Case Reports in Nephrology最新文献_第6页

Crescentic Glomerulonephritis and Membranous Nephropathy: A Rare Overlap. 月牙状肾小球肾炎和膜性肾病:罕见的重叠。

Case Reports in Nephrology Pub Date : 2022-06-24 eCollection Date: 2022-01-01 DOI: 10.1155/2022/8292458

Mohamedanwar Ghandour, Heba Osman, Samer Alkassis, Alix Charles, Kristina Zalewski, Jarrett Weinberger, Yahya Malik-Osman, Zeenat Y Bhat

{"title":"Crescentic Glomerulonephritis and Membranous Nephropathy: A Rare Overlap.","authors":"Mohamedanwar Ghandour, Heba Osman, Samer Alkassis, Alix Charles, Kristina Zalewski, Jarrett Weinberger, Yahya Malik-Osman, Zeenat Y Bhat","doi":"10.1155/2022/8292458","DOIUrl":"https://doi.org/10.1155/2022/8292458","url":null,"abstract":"Background: Membranous nephropathy (MN) is a disease that affects the basement membrane of the glomeruli of the kidney resulting in proteinuria. The concurrent incidence of vasculitic glomerulonephritis and MN in the same patient is unusual. Herein, we report a case with this unusual combination.Case: Our patient is a 53-year-old Hispanic male with a medical history of tobacco use, type 2 diabetes mellitus, and hypertension who presented with hematuria and was found to have nephrotic range proteinuria and renal impairment. Blood workup revealed positive ANCA serology, which led to a renal biopsy that showed crescentic vasculitis in addition to membranous nephropathy. The patient was started on intermittent hemodialysis (HD) and treated initially with intravenous (IV) pulse steroids; subsequently, oral prednisolone and IV cyclophosphamide were initiated. The patient remained HD dependent at the time of discharge with the resolution of hematuria. A follow-up with an outpatient nephrology clinic was arranged.Conclusion: Membranous nephropathy complicated by crescentic glomerulonephritis has a more aggressive clinical course and decline in renal function compared to MN alone which can lead to initiating renal replacement therapy. However, immunosuppressive drugs can result in significant improvement of renal function if started early enough.","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":" ","pages":"8292458"},"PeriodicalIF":0.0,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9249512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40556916","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

Calciphylaxis: A Long Road to Cure with a Multidisciplinary and Multimodal Approach. 钙抑制:多学科、多模式治疗的漫漫长路。

Case Reports in Nephrology Pub Date : 2022-06-08 eCollection Date: 2022-01-01 DOI: 10.1155/2022/3818980

Vasiliki Zoi, Dimitra Bacharaki, Aggeliki Sardeli, Minas Karagiannis, Sophia Lionaki

{"title":"Calciphylaxis: A Long Road to Cure with a Multidisciplinary and Multimodal Approach.","authors":"Vasiliki Zoi, Dimitra Bacharaki, Aggeliki Sardeli, Minas Karagiannis, Sophia Lionaki","doi":"10.1155/2022/3818980","DOIUrl":"https://doi.org/10.1155/2022/3818980","url":null,"abstract":"Calciphylaxis is a rare yet potentially fatal condition, resulting from ectopic calcification of the small arterioles of the dermis with resulting necrotic lesions infection, sepsis, and death. In hemodialysis patients, its prevalence ranges between 1 and 4%, while mortality amounts to 30-80%. We present in here a 45-year-old female on chronic dialysis with morbid obesity, who was admitted for painful nodules in the lower abdomen and necrotic lesions at the lower extremities. Severe uremia and uncontrolled secondary hyperparathyroidism were the main characteristics in this patient, and thus, a clinical diagnosis of calciphylaxis was made. Treatment modalities included wound care plus antibiotics and analgesics, daily hemodialysis, and strategies targeting calcification with sodium thiosulfate, cinacalcet, and non-calcium-containing binders. A crucial factor for overcoming the infection-lesion vicious circle is thorough and daily care of the lesions. Nursing attention was focused on the motivation of her self-care, for the prevention of institutionalization and the psychological support of the patient and her family. The most intriguing feature was the fact that she experienced several exacerbations during the follow-up time. During the final relapse, she was prescribed hyperbaric oxygen sessions that actually put the disease under control thereafter. The good outcome for this patient was probably related to the combination of close follow-up along with a multidisciplinary approach.","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":" ","pages":"3818980"},"PeriodicalIF":0.0,"publicationDate":"2022-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9200596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40025742","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

ANCA-Negative Vasculitis in Eosinophilic Granulomatosis with Polyangiitis Complicated with Membranous Nephropathy: A Case Report and Brief Literature Review 嗜酸性肉芽肿病合并多血管炎并发膜性肾病的anca阴性血管炎1例报告及简要文献复习

Case Reports in Nephrology Pub Date : 2022-05-06 DOI: 10.1155/2022/8110940

Eri Kasama, Jun Ino, Fumika Iemura, S. Kumon, Mio Kodama, Keitaro Sato, Hitoshi Eizumi, K. Nitta, J. Hoshino

