Case Reports in Nephrology and Dialysis最新文献

{"title":"Vena Cava Superior Syndrome Six Years after Central Venous Catheter Removal in a Patient on Hemodialysis.","authors":"Michelle Janssen,&nbsp;Susan Logtenberg","doi":"10.1159/000525795","DOIUrl":"https://doi.org/10.1159/000525795","url":null,"abstract":"<p><p>Vena cava superior (VCS) syndrome is rarely seen as a complication of central-venous-catheter placement. Usually, the syndrome appears when the presence of the catheter causes intraluminal obstruction or thrombosis. In this case report, however, we describe a patient on intermittent hemodialysis who had been free of any venous central line for over 6 years, presented with a VCS syndrome. The CT scan showed an absent VCS without extravascular compression. Previous catheter placement was diagnosed as the case of the VCS syndrome. It is important to realize that VCS syndrome can occur late after removal of central venous catheters, and thus, clinicians should be aware of its symptoms in any patient who has had an upper central line in the past medical history.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"12 2","pages":"132-137"},"PeriodicalIF":0.7,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/0c/cnd-0012-0132.PMC9459634.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33485333","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":"Rifabutin-Induced SIADH and Leucopenia in a Renal Transplant Recipient with Genitourinary Tract Tuberculosis: A Case Report and Review of the Literature.","authors":"Maha Mohamed,&nbsp;Muhammad Waseem Athar,&nbsp;Yaasir Mamoojee,&nbsp;Alison Brown,&nbsp;Frances Dowen,&nbsp;Jim Macfarlane","doi":"10.1159/000525921","DOIUrl":"https://doi.org/10.1159/000525921","url":null,"abstract":"<p><p>Tuberculosis (TB) infection of the genitourinary tract (GU TB) is rare in renal transplant recipients, with only a few published case series. GU TB is difficult to diagnose with or without immunosuppression but must always be suspected in any patient with unexplained sterile pyuria. As GU TB is associated with graft rejection, prompt diagnosis and treatment are vital. Treatment is challenging, as rifampicin, the most effective drug used to treat tuberculosis, is a significant inducer of cytochrome P-450 3A metabolism, with the potential to cause significant reductions in the serum levels of calcineurin inhibitors. For this reason, rifabutin, a weaker cytochrome P-450 3A inducer, with similar efficacy against TB, is sometimes used as an alternative to rifampicin in transplant recipients. We present a renal transplant patient diagnosed with GU TB, treated with a regime containing rifabutin, who subsequently developed profound hyponatremia and leucopenia. Serum and urine biochemistry was consistent with a diagnosis of the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Both SIADH and leucopenia resolved with rifabutin cessation. This is the first report of biochemically proven, idiosyncratic SIADH and leucopenia associated with the use of rifabutin in the treatment of GU TB in a renal transplant recipient.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"12 2","pages":"117-123"},"PeriodicalIF":0.7,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3c/26/cnd-0012-0117.PMC9459626.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33485336","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":"Four Cases of Serum Copper Excess in Patients with Renal Anemia Receiving a Hypoxia-Inducible Factor-Prolyl Hydroxylase Inhibitor: A Possible Safety Concern.","authors":"Hironori Nakamura,&nbsp;Shigekazu Kurihara,&nbsp;Mariko Anayama,&nbsp;Yasushi Makino,&nbsp;Masaki Nagasawa","doi":"10.1159/000525735","DOIUrl":"https://doi.org/10.1159/000525735","url":null,"abstract":"<p><p>Copper is an indispensable trace metal element and is mainly absorbed in the stomach and small intestine and excreted into the bile. Hypoxia-inducible factor-prolyl hydroxylase inhibitors (HIF-PHIs) have emerged as a novel approach for renal anemia management. Many intestinal genes, including <i>divalent metal transporter 1, duodenal cytochrome B</i>, and copper transporter ATPase7A, related to iron absorption are transactivated by HlF-α, during iron deficiency. We first report 4 cases of patients with renal anemia who showed excess in serum copper level during roxadustat or daprodustat treatment, which were decreased to the normal level after discontinuing HIF-PHIs and changing the drug to darbepoetin alfa, suggesting that HIF-PHI is associated with serum copper excess. HIF-PHI modulates iron metabolism, such as iron absorption, sequestration, and mobilization, and may increase serum copper levels by increasing copper absorption and/or redistribution of copper in tissues. Therefore, it is urgent to examine the correlation between HIF-PHI use and serum copper levels because copper excess might be involved in several acute or chronic adverse events.