Case Reports in Nephrology最新文献

{"title":"Acute Oxalate Nephropathy Caused by Excessive Vegetable Juicing and Concomitant Volume Depletion.","authors":"Harshad Chaudhari,&nbsp;Jennine Michaud,&nbsp;Nityasree Srialluri,&nbsp;Smita Mahendrakar,&nbsp;Christine Granz,&nbsp;Michael Yudd","doi":"10.1155/2022/4349673","DOIUrl":"https://doi.org/10.1155/2022/4349673","url":null,"abstract":"<p><p>Acute oxalate nephropathy (AON) induced by high dietary intake of oxalate-rich food is a rare cause of acute kidney injury and end-stage renal disease (ESRD). We describe a 68-year-old man with adequate baseline renal function who developed severe AON and ESRD. Six months earlier, he started a daily oxalate-rich fruit and vegetable juice diet high in spinach, with a calculated daily oxalate dietary intake of 1500 mg, about 10 times a typical diet. Renal biopsy showed extensive tubular oxalate deposits and acute tubular damage; the renal tissue was relatively free of chronic changes such as glomerulosclerosis, tubular atrophy, and interstitial fibrosis. A year later, he remains dialysis dependent.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":" ","pages":"4349673"},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8820937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39609486","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":"<i>Candida auris</i> Invasive Infection after Kidney Transplantation.","authors":"Javier Reque,&nbsp;Rosa Arlandis,&nbsp;Nayara Panizo,&nbsp;Maria José Pascual,&nbsp;Alejandro Perez-Alba","doi":"10.1155/2022/6007607","DOIUrl":"https://doi.org/10.1155/2022/6007607","url":null,"abstract":"<p><strong>Introduction: </strong><i>C. auris</i> has been associated not only with a variety of invasive fungal infections, including candidemia, sometimes related to central venous catheter, but also with pericarditis and respiratory tract and urinary tract infections.</p><p><strong>Materials and methods: </strong>We describe the case of a patient with persistent fever despite antibiotics, who presented with <i>Candida</i> isolation in blood cultures, typified as <i>Candida auris</i> species.</p><p><strong>Results: </strong>A 57-year-old male receiving peritoneal dialysis underwent kidney transplantation which was complicated by primary nonfunction due to arterial thrombosis necessitating graft nephrectomy. During the postoperative period, he presented with <i>Pseudomonas aeruginosa</i> pneumonia that was treated with levofloxacin and catheter-related <i>Enterococcus faecalis</i> bacteremia treated with linezolid. After hospital discharge, he then presented with herpes zoster infection treated with valacyclovir. Ten days later, he developed peritonitis and exit site infection with multidrug-resistant <i>Pseudomonas aeruginosa</i> treated with intraperitoneal aztreonam and peritoneal dialysis catheter removal. Despite broad-spectrum antibiotic therapy, the patient remained febrile. All microbiology laboratory tests were negative, so it was decided to stop antibiotic therapy for 48 hours and repeat cultures in order to avoid possible false negatives. In new blood cultures performed after suspension of antibiotic therapy, candidemia was observed, later typified as <i>Candida auris</i> species. After completing antifungal treatment (three weeks with intravenous amphotericin B 100 mg qd and two weeks of intravenous anidulafungin 100 mg qd), microbiological cultures remained negative and the patient made uneventful recovery.</p><p><strong>Conclusion: </strong><i>Candida auris</i> invasive infection has been mainly described in patients with severe underlying comorbidities and immunocompromise. Multidrug-resistant clusters of <i>Candida auris</i> are increasingly emerging.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":" ","pages":"6007607"},"PeriodicalIF":0.0,"publicationDate":"2022-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8816593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39756492","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 Novel Homozygous Mutation in the <i>COL4A4</i> Gene (Gly1436del) Causing Alport Syndrome Exposed by Pregnancy: A Case Report and Review of the Literature.","authors":"Ulrich Jehn,&nbsp;Cornelie Müller-Hofstede,&nbsp;Barbara Heitplatz,&nbsp;Veerle Van Marck,&nbsp;Stefan Reuter,&nbsp;Hermann Pavenstädt,&nbsp;Britta George","doi":"10.1155/2022/5243137","DOIUrl":"https://doi.org/10.1155/2022/5243137","url":null,"abstract":"<p><strong>Background: </strong>Alport syndrome results from a hereditary defect of collagen IV synthesis. This causes progressive glomerular disease, ocular abnormalities, and inner ear impairment. <i>Case Presentation</i>. Herein, we present a case of Alport syndrome in a 28-year-old woman caused by a novel mutation (Gly1436del) in the <i>COL4A4</i> gene that was not unveiled until her first pregnancy. Within the 29^th pregnancy week, our patient presented with massive proteinuria and nephrotic syndrome. Light microscopic examination of a kidney biopsy showed typical histological features of segmental sclerosis, and electron microscopy revealed extensive podocyte alterations as well as thickness of glomerular basement membranes with splitting of the lamina densa. One and a half years after childbirth, renal function deteriorated to a preterminal stage, whereas nephrotic syndrome subsided quickly after delivery.