{"title":"ANCA-Negative Vasculitis in Eosinophilic Granulomatosis with Polyangiitis Complicated with Membranous Nephropathy: A Case Report and Brief Literature Review","authors":"Eri Kasama, Jun Ino, Fumika Iemura, S. Kumon, Mio Kodama, Keitaro Sato, Hitoshi Eizumi, K. Nitta, J. Hoshino","doi":"10.1155/2022/8110940","DOIUrl":"https://doi.org/10.1155/2022/8110940","url":null,"abstract":"Renal involvement in eosinophilic granulomatosis with polyangiitis (EGPA) typically occurs in anti-neutrophil cytoplasmic autoantibody (ANCA)-positive cases presenting with rapidly progressive renal insufficiency and urinary abnormalities induced by primarily necrotizing crescentic glomerulonephritis (NCGN). Recently, ANCA-negative EGPA has also been reported to manifest with renal involvement, such as NCGN or non-NCGN, including membranous nephropathy (MN). Herein, we report a 70-year-old female who presented with purpura on the lower legs, upper limb numbness, renal dysfunction (eGFR, 20.5 ml/min/1.73 m2), and eosinophilia (eosinophils, 37,570/μl). MPO-and PR3-ANCA were negative, and urinalysis revealed urine protein (0.63 g/day) but without red blood cells in the urine sediment. Thus, she was diagnosed with ANCA-negative EGPA with rapidly progressive renal dysfunction. A renal biopsy revealed vasculitis in the interlobular arteries without NCGN, with the vasculitis being complicated by MN. Micrograph findings on fluorescence immunostaining contained both primary and secondary characteristics of MN (dominance of IgG subclass 4 more than subclass 1 vs. negativity of PLA2R and THSD7A). After treatment with prednisolone, her eosinophil counts normalized, and renal dysfunction improved. Furthermore, urine protein did not increase above 1.0 g/day during the clinical course. This is a rare case of ANCA-negative EGPA presenting with acute renal dysfunction without NCGN and subclinical MN with unknown etiology. It is important to recognize that EGPA pathology varies widely throughout the disease course, and the clinical course of subclinical MN should be carefully assessed in further follow-ups.","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80301145","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}

引用次数: 1

Exacerbation of Congenital Hydronephrosis as the First Presentation of COVID-19 Infection in Children 儿童COVID-19感染的首发表现为先天性肾积水加重

Case Reports in Nephrology Pub Date : 2022-05-04 DOI: 10.1155/2022/9562671

M. Mohkam, M. Jamee, Farshid Kompani, M. Khalili, Atena Seifi, L. Mohajerzadeh

{"title":"Exacerbation of Congenital Hydronephrosis as the First Presentation of COVID-19 Infection in Children","authors":"M. Mohkam, M. Jamee, Farshid Kompani, M. Khalili, Atena Seifi, L. Mohajerzadeh","doi":"10.1155/2022/9562671","DOIUrl":"https://doi.org/10.1155/2022/9562671","url":null,"abstract":"Background Congenital hydronephrosis is one of the most common abnormalities of the upper urinary tract, which can be exacerbated by a variety of intrinsic or extrinsic triggers. The urinary tract system is one of the major organs complicated by COVID-19 infection. Case Presentations. Here, we report five patients with an established diagnosis of congenital hydronephrosis, who presented with acute abdominal pain and fever and an abrupt increase in the anteroposterior pelvic diameter (APD). Patients had a previous stable course and were under regular follow-up with serial ultrasonographic studies. They underwent surgery or supportive treatment due to the later exacerbation of hydronephrosis. Based on the clinical and imaging findings, no plausible etiologies for these exacerbation episodes, including infection, nephrolithiasis, or abdominal masses, could be postulated. The common aspect in all these patients was the evidence of a COVID-19 infection. Conclusions Infection with COVID-19 in children with antenatal hydronephrosis may exacerbate the degree of hydronephrosis and renal APD in ultrasonography, which itself may be mediated by the increase in inflammatory mediators.","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85295001","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}

引用次数: 0

Beer Potomania: Why Initial Fluid Resuscitation May Be Harmful 啤酒狂躁:为什么最初的液体复苏可能有害

Case Reports in Nephrology Pub Date : 2022-04-22 DOI: 10.1155/2022/8778304

Z. Yu, Lisa Fisher

引用次数: 2

Hypercalcemia, Acute Kidney Injury, and Metabolic Alkalosis 高钙血症、急性肾损伤和代谢性碱中毒

Case Reports in Nephrology Pub Date : 2022-04-06 DOI: 10.1155/2022/1320259

Faten Aqeel, Jennifer Rose F Del Castillo, B. Jaar, Mohamad A. Hanouneh

引用次数: 0

Multiple Focal Brown Tumors (Osteitis Fibrosa Cystica) in a Renal Transplant Recipient 肾移植受者多发局灶性棕色肿瘤(囊性纤维性骨炎)

