Case Reports in Nephrology最新文献

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Gitelman Syndrome in a Child Presenting With Polyuria and Polydipsia: Diagnostic Challenges in a Resource-Limited Setting. Gitelman综合征在儿童多尿和多饮:在资源有限的设置诊断挑战。
Case Reports in Nephrology Pub Date : 2026-05-31 eCollection Date: 2026-01-01 DOI: 10.1155/crin/8879176
Erneus Ernest, Devis Simbila
{"title":"Gitelman Syndrome in a Child Presenting With Polyuria and Polydipsia: Diagnostic Challenges in a Resource-Limited Setting.","authors":"Erneus Ernest, Devis Simbila","doi":"10.1155/crin/8879176","DOIUrl":"10.1155/crin/8879176","url":null,"abstract":"<p><p>Gitelman syndrome (GS) is a rare inherited renal salt-wasting tubulopathy characterized by hypokalemia, hypomagnesemia, and hypocalciuria. Its nonspecific presentation often overlaps with that of more common pediatric conditions, leading to delayed diagnosis, particularly in resource-limited settings. We report an 11-year-old boy who presented with progressive weight loss, polyuria, polydipsia, and salt craving. His course was complicated by recurrent episodes of severe hypokalemia and hypomagnesemia, and he was initially evaluated for diabetes mellitus, other endocrine disorders, chronic infections such as tuberculosis, and malnutrition without a definitive diagnosis. During the index admission, he developed acute worsening of muscle weakness associated with severe hypokalemia and hypomagnesemia and biochemical findings consistent with renal salt wasting, supporting a diagnosis of GS in the absence of genetic testing. Management with correction of hypovolemia, electrolyte supplementation, liberal salt intake, and nutritional support led to marked clinical improvement and stabilization of biochemical abnormalities on follow-up. This case highlights the importance of maintaining a high index of suspicion for GS in children presenting with polyuria, polydipsia, salt craving, and unexplained electrolyte disturbances, particularly in resource-limited settings.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"8879176"},"PeriodicalIF":0.0,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197319","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: 0
Mercury in Retrograde: The Tale of Toxicity. 水星逆行:毒性的故事。
Case Reports in Nephrology Pub Date : 2026-05-27 eCollection Date: 2026-01-01 DOI: 10.1155/crin/1913507
Sandra Abadir, Rafi Orphali, Garo Kalfayan, Arian Gower, Mercury Lin, Jasprit Takher
{"title":"Mercury in Retrograde: The Tale of Toxicity.","authors":"Sandra Abadir, Rafi Orphali, Garo Kalfayan, Arian Gower, Mercury Lin, Jasprit Takher","doi":"10.1155/crin/1913507","DOIUrl":"10.1155/crin/1913507","url":null,"abstract":"<p><strong>Introduction: </strong>Mercuric chloride is a highly toxic inorganic compound with historical medical use but severe potential for harm when ingested. Acute mercury poisoning is rare but can lead to multiorgan toxicity, particularly affecting the kidneys and gastrointestinal tract. Prompt recognition and intervention are essential to prevent long-term sequelae and mortality.</p><p><strong>Case presentation: </strong>An 18-year-old male with a psychiatric history presented one hour after intentional ingestion of five mercuric chloride tablets. He exhibited mild abdominal symptoms, and initial laboratory studies revealed proteinuria, glycosuria, and rising creatinine. Imaging showed echogenic kidneys, and serum mercury levels were markedly elevated at 840 μg/L. He was treated with oral dimercaptosuccinic acid (DMSA), intravenous fluids, and gastrointestinal decontamination. Despite therapy, his renal function declined, with creatinine peaking at 9.6 mg/dL, requiring hemodialysis. Renal biopsy demonstrated acute tubular necrosis without immune complex deposition. After six sessions of hemodialysis and 16 days of chelation therapy, renal function and mercury levels improved, allowing discharge to psychiatric care.</p><p><strong>Discussion: </strong>Mercuric chloride exerts its nephrotoxic effects primarily through oxidative injury to proximal tubular cells, resulting in acute tubular necrosis. While chronic mercury exposure is more often associated with glomerular diseases, acute ingestion more typically causes tubular injury. Chelation with DMSA facilitates mercury elimination but may be insufficient when renal impairment occurs. In such cases, hemodialysis becomes essential for toxin clearance and metabolic support. This case underscores the importance of early, combined therapeutic interventions.