</p><p><strong>Conclusion: </strong>This case report highlights the awareness of atypical AS courses and emphasizes the importance of genetic testing in such cases.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":" ","pages":"5243137"},"PeriodicalIF":0.0,"publicationDate":"2022-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8752291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39909634","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":"Simultaneous Pancreas-Kidney Transplant Complicated by Kidney Allograft Torsion and Pseudoaneurysms of the <i>Y</i>-Allograft: A Case Report and Review of the Literature.","authors":"Sarah L Tan,&nbsp;Rachel Y P Tan,&nbsp;Gabrielle Cehic,&nbsp;Michael Wu,&nbsp;John Kanellis,&nbsp;Jeffrey Barbara","doi":"10.1155/2022/1748141","DOIUrl":"https://doi.org/10.1155/2022/1748141","url":null,"abstract":"<p><strong>Background: </strong>We report and review the literature of two rare complications of simultaneous pancreas-kidney transplantation (SPKT) occurring in one patient. <i>Case Report</i>. A 39-year-old man with dialysis-dependent kidney failure secondary to type 1 diabetes mellitus underwent successful SPKT in October 2018. Three months later, he presented with an acute kidney injury (AKI) and returned to dialysis. Kidney scintigraphy showed a central photopenic region, and angiograms showed absent flow in the kidney transplant artery without treatable thrombus and the incidental finding of two pseudoaneurysms of the pancreatic <i>Y</i>-graft. He remained dialysis-dependent for three weeks before spontaneous partial recovery of allograft function; repeat kidney scintigraphy showed significant improvement in perfusion. However, in April 2019 he was readmitted with a sudden deterioration in kidney allograft function again necessitating haemodialysis. Repeat imaging confirmed that the kidney allograft had shifted from the left iliac fossa to the midline. He underwent surgical exploration, during which torsion of the kidney allograft was confirmed and a nephropexy was performed. The kidney allograft was originally implanted in the left retroperitoneum via a midline transperitoneal approach, which likely predisposed it to torsion. The pseudoaneurysms of the pancreatic <i>Y</i>-graft were managed conservatively, and surveillance imaging demonstrated that they remained stable in size. The patient regained reasonable kidney allograft function (estimated glomerular filtration rate, eGFR, of 45 mL/min) and maintained normal pancreatic allograft function.</p><p><strong>Conclusion: </strong>Kidney allograft torsion should be considered post-SPKT in patients with AKI and absent arterial flow. Although most case reports describe surgical management of pseudoaneurysms post-SPKT, our case demonstrates successful conservative management.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2022 ","pages":"1748141"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9759385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10393629","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":"An Unusual Case of Kidney Injury in a Young Woman with a Connective Tissue Disease.","authors":"Roberto Rivera,&nbsp;Salvador Vila","doi":"10.1155/2022/3833649","DOIUrl":"https://doi.org/10.1155/2022/3833649","url":null,"abstract":"<p><p>A 32-year-old female was admitted to our institution with thrombocytopenia, fever, serositis, hepatosplenomegaly, diffuse lymphadenopathy, and renal insufficiency. A diagnosis of systemic lupus erythematosus was made. Due to recalcitrant thrombocytopenia, serositis, and renal insufficiency methylprednisolone was prescribed in high doses. In addition to proteinuria and hematuria, she was found to have uric acid crystals in her urinalysis. A serum uric acid was found elevated at 18 mg/dL. Rasburicase infusions were started. Within 5 days of commencing rasburicase and continuing high-dose methylprednisolone, her serum creatinine normalized and proteinuria resolved. The microhematuria disappeared within 2 weeks of beginning rasburicase. The rapid reversal of renal insufficiency and all urinary abnormalities after the start of rasburicase infusions suggests that the renal injury was most likely due to uric acid-mediated renal injury and not lupus nephritis. Our case illustrates the co-occurrence of 2 distinct clinical entities, one common for the patient's age, sex, and foremost clinical findings, while the other uncommon and unexpected, but both associated to kidney injury. Clinicians must be aware that careful evaluation of symptoms and laboratory tests is needed to make a thorough differential diagnosis and provide the right treatment at the most opportune moment.