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"12 2","pages":"124-131"},"PeriodicalIF":0.7,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f7/57/cnd-0012-0124.PMC9459559.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33485334","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":"Acute Kidney Injury following Exposure to Formaldehyde-Free Hair-Straightening Products.","authors":"Nabil Abu-Amer,&nbsp;Natalie Silberstein,&nbsp;Margarita Kunin,&nbsp;Sharon Mini,&nbsp;Pazit Beckerman","doi":"10.1159/000525567","DOIUrl":"https://doi.org/10.1159/000525567","url":null,"abstract":"<p><p>Formaldehyde-free hair-straightening products are hair-smoothening solutions widely used by professional beauty salons. Formaldehyde-free hair straighteners do not technically contain formaldehyde; however, they contain other chemicals such as glyoxyloyl carbocysteine which releases formaldehyde upon contact with heat. Moreover, its by-product glyoxylate may convert to oxalate; both compounds have potential nephrotoxic effect. Here, we report a case of a 41-year-old woman who presented to the emergency room with weakness, nausea, vomiting, and stage 3 acute kidney injury (AKI) according to Kidney Disease: Improving Global Outcomes (KDIGO) acute kidney injury staging shortly after exposure to formaldehyde-free hair-straightening product; other causes of AKI were excluded such as preceding acute illness, drug history, or other nephrotoxic agent exposure. On physical examination, the patient was pale, and her vital signs were normal. The urine microscopy and serologic workup were not indicative. Kidney core biopsy revealed interstitial edema, acute interstitial nephritis, and oxalate crystal nephropathy. Kidney function completely recovered after a short course of steroid therapy. In this case, AKI was a complication caused by exposure to hair-straightening products branded as formaldehyde free but actually containing other chemical products which release formaldehyde and other toxic chemicals when heated during the straightening procedure and may cause systemic toxicity, particularly kidney injury. Different cosmetic products are widely in use, but not all are under tight regulation, and therefore, it is important to raise the awareness among both medical teams and consumers of possible adverse health effects of different cosmetic products.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"12 2","pages":"112-116"},"PeriodicalIF":0.7,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b5/ab/cnd-0012-0112.PMC9386411.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33486248","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":"Propylthiouracil-Induced Antineutrophil Cytoplasmic Antibodies-Associated Vasculitis with Renal and Lung Involvement.","authors":"Albert Hing Wong,&nbsp;Wei-Kei Wong,&nbsp;Lai-Meng Looi,&nbsp;Jeyakantha Ratnasingam,&nbsp;Soo-Kun Lim","doi":"10.1159/000525182","DOIUrl":"https://doi.org/10.1159/000525182","url":null,"abstract":"<p><p>Propylthiouracil (PTU)-induced antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) is a rare and heterogeneous disease. Moreover, optimal treatment is still lacking. We described the case of a 44-year-old lady with underlying Graves' disease who had cough, blood-streaked sputum, and impaired renal function. A strongly positive anti-myeloperoxidase antibody (>200 U/mL) along with pauci-immune glomerulonephritis and pulmonary hemorrhage resulted in the diagnosis of PTU-induced AAV, given that the patient had been on PTU for 3 years. PTU withdrawal, therapeutic plasma exchanges, and oral cyclophosphamide provided favorable clinical and biochemical outcomes. She remained well on azathioprine 50 mg daily as maintenance therapy and clinically euthyroid with carbimazole 2.5 mg daily. The effective treatment for drug-induced ANCA vasculitis remains controversial, but rapid withdrawal of the offending medication should be the mainstay of treatment. In severe drug-induced ANCA vasculitis with pulmonary hemorrhage and/or life-threatening organ involvement such as kidney failure requiring dialysis, therapeutic plasma exchange with immunosuppressants is often required. In this case, we have shown that patient achieved remission after therapeutic plasma exchange with cyclophosphamide in the acute stage of treatment and remained symptom-free with azathioprine in the maintenance phase of treatment for 24 months.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":" ","pages":"105-111"},"PeriodicalIF":0.7,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b3/f8/cnd-0012-0105.PMC9251458.