</p><p><strong>Conclusion: </strong>Acute mercuric chloride ingestion is a medical emergency that can cause life-threatening renal toxicity. Timely initiation of chelation therapy and supportive measures, including hemodialysis, are crucial for recovery. This case demonstrates that even in severe presentations, multidisciplinary management can result in favorable outcomes.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"1913507"},"PeriodicalIF":0.0,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136794","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: 0
Rapidly Progressive IgA Nephropathy in a Patient With a History of Breast Cancer: A Case Report and Literature Review. 乳腺癌患者快速进展性IgA肾病1例报告及文献回顾
Case Reports in Nephrology Pub Date : 2026-05-25 eCollection Date: 2026-01-01 DOI: 10.1155/crin/5546873
Roger Leon Montesinos, Edwin Quispe Marca, Carla Arnez Torrico, Daniel Segura Herbas, Luis Céspedes Limachi, Zulma Tapia Arenas, Wilder Villca Mamani
{"title":"Rapidly Progressive IgA Nephropathy in a Patient With a History of Breast Cancer: A Case Report and Literature Review.","authors":"Roger Leon Montesinos, Edwin Quispe Marca, Carla Arnez Torrico, Daniel Segura Herbas, Luis Céspedes Limachi, Zulma Tapia Arenas, Wilder Villca Mamani","doi":"10.1155/crin/5546873","DOIUrl":"10.1155/crin/5546873","url":null,"abstract":"<p><p>IgA nephropathy (IgAN), or Berger's disease, is the most common primary glomerulopathy worldwide. It is characterized by dominant mesangial deposition of immunoglobulin A1 (IgA1), typically of the galactose-deficient form (Gd-IgA1), which triggers the formation of circulating immune complexes and subsequent glomerular inflammation. Clinical presentation includes hematuria, proteinuria, and, in severe cases, progressive renal failure. A rare variant is the extracapillary or crescentic form, which follows an aggressive course. We report the case of a 52-year-old woman with a history of Stage II right-sided infiltrating ductal breast carcinoma, treated in 2023 with radical mastectomy, AC-T chemotherapy, and radiotherapy. Complete oncologic remission was confirmed by SPECT imaging. In January 2025, with a known baseline creatinine of 1.2 mg/dL, the patient presented with macroscopic hematuria, hypertension, and rapid decline in renal function. Workup revealed subnephrotic proteinuria (1854 mg/24 h), active urinary sediment with 65% dysmorphic erythrocytes and red blood cell casts, and a creatinine peak of 4.7 mg/dL. Autoimmune serologies were negative. Kidney biopsy showed IgAN with cellular crescents in 64% of glomeruli and an Oxford classification of M0 E0 S1T1 C2. Immunofluorescence confirmed mesangial IgA and C3 deposits. Despite treatment with intravenous methylprednisolone, cyclophosphamide, and oral prednisone, yet no renal recovery was achieved, and the patient remains on chronic hemodialysis. To our knowledge, this is the first reported case in Bolivia of extracapillary IgAN occurring after breast cancer remission, highlighting a rare clinical association and raising the possibility of an underlying immune-mediated link between malignancy and crescentic IgAN, without establishing causality.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"5546873"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13201900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148041227","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: 0
A Novel CRB2 Mutation Associated With FSGS and ESRD in an Adult Patient. 一种与成年患者FSGS和ESRD相关的新型CRB2突变
Case Reports in Nephrology Pub Date : 2026-05-20 eCollection Date: 2026-01-01 DOI: 10.1155/crin/8140153
Michele Marchini, Sonila Mocka, Matteo Trezzi