Case Reports in Nephrology Pub Date : 2022-03-07 DOI: 10.1155/2022/4675041

Thavathurai Priyanthan, A. Hermann, J. A. Bojsen, A. Krøigaard, C. Bistrup, E. B. Pedersen

{"title":"Multiple Focal Brown Tumors (Osteitis Fibrosa Cystica) in a Renal Transplant Recipient","authors":"Thavathurai Priyanthan, A. Hermann, J. A. Bojsen, A. Krøigaard, C. Bistrup, E. B. Pedersen","doi":"10.1155/2022/4675041","DOIUrl":"https://doi.org/10.1155/2022/4675041","url":null,"abstract":"Brown tumors (BTs) are manifestations of osteitis fibrosa cystica that develops due to increased osteoclast activity secondary to hyperparathyroidism (HPTH). The name comes from its characteristic brown color due to high hemosiderin level and hemorrhage surrounded by osteoclastic giant cells, fibrous tissue, and bone fragments. Presentation can be either unifocal or rarely multifocal. Misdiagnosis of BT compared to malignant giant cell tumor is not uncommon. Early diagnosis and intervention may prevent destructive bone changes. Treatment of BTs due to chronic renal failure should be aimed primarily at its prevention with phosphate binders, vitamin D (analogues), calcimimetics, and prolonged dialysis sessions. Parathyroidectomy can be the option in nonresponsive cases. In this report, we present an unusual case of multiple brown tumors in a 54-year-old female renal transplant patient involving the spine, jaw, and scapula, initially misdiagnosed as giant cell tumor. Five years later, the patient was diagnosed with BT because of the medical history, morphology, and negative p63 staining in combination with secondary/tertiary hyperparathyroidism. The patient subsequently underwent subtotal parathyroidectomy.","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90035184","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}

引用次数: 1

Very Early Severe Posttransplant Recurrent Antineutrophil Cytoplasmic Antibody-Associated Glomerulonephritis after Kidney Transplantation: Two Case Reports 肾移植术后极早期严重复发性抗中性粒细胞胞浆抗体相关性肾小球肾炎2例报告

Case Reports in Nephrology Pub Date : 2022-03-03 DOI: 10.1155/2022/9740225

Reda Laamech, Hamza Naciri-Bennani, D. Giovannini, Johan Noble, B. Janbon, P. Malvezzi, T. Jouve, L. Rostaing

引用次数: 3

Dialysis Disequilibrium: Is Acidosis More Important than Urea? 透析不平衡:酸中毒比尿素更重要吗?

Case Reports in Nephrology Pub Date : 2022-02-22 DOI: 10.1155/2022/4964033

Akshay Athavale, K. Wyburn, P. Snelling, S. Chadban

引用次数: 1

Coexistence of Lupus Nephritis, Ulcerative Colitis, and Communicating Hydrocephalus: A Report of a 21-Year-Old Male. 狼疮性肾炎、溃疡性结肠炎和通讯性脑积水共存:一个21岁男性的报告。

Case Reports in Nephrology Pub Date : 2022-02-04 eCollection Date: 2022-01-01 DOI: 10.1155/2022/1079300

Bushra Ali Khan, Nida Saleem, Danyal Hassan, Shabaz Kiani, Muhammad Haneef

{"title":"Coexistence of Lupus Nephritis, Ulcerative Colitis, and Communicating Hydrocephalus: A Report of a 21-Year-Old Male.","authors":"Bushra Ali Khan, Nida Saleem, Danyal Hassan, Shabaz Kiani, Muhammad Haneef","doi":"10.1155/2022/1079300","DOIUrl":"https://doi.org/10.1155/2022/1079300","url":null,"abstract":"Systemic lupus erythematosus (SLE) and ulcerative colitis (UC) are multisystem autoimmune disorders that rarely coexist. We report a case history of a 21-year-old male, presenting with bloody diarrhea and, later, diagnosed to have ulcerative colitis on colonic biopsy. There was clinically silent renal impairment leading to end-stage kidney disease requiring hemodialysis possibly secondary to ongoing lupus nephritis as suggested by positive lupus-specific antibodies' detection. Besides this, the diagnosis of lupus associated with early communicating hydrocephalus was made on CT brain findings which clinically responded well to the initiation of immunosuppressive therapy. It is imperative to keep in mind the remote possibility of ulcerative colitis in an SLE patient with gastrointestinal (GI) manifestations. Communicating hydrocephalus is a rare neurological manifestation of SLE leading to seizures and can respond well to the initiation of steroids and immunosuppressants. Therefore, a trial of immunosuppressant medications must be given even in a patient with end-stage renal disease (ESRD) to halter extra renal rare lupus manifestations.","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":" ","pages":"1079300"},"PeriodicalIF":0.0,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8843975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39641773","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