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40601516","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":"Membranous Nephropathy-Like Apolipoprotein E Deposition Disease with Apolipoprotein E Toyonaka and Homozygous Apolipoprotein E2/2 without Dyslipidemia, with Characteristic Electron-Dense Deposits.","authors":"Akihiko Koshino,&nbsp;Chikako Takaeda,&nbsp;Takahiro Matsuno,&nbsp;Shinji Kitajima,&nbsp;Yasunori Iwata,&nbsp;Norihiko Sakai,&nbsp;Kiyotaka Nagahama,&nbsp;Yo Niida,&nbsp;Takao Saito,&nbsp;Hitoshi Yokoyama,&nbsp;Takashi Wada","doi":"10.1159/000525086","DOIUrl":"https://doi.org/10.1159/000525086","url":null,"abstract":"<p><p>Recently, several cases of novel apolipoprotein E (apoE)-related glomerular disease known as membranous nephropathy (MN)-like apoE deposition disease with apoE Toyonaka (Ser197Cys) and homozygous apoE2/2 have been reported. However, the clinical and pathological characteristics are uncertain due to the small number of reports. Here, we report an additional case with various clinical and pathological characteristics. A 28-year-old Japanese man with mild proteinuria and hematuria underwent a kidney biopsy. Examination under a light microscope revealed mesangial proliferation, mesangial matrix expansion, and segmental spike lesion. An immunofluorescence study showed no immunoglobulin or complement depositions. In the electron microscopic (EM) examination, massive deposits with various electron densities in the subepithelial, subendothelial, and paramesangial areas were more prominent than those reported in previous cases, which resembled microbubbles or microcysts on higher magnification. The glomerular basement membrane (GBM) structure was partly degenerated by these deposits. Serum triglyceride and cholesterol levels were within the normal range. However, the serum apoE concentration was significantly high, and glomerular apoE accumulation was detected in immunohistochemistry. The DNA sequence revealed apoE Toyonaka and homozygous apoE2/2 similar to that of the previous cases with MN-like apoE deposition disease. MN-like apoE deposition disease can manifest as only mild hematuria and proteinuria without dyslipidemia. Various characteristic deposits associated with GBM degeneration can be observed in the EM study.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":" ","pages":"96-104"},"PeriodicalIF":0.7,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/88/ce/cnd-0012-0096.PMC9247525.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40601514","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":"Spontaneous Twin Pregnancy: A Challenging and Exceptional Scenario in a Patient on Maintenance Hemodialysis in Sub-Saharan Africa.","authors":"Mahamat Maimouna, Hermine Menye Ebana Fouda, Victorine Nzana F, Aristide Eric Tomta Nono, Isabelle Nkwelle Mekone, Peter Mbala, François Folefack Kaze, Gloria Ashuntantang","doi":"10.1159/000524902","DOIUrl":"10.1159/000524902","url":null,"abstract":"<p><p>Chronic hemodialysis is associated with reduced fertility. Hence, pregnancy remains rare, challenging, and deleterious when unplanned, especially in low-resource countries. Contraception and births are very important in these settings. Though the main modes of contraception have been proposed in the chronic kidney disease (CKD) population, contraception still remains challenging in patients on maintenance hemodialysis. Most doctors, however, overlook contraception because of the low fertility, high rate of amenorrhea, and low libido. Furthermore, patients are less receptive to contraceptive counseling either because of a high desire to give birth or due to amenorrhea and low libido. Management of unplanned pregnancies is therefore very challenging and a multidisciplinary approach is the rule; however, it does not guarantee a good prognosis for both the mother and child. Very few cases of multiple pregnancies without induction of ovulation have been reported in patients with severe renal failure, especially those on maintenance dialysis. A 32-year-old multiparous woman with end-stage kidney failure (ESKF) and a residual diuresis of 700 mL per day who had been on inadequate maintenance hemodialysis for 36 months, presented with abdominal distension, which was confirmed on abdominal ultrasound to be a twin pregnancy at 22 weeks of gestation. Thereafter, we intensified hemodialysis (3 sessions/week), managed hypertension and anemia. The obstetrical course was uneventful until the 25th week of gestation when she developed grade 3 (WHO) hypertension and peripheral fluid overload. At the 29th week, she had a spontaneous vaginal preterm delivery of 2 babies weighing 1,350 g and 1,000 g, with an Apgar score of 8 and 7, respectively. Babies, however, died on day 1 and day 5 postpartum, respectively, from respiratory distress and early neonatal infection. The evolution of the mother was uneventful as she continued with her hemodialysis sessions. Twin pregnancies are a rare and very high-risk condition in end-stage renal disease and require multidisciplinary management.