{"title":"A Novel CRB2 Mutation Associated With FSGS and ESRD in an Adult Patient.","authors":"Michele Marchini, Sonila Mocka, Matteo Trezzi","doi":"10.1155/crin/8140153","DOIUrl":"10.1155/crin/8140153","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a major global health concern, with a substantial proportion of cases that remain of undetermined cause. Mutations in genes affecting podocyte structure and function, are increasingly recognized as causes of focal segmental glomerulosclerosis (FSGS), a common but highly nonspecific histological pattern of kidney injury, that ultimately lead to CKD.</p><p><strong>Case presentation: </strong>We report the case of a 55-year-old male who presented with hypertension and end-stage renal disease (ESRD) of unknown etiology. He had a progressive decline in kidney function and proteinuria beginning in young adulthood. A kidney biopsy showed a pattern of FSGS. A comprehensive workup did not identify autoimmune or inflammatory causes. Whole-exome sequencing detected a previously undescribed heterozygous CRB2 mutation (c.1037G > T, p.Cys346Phe), predicted to be deleterious.</p><p><strong>Discussion: </strong>Animal models of CRB2 deprivation in podocytes showed progression toward FSGS. In humans, CRB2 mutations have previously been linked to severe early-onset nephrotic syndrome, typically in homozygous or compound heterozygous states. This is the first report of an adult-onset CRB2-associated FSGS in a heterozygous state, suggesting a milder disease course with a progressive kidney decline. As with other genetic forms of FSGS, we hypothesize that heterozygous CRB2 mutations may permit near-normal renal function for years until cumulative stressors trigger podocyte injury and CKD progression.</p><p><strong>Conclusion: </strong>This case expands the clinical spectrum of CRB2-related kidney disease and highlights the importance of genetic testing in adults with unexplained CKD. Identifying genetic forms of CKD may refine diagnostic and therapeutic approaches in nephrology.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"8140153"},"PeriodicalIF":0.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986743","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: 0
Rifampin: The Cause of Acute Tubular Injury-A Case Report. 利福平:急性肾小管损伤的原因——1例报告。
Case Reports in Nephrology Pub Date : 2026-04-28 eCollection Date: 2026-01-01 DOI: 10.1155/crin/7336365
Muhammad Umer Arif, Areeba Farooq, Harjinder Singh, Muhammad Talha Javaid, Mudassar Hussain
{"title":"Rifampin: The Cause of Acute Tubular Injury-A Case Report.","authors":"Muhammad Umer Arif, Areeba Farooq, Harjinder Singh, Muhammad Talha Javaid, Mudassar Hussain","doi":"10.1155/crin/7336365","DOIUrl":"10.1155/crin/7336365","url":null,"abstract":"<p><p>Tuberculosis (TB) presents with fever, night sweats, and cough. The antituberculous therapy (ATT) used to treat TB affects various systems, including the renal system and the hepatobiliary system. ATT-induced acute tubular necrosis (ATN) can have various presentations, such as fever, vomiting, diarrhea, abdominal pain, oliguria, and cola-colored urine. We present a case of a 56-year-old patient using ATT. He presented with the complaint of altered mental status, vomiting, jaundice, and cola-colored urine. Labs revealed elevated liver enzymes, elevated creatinine, anemia, and thrombocytopenia. The autoimmune profile was normal; however, the biopsy revealed ATN. In addition to supportive management, hemodialysis and steroid therapy were initiated. Discontinuation of rifampin along with continuation of modified ATT therapy led to improved renal function tests, platelet counts, and Hb levels.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"7336365"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811236","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: 0
Indirect Disaster-Related Deaths Among Hemodialysis Patients Following the Fukushima Daiichi Nuclear Power Plant Accident. 福岛第一核电站事故后血液透析患者的间接灾害相关死亡。
Case Reports in Nephrology Pub Date : 2026-04-13 eCollection Date: 2026-01-01 DOI: 10.1155/crin/8847100
Ryoma Yoshida, Toyoaki Sawano, Yuna Uchi, Moe Kawashima, Kemmei Kitazawa, Hidenori Marui, Hiroki Yoshimura, Saori Nonaka, Naomi Ito, Chika Yamamoto, Toshiki Abe, Michio Murakami, Momoka Yamamura, Tianchen Zhao, Mamoru Sakakibara, Kazuko Yagiuchi, Mako Otsuki, Akihiko Ozaki, Tomoyoshi Oikawa, Shinichi Niwa, Masaharu Tsubokura