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2022 ","pages":"3833649"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9170509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10245969","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":"Anaphylactic Reactions Caused by Nafamostat Mesylate during Hemodialysis before Surgery for Carpal Tunnel Syndrome.","authors":"Yuta Nakamura,&nbsp;Kaoru Tada,&nbsp;Masashi Matsuta,&nbsp;Atsuro Murai,&nbsp;Hiroyuki Tsuchiya","doi":"10.1155/2021/1148156","DOIUrl":"https://doi.org/10.1155/2021/1148156","url":null,"abstract":"<p><p>Nafamostat mesylate (NM) has been used to treat pancreatitis and disseminated intravascular coagulation during hemodialysis (HD). However, there have been some reports of adverse effects related to anaphylactic reactions. We present a case in which anaphylactic reactions caused by NM during preoperative HD caused repeated postponement of surgery for carpal tunnel syndrome. Symptoms including fever, shivering, chills, low blood pressure, tachycardia, nausea, and vomiting appeared during preoperative HD, and surgery was postponed thrice. Initially, the patient was misdiagnosed with sepsis because of elevated C-reactive protein and procalcitonin levels. However, since the symptoms appeared only when NM was administered and disappeared quickly after the administration of NM was terminated, the condition was diagnosed as anaphylactic reactions caused by NM. Therefore, it is essential to consider anaphylactic reactions caused by NM as differential diagnoses, when symptoms, such as fever, are observed during perioperative HD.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2021 ","pages":"1148156"},"PeriodicalIF":0.0,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8731279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39802852","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":"An Interesting Case of Nonlupus Full-House Nephropathy.","authors":"Satyanand Sathi,&nbsp;Alok Sharma,&nbsp;Anil Kumar Garg,&nbsp;Virendra Singh Saini,&nbsp;Manoj Kumar Singh,&nbsp;Devinder Vohra,&nbsp;Arvind Trivedi","doi":"10.1155/2021/9043003","DOIUrl":"https://doi.org/10.1155/2021/9043003","url":null,"abstract":"<p><p>Full-house immunofluorescence and endothelial tubuloreticular inclusions are known as characteristic features of lupus nephritis. However, both features are not pathognomonic for lupus nephritis. A kidney biopsy specimen showing full-house immunofluorescence pattern in the absence of autoantibodies and classical clinical features of Systemic Lupus Erythematosus (SLE) is now considered as nonlupus full-house nephropathy (FHN). Nonlupus FHN may be idiopathic or due to other disease processes known as secondary nonlupus FHN. Here, we report the case of a 36-year-old female who presented with nephrotic proteinuria with bland urine sediment. Additional analyses revealed normal serum antinuclear antibody (ANA), normal anti-double-stranded DNA (anti-dsDNA) antibodies, and normal serum C3 and C4 levels. A renal biopsy showed a normal-appearing glomerulus without any proliferation or capillary wall thickening and widespread glomerular immune deposits (full-house effect; IgA, IgG, IgM, C3, and C1Q) on direct immunofluorescence. Renal electron microscopy showed diffuse effacement of visceral epithelial cell foot processes and mesangial electron dense deposits. The patient was diagnosed as nonlupus FHN. There is a controversial role of steroids and other immunosuppressive drugs in the treatment of nonlupus FHN patients, but our case patient responded favourably to steroid therapy. The term nonlupus FHN can be used as an umbrella term for patients who do not satisfy the clinical and serological criteria of SLE.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2021 ","pages":"9043003"},"PeriodicalIF":0.0,"publicationDate":"2021-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8727156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39668880","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":"From the Old, the Best: Parathyroidectomy in the Management of Soft-Tissue and Vascular Calcification in Patients with Chronic Renal Disease.","authors":"P Mariel Hernandez,&nbsp;B Daniel Enos,&nbsp;T Gonzalo Labarca,&nbsp;A Guillermo Vanderstelt","doi":"10.1155/2021/9985308","DOIUrl":"https://doi.org/10.1155/2021/9985308","url":null,"abstract":"<p><p><i>Introduction</i>. Bone mineral disease in patients with chronic kidney disease (CKD-MBD) is a clinical syndrome involving bone, biochemical changes, and extraosseous calcification. These complications increase morbidity and mortality. Prevalence reports are rare. <i>Case Report</i>. This case shows a young woman on peritoneal dialysis (PD) for 10 years with severe secondary hyperparathyroidism and soft-tissue calcifications in the hands, pelvis, and right knee, as well as severe vascular calcification, managed with calcimimetics without success. We decided to perform subtotal parathyroidectomy (STPTX). Three months after surgery, she had satisfactory evolution, despite notable hungry bone disease, without bone pain or functional limitation and almost no calcifications. <i>Discussion</i>. The benefit of hemodialysis has been shown with better volume management and improvement of calcium/phosphate products. STPTX allowed biochemical control and calcification improvement, with an evident better quality of life for our patient. Therapeutic alternatives need to be tailored to the patient's characteristics in the calcimimetics era.