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":" ","pages":"90-95"},"PeriodicalIF":0.7,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9d/ad/cnd-0012-0090.PMC9247437.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40601513","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":"Urothelial Carcinoma in an Allograft kidney.","authors":"Maria Baand Hejlesen,&nbsp;Mohammad Hassan Youssef,&nbsp;Jesper Noergaard Bech,&nbsp;Frank Holden Mose","doi":"10.1159/000524901","DOIUrl":"https://doi.org/10.1159/000524901","url":null,"abstract":"<p><p>Patients who have been kidney transplanted have an increased risk of developing cancer. This case report presents a rarely described case in which a patient, who had received a kidney transplant from a deceased donor, was diagnosed with disseminated urothelial carcinoma originating from the allograft. After the removal of the allograft and the immunosuppressive treatment, there was regression in the cancer. Unfortunately, it was not a complete regression of the urothelial cancer and the patient died. This case indicates that there is a risk of getting cancer from the transplanted kidney from a deceased donor, but also that the immunosuppressive treatment can contribute to the development of this cancer.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":" ","pages":"85-89"},"PeriodicalIF":0.7,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/89/53/cnd-0012-0085.PMC9247438.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40601515","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":"Lautropia mirabilis: An Exceedingly Rare Cause of Peritoneal Dialysis-Associated Peritonitis","authors":"Gonçalo Calheiros Cruz, M. Sousa, Sara Vilela, F. Teixeira e Costa, F. J. Silva","doi":"10.1159/000524494","DOIUrl":"https://doi.org/10.1159/000524494","url":null,"abstract":"Lautropia mirabilis is a gram-negative coccoid bacterium isolated from oral and upper respiratory sites with unclear pathogenic potential. We present an exceedingly rare case of peritoneal dialysis-associated peritonitis due to L. mirabilis in a patient with a recent history of periodontal infection, successfully treated with intraperitoneal antibiotics. We propose that clinicians consider this organism as a potential cause of illness.","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"12 1","pages":"81 - 84"},"PeriodicalIF":0.7,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42867356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interest of a Kidney Biopsy to Rule out ANCA-Associated Renal Vasculitis in Glomerulonephritis Patients with a Positive ANCA","authors":"F. Garo, C. Aglaé, H. Perrochia, P. Ahmadpoor, L. Daniel, O. Moranne","doi":"10.1159/000521862","DOIUrl":"https://doi.org/10.1159/000521862","url":null,"abstract":"Kidney biopsy is the gold standard for diagnosing glomerular kidney disease. Some authors debate the necessity of systematically performing kidney biopsies in ANCA-associated vasculitis (AAV) to confirm the diagnosis and assess the severity of renal damage. Nevertheless, kidney involvement is considered an organ-threatening disease requiring an aggressive immunosuppressive regimen. We present a series of 4 cases with a high clinical suspicion of ANCA-associated crescentic glomerulonephritis based on rising serum creatinine, presence of proteinuria and/or hematuria, and presence of ANCA with specificity against PR-3 or MPO. The main diagnosis, however, was arterionephrosclerosis without renal AAV. Certain comorbidities, such as diabetes and/or high blood pressure, can quickly mimic progressive glomerulonephritis. In addition, some patients with AAV do not have high creatinine, proteinuria, or hematuria levels. ANCA alone is not specific to AAV and has a poor positive predictive value. The main concern is to prevent the unnecessary, inappropriate complications of heavy immunosuppression, i.e., serious infections or risk of future malignancies. Kidney pathological confirmation is important in patients with no compatible extra-renal manifestations of AAV or any other possible renal diagnosis such as may be found in polyvascular disease or diabetic patients.","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"12 1","pages":"73 - 80"},"PeriodicalIF":0.7,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45496049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}