{"title":"Indirect Disaster-Related Deaths Among Hemodialysis Patients Following the Fukushima Daiichi Nuclear Power Plant Accident.","authors":"Ryoma Yoshida, Toyoaki Sawano, Yuna Uchi, Moe Kawashima, Kemmei Kitazawa, Hidenori Marui, Hiroki Yoshimura, Saori Nonaka, Naomi Ito, Chika Yamamoto, Toshiki Abe, Michio Murakami, Momoka Yamamura, Tianchen Zhao, Mamoru Sakakibara, Kazuko Yagiuchi, Mako Otsuki, Akihiko Ozaki, Tomoyoshi Oikawa, Shinichi Niwa, Masaharu Tsubokura","doi":"10.1155/crin/8847100","DOIUrl":"10.1155/crin/8847100","url":null,"abstract":"<p><strong>Introduction: </strong>Disaster-related deaths (DRDs) are indirect fatalities caused by physical or psychological stress during evacuation. Patients undergoing hemodialysis (HD) face increased vulnerability during disasters due to reduced dialysis frequency, elevated mental stress, and limited access to medical resources. Although their risk is heightened, detailed analyses of DRDs in HD patients remain sparse.</p><p><strong>Methods: </strong>This retrospective study analyzed 13 HD-related DRD cases in Minamisoma City, Fukushima Prefecture, following the Fukushima Daiichi Nuclear Power Plant accident. A total of 520 DRDs were certified in the city. Data from local government records were extracted, focusing on time of death, causes of death, and psychiatric symptoms.</p><p><strong>Results: </strong>The mean age (± standard deviation) at death for HD patients was 77.92 (±8.37) years, which was younger than the mean age (± standard deviation) of 82.81 (±11.97) years among non-HD individuals (Welch's <i>t</i>-test, <i>p</i> = 0.060). Most deaths occurred during the chronic phase of the disaster. Primary causes included exacerbation of chronic kidney disease, cardiovascular complications, and sepsis. Over half of the patients exhibited psychiatric symptoms such as depression or mood instability.</p><p><strong>Discussion: </strong>This case series illustrates the severe impact of disruptions in medical care and the stress of repeated evacuations. Challenges include insufficient continuity of care and prolonged psychological distress, particularly during the chronic disaster phase. Our findings suggest that ensuring uninterrupted HD and providing long-term psychological support may be essential to mitigating DRDs in this population.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"8847100"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688413","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: 0
Spontaneous Remission of Late Relapsing Membranous Nephropathy After Previous Immunosuppressant-Induced Remission: Case Report. 既往免疫抑制剂诱导缓解后晚期复发性膜性肾病的自发缓解:病例报告。
Case Reports in Nephrology Pub Date : 2026-04-12 eCollection Date: 2026-01-01 DOI: 10.1155/crin/6703642
Yangming Cao
{"title":"Spontaneous Remission of Late Relapsing Membranous Nephropathy After Previous Immunosuppressant-Induced Remission: Case Report.","authors":"Yangming Cao","doi":"10.1155/crin/6703642","DOIUrl":"10.1155/crin/6703642","url":null,"abstract":"<p><p>This is the first detailed report of spontaneous remission of late relapsing membranous nephropathy (MN) after previous immunosuppressant-induced remission. In March 2004, a 52-year-old Hispanic male presented with severe nephrotic syndrome with proteinuria of 13 g/24 h. The workup for infectious and autoimmune diseases was unrevealing. Renal biopsy showed MN (Stage II). A CT scan showed no malignancy but left pulmonary embolism and left renal vein thrombosis. Anticoagulation was started for asymptomatic thromboembolism. He achieved sustained complete remission of nephrotic syndrome after a prolonged, complicated treatment course of multiple immunosuppressants (corticosteroids and mycophenolate mofetil for 1 year, followed by alternating monthly corticosteroids and chlorambucil for 6 months, and again corticosteroids and mycophenolate mofetil for 6 years). Then in July 2021 (now at the age of 69 years), he developed nephrotic syndrome again with proteinuria of 6 g/24 h. Serological work-up was all negative except for the elevated serum Antiphospholipase A2 receptor (PLA2R) antibody at 42 RU/mL (nl < 14). Renal biopsy in November 2021 showed again MN (Stage III to IV). Immunohistochemistry staining of the biopsy tissue for PLA2R1 antigen was positive. A decision was made to observe him instead of starting immunosuppressants. He was treated with diuretics and Lisinopril. Anti-PLA2R antibody steadily improved to normal range