PDAP often necessitates empirical antibiotic therapy, carrying a high risk of failure and increased healthcare costs. This case suggests that tNGS could be used as a complementary diagnostic tool in selected cases of refractory, culture-negative PDAP, potentially aiding the identification of pathogens and guiding therapy.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"15 1","pages":"269-277"},"PeriodicalIF":0.9,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12685340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713268","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":"Combined Extracorporeal Therapy with Pathogen Hemoadsorption and Cell-Directed Immunomodulation Strategies: A Two-Case Series.","authors":"Junya Hagiwara, Linda E Sousse, Fadi Abouzahr, Mohammad Ahmad, Jeffrey D DellaVolpe","doi":"10.1159/000548837","DOIUrl":"10.1159/000548837","url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis remains a critical global health issue, causing multiple organ failure and high mortality rates, despite advances in antimicrobial therapies and supportive care. Extracorporeal blood purification (EBP) techniques have emerged as promising adjunctive strategies for the management of severe infections. The Seraph^® 100 Microbind^® Affinity Blood Filter (Seraph 100, ExThera Medical, Martinez, CA, USA) targets pathogens, while the Selective Cytopheretic Device (SCD, SeaStar Medical, Denver, CO, USA) neutralizes activated leukocytes. Although individually validated, evidence of the combined use of Seraph 100 and SCD remains scarce.</p><p><strong>Case presentations: </strong>We present two cases that illustrate the combined use of Seraph 100 and SCD. The first case involves a 43-year-old woman with bacterial pneumonia, septic shock, and acute kidney injury (AKI). She underwent Seraph 100 hemoperfusion followed by SCD therapy, which improved her hemodynamics, oxygenation, and renal function, ultimately leading to full recovery. The second case involved a 31-year-old man with influenza, severe hypoxemia, and multi-organ failure. Despite advanced therapies, including veno-arterial venous extracorporeal membrane oxygenation, Seraph 100, and SCD, his condition deteriorated, resulting in multi-organ failure and eventual death.</p><p><strong>Conclusion: </strong>These cases highlight the potential benefits and challenges of combining EBP, such as Seraph 100 and SCD. While successful in one case, the fatal outcome in the second underscores the importance of optimal patient selection, timing, and therapeutic strategies. Further research is needed to evaluate the efficacy of combined EBP and to identify approaches for improving outcomes in critically ill patients.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"15 1","pages":"260-268"},"PeriodicalIF":0.9,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12676126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699707","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}