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2021 ","pages":"9985308"},"PeriodicalIF":0.0,"publicationDate":"2021-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8595030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39638210","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":"<i>Roseomonas mucosa</i>-Induced Peritonitis in a Patient Undergoing Continuous Cycler Peritoneal Dialysis: Case Report and Literature Analysis.","authors":"Sasmit Roy,&nbsp;Sumit Patel,&nbsp;Hardhik Kummamuru,&nbsp;Amarinder Singh Garcha,&nbsp;Rohan Gupta,&nbsp;Sreedhar Adapa","doi":"10.1155/2021/1979332","DOIUrl":"https://doi.org/10.1155/2021/1979332","url":null,"abstract":"<p><p><i>Roseomonas</i> species, a rare Gram-negative microorganism, has seldom been reported to cause peritonitis in end-stage renal disease patients on peritoneal dialysis. Only seven cases of peritonitis by this rare microorganism have been reported worldwide. Treatment options can be challenging if not detected early and can lead to significant morbidity and mortality along with the switching of the dialysis modality to hemodialysis which is highly undesirable. Our patient is a 65-year-old Caucasian female who needed to be changed to emergency hemodialysis due to inability to perform peritoneal dialysis from suspected peritonitis and was subsequently discovered to have peritonitis from <i>Roseomonas mucosa</i>. She recovered with a prolonged antibiotics course and returned to peritoneal dialysis in 3 months following her treatment completion. Prompt diagnosis and prolonged antibiotics are a cornerstone in the management of this rare microorganism to prevent mortality and morbidity from peritonitis.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2021 ","pages":"1979332"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39609712","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":"Complement Factor H Gene Variant in a Patient with Thrombotic Microangiopathy on a Mixed Clinical Background.","authors":"Yoichi Iwafuchi,&nbsp;Tetsuo Morioka,&nbsp;Yuko Oyama,&nbsp;Shin Goto,&nbsp;Ichiei Narita","doi":"10.1155/2021/2519918","DOIUrl":"https://doi.org/10.1155/2021/2519918","url":null,"abstract":"<p><p>We report the case of a patient with <i>complement factor H</i> gene variant, who developed thrombotic microangiopathy on a mixed clinical background. A 79-year-old woman was transferred to Sanjo General Hospital for maintenance hemodialysis. She suffered from gastric non-Hodgkin lymphoma about two years ago and received chemotherapy and radiation therapy, leading to complete remission. About 13 weeks prior to her transfer to our hospital, she was referred to another hospital due to acute kidney injury, hemolytic anemia, and thrombocytopenia. Hemodialysis was immediately initiated, after which intravenous methylprednisolone and oral prednisolone were started; however, she became anuric within approximately week. The possibility of thrombotic microangiopathy was examined. However, she was in poor general condition and did not get the consent of her family, so no invasive searches such as a kidney biopsy were performed. Despite the cause of acute kidney insufficiency being unclear, she was transferred to us for maintenance hemodialysis. Her general condition was stable, and her renal function improved; hence, two months after transfer, a kidney biopsy was performed. Her clinical and typical renal histological findings indicated a diagnosis of thrombotic microangiopathy. There was a possible CFH gene of a very rare variant \"c.526 T > <i>C</i> (p.Phe176Leu)\" in exon 5. She was able to withdraw from hemodialysis therapy two weeks after the initiation of an angiotensin-converting enzyme inhibitor. Based on her clinical course and kidney biopsy findings, she was diagnosed with thrombotic microangiopathy with a very rare CFH variant. To ensure proper treatment choices such as eculizumab, the presence of complement dysregulation should be considered in cases of secondary thrombotic microangiopathy.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2021 ","pages":"2519918"},"PeriodicalIF":0.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8560281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39693178","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}