and the nephrotic syndrome gradually improved and finally resolved by August 2023. There was no recurrence of nephrotic syndrome up to the most recent visit in March 2026. A review of the literature shows that a repeat biopsy in patients already known to have MN (especially those PLA2R-mediated cases) with relapse of nephrosis and stable renal function may not be necessary. In routine practice, the watchful waiting strategy for relapse of MN is less often taken as it should be. Therefore, more patients with relapsing MN deserve an observation period before starting immunosuppressants. Hopefully, KDIGO guidelines can include this point for relapsing MN.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"6703642"},"PeriodicalIF":0.0,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688332","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: 0
Successful Simultaneous Peritoneal Dialysis Catheter Removal and Reinsertion During Surgical Repair of Acute Small Bowel Perforation: A Case Report. 急性小肠穿孔手术修复术中成功同时取出和重新插入腹膜透析导管一例报告。
Case Reports in Nephrology Pub Date : 2026-04-11 eCollection Date: 2026-01-01 DOI: 10.1155/crin/8739668
Pannawat Mongkolrattanakul, Chote Jitopas, Vatcharee Chareonphaibul, Kittiphan Chienwichai
{"title":"Successful Simultaneous Peritoneal Dialysis Catheter Removal and Reinsertion During Surgical Repair of Acute Small Bowel Perforation: A Case Report.","authors":"Pannawat Mongkolrattanakul, Chote Jitopas, Vatcharee Chareonphaibul, Kittiphan Chienwichai","doi":"10.1155/crin/8739668","DOIUrl":"10.1155/crin/8739668","url":null,"abstract":"<p><p>Bowel perforation is a rare but serious complication of Tenckhoff catheter placement for peritoneal dialysis (PD), particularly when blind insertion techniques such as the Seldinger method are used. Standard management typically involves catheter removal, surgical repair of the bowel, and delayed reinsertion of a new catheter following completion of systemic antibiotic therapy. Although this approach minimizes the risk of infection, it necessitates a second surgical procedure and can significantly delay the initiation of PD. We report the case of a 60-year-old woman with end-stage kidney disease secondary to diabetic nephropathy who developed small bowel perforation during Tenckhoff catheter insertion via the Seldinger technique. To avoid a second operation, and in accordance with the patient's preference, simultaneous catheter removal and contralateral reinsertion were performed during surgical repair of the perforation. The peritoneal cavity was irrigated with 2.5 L of normal saline, a drain was placed, and the patient received a 14-day course of intravenous meropenem with peritoneal rest. The drain was removed on postoperative Day 5, and automated PD was successfully resumed two weeks later without any evidence of peritonitis. This case suggests that simultaneous catheter removal and reinsertion during bowel repair may be technically feasible under specific, favorable intraoperative conditions, potentially avoiding an additional procedure and facilitating earlier return to PD. However, this approach is not supported by current guidelines, which recommend delayed catheter reinsertion to allow adequate peritoneal healing, and should not be considered standard practice.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"8739668"},"PeriodicalIF":0.0,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13069911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670565","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: 0
End-Stage Renal Disease Patient on Hemodialysis With Baclofen-Related Neurotoxicity and Pancreatitis. 终末期肾病患者血液透析伴巴氯芬相关神经毒性和胰腺炎。
Case Reports in Nephrology Pub Date : 2026-04-07 eCollection Date: 2026-01-01 DOI: 10.1155/crin/5482934
Abdulaziz Alroshodi
{"title":"End-Stage Renal Disease Patient on Hemodialysis With Baclofen-Related Neurotoxicity and Pancreatitis.","authors":"Abdulaziz Alroshodi","doi":"10.1155/crin/5482934","DOIUrl":"10.1155/crin/5482934","url":null,"abstract":"<p><strong>Background: </strong>Baclofen is a centrally acting muscle relaxant used orally and intrathecally for the management of spasticity, muscular spasms, and refractory hiccups. Baclofen is predominantly absorbed via the gastrointestinal tract, with over 80% excreted via the kidneys; hence, individuals with end-stage renal disease (ESRD) are at a heightened risk for baclofen toxicity. Baclofen can penetrate the blood-brain barrier, resulting in neurotoxicity. The potential of baclofen to induce acute pancreatitis is inadequately comprehended, with a limited number of instances documented in the medical literature. This report details an uncommon instance of an ESRD patient undergoing hemodialysis who had both baclofen-induced neurotoxicity and pancreatitis.</p><p><strong>Case presentation: </strong>We present a case of a 55-year-old woman who is known to have ESRD; she is currently on hemodialysis three times a week. After only two baclofen doses (10 mg, 12 h apart), given for chronic cervical pain, the patient developed a profound decrease in her level of consciousness (LOC). The next day, when her LOC had improved after dialysis, she reported nausea, vomiting, and epigastric abdominal pain as well. Her initial laboratory report showed an elevated amylase level. So, the assessment was a baclofen neurotoxicity in an ESRD patient, which was accompanied by mild-moderate pancreatitis after only two doses. Since baclofen is highly dialyzable, she was commenced on daily conventional hemodialysis using a high-flux dialyzer for three consecutive days. She did not require continuous dialysis. Her LOC improved dramatically after the second session, and she returned to her baseline just after the third session. However, she reported headache and hallucinations after. Pancreatitis symptoms improved with supportive measures later.</p><p><strong>Conclusion: </strong>The case highlights the need for increased awareness among healthcare providers about the potential risks of baclofen use, particularly in patients with ESRD. Even a small dosing can cause neurotoxicity. This is a very rare case of baclofen neurotoxicity accompanied by pancreatitis, who did respond very well to conventional hemodialysis. Patients with decreased renal function should avoid using baclofen, as its accumulation depends on renal excretion capacity.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"5482934"},"PeriodicalIF":0.0,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147643935","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: 0
Nephrotic-Nephritic Syndrome Following Unilateral Nephrectomy in Wilms Tumour in a Child. 儿童肾母细胞瘤单侧肾切除术后肾病综合征。
Case Reports in Nephrology Pub Date : 2026-04-05 eCollection Date: 2026-01-01 DOI: 10.1155/crin/6427670
Rawshan Zuhair Jaber
{"title":"Nephrotic-Nephritic Syndrome Following Unilateral Nephrectomy in Wilms Tumour in a Child.","authors":"Rawshan Zuhair Jaber","doi":"10.1155/crin/6427670","DOIUrl":"10.1155/crin/6427670","url":null,"abstract":"<p><strong>Background: </strong>Wilms tumour (WT) represents the most frequent kidney malignant tumour in the paediatric population and is occasionally linked to specific congenital syndromes. Treatment typically includes multimodal therapy consisting of chemotherapy, surgery and/or radiotherapy (RT), with a success rate of approximately 90%. The incidence of nephrotic-nephritic syndrome following unilateral nephrectomy is extremely rare; however, certain long-term kidney complications have been documented.</p><p><strong>Case report: </strong>A 5-year-old female was diagnosed with WT, Stage 3 with favourable histology. She underwent left radical nephrectomy with preoperative spillage and received RT for the whole abdomen followed by chemotherapy. She was complaint from insidious onset fever, shortness of breath, progressive generalized oedema, reddish urine and headache, occurring 5 days from the 5<sup>th</sup> cycle of chemotherapy and investigation confirm diagnosis of nephrotic-nephritic syndrome.</p><p><strong>Conclusion: </strong>Kidney injury poses a risk in cases following nephrectomy, with hyperfiltration, treatment toxicity and immune effects contributing to the condition. Early detection and management are essential for kidney preservation.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"6427670"},"PeriodicalIF":0.0,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632153","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}
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