Tamara Davidovic, J. Schimpf, H. Sprenger-Mähr, Armin Abbassi-Nik, A. Soleiman, E. Zitt, K. Lhotta
{"title":"De Novo and Relapsing Glomerulonephritis following SARS-CoV-2 mRNA Vaccination in Microscopic Polyangiitis","authors":"Tamara Davidovic, J. Schimpf, H. Sprenger-Mähr, Armin Abbassi-Nik, A. Soleiman, E. Zitt, K. Lhotta","doi":"10.1155/2021/8400842","DOIUrl":"https://doi.org/10.1155/2021/8400842","url":null,"abstract":"Vaccination against SARS-CoV-2 is the most important advance in the fight against the ongoing coronavirus pandemic. Recent case reports show that the SARS-CoV-2 vaccines can very rarely cause de novo or relapsing glomerular disease. Here, we report two female patients with microscopic polyangiitis, who developed severe glomerulonephritis after immunisation with the BNT162b2 mRNA vaccine. One patient with a possible ongoing but undiagnosed disease developed severe necrotising glomerulonephritis after the second vaccination. In the other patient with a long-lasting disease, rituximab maintenance therapy had been postponed because of the coronavirus pandemic. She noted macrohematuria immediately after the second vaccine dose and developed a severe renal relapse leading to end-stage kidney disease. We suggest that patients with ANCA-associated vasculitis be carefully monitored for disease activity immediately before and after receiving the SARS-CoV-2 vaccination, especially if maintenance therapy has been interrupted. Ultimately, mRNA vaccines should probably be avoided in these patients.","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"600 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77264569","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":"\"Recurrent Papillary Necrosis and Nephrocalcinosis Induced by Nonsteroidal Anti-Inflammatory Drugs for Gouty Arthritis Associated with Congenital Chloride-Losing Diarrhea: A Major Risk for Kidney Loss\".","authors":"Kamel El-Reshaid, Shaikha Al-Bader, Hossameldin Sallam","doi":"10.1155/2021/3558278","DOIUrl":"https://doi.org/10.1155/2021/3558278","url":null,"abstract":"<p><p>Congenital chloride-losing diarrhea (CCLD) is a rare genetic disorder due to autosomal recessive mutation in the SLC26A3 gene on chromosome 7. It is characterized with chronic watery diarrhea with high fecal chloride (Cl: >90 mmol/L), low potassium (K), and metabolic alkalosis with low urinary Cl and K. The overall long-term prognosis is favorable with optimal life-long salt and K supplementation. In this case report, we describe a man with progressive renal failure and small kidneys that showed nephrocalcinosis and papillary necrosis. His disease was diagnosed since birth and was confirmed by our tests. He was incompliant with therapy and had developed gout. The latter complication of his disease has led to excessive NSAID use over the past years. Reinstitution of diet, drug therapy, and allopurinol had stabilized his renal disease for 1 year of follow-up. In conclusion, excessive analgesic use is a risk factor for renal failure in CCLD.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2021 ","pages":"3558278"},"PeriodicalIF":0.0,"publicationDate":"2021-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8578686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39877301","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 Esophageal Necrosis Early after Renal Transplantation.","authors":"Ahmad Makeen, Faisal Al-Husayni, Turki Banamah","doi":"10.1155/2021/5164373","DOIUrl":"https://doi.org/10.1155/2021/5164373","url":null,"abstract":"<p><strong>Background: </strong>Acute esophageal necrosis (AEN) is defined as a diffused black discoloration of the esophageal mucosa involving mainly the distal part of the esophagus. It is considered a rare clinical entity with a high mortality rate. The etiology of AEN is unknown, but it has been correlated to many causes such as malignancies, infections, and hemodynamics instability. Here, we report a case of a patient developing AEN a few days after kidney transplantation. <i>Case Presentation</i>. A 57-year-old male was admitted electively for kidney transplantation that he received from his son. The surgery was complicated with a significant drop in blood pressure but otherwise was uneventful. The patient was showing good signs of recovery but then suffered from significant hematemesis. An urgent upper esophagogastroduodenoscopy revealed black discoloration of the esophageal mucosa in keeping with AEN. The patient was treated with proton pump inhibitors infusion and started empirically on antivirals and antifungals. The patient's condition improved in regards to the AEN; nonetheless, the complications resulted in graft loss, and the patient returned to hemodialysis.</p><p><strong>Conclusion: </strong>AEN is a critical condition that mandates early intervention. Identifying high-risk populations may aid in early anticipation and diagnosis. Patients with chronic kidney disease are at risk of atherosclerosis leading to a low flow state which is exacerbated during renal transplantation surgery, especially if the procedure was complicated with a drop in blood pressure.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2021 ","pages":"5164373"},"PeriodicalIF":0.0,"publicationDate":"2021-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8536408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39552967","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}
Laura Biederman, Anjali A Satoskar, Mohankumar Doraiswamy, Samir Parikh, Brad Rovin, Brian Mussio, Galina Mikhalina, Sergey V Brodsky
{"title":"Can Antinuclear Antibodies (ANA) be Monoclonal?","authors":"Laura Biederman, Anjali A Satoskar, Mohankumar Doraiswamy, Samir Parikh, Brad Rovin, Brian Mussio, Galina Mikhalina, Sergey V Brodsky","doi":"10.1155/2021/7006466","DOIUrl":"https://doi.org/10.1155/2021/7006466","url":null,"abstract":"<p><strong>Background: </strong>Nuclear staining by immunofluorescence in a kidney biopsy is often seen in patients with positive antinuclear antibodies (ANA) in the serum. These ANA are usually polyclonal, but herein we report 9 cases with an unusual finding of monoclonal nuclear staining by immunofluorescence on kidney biopsy. <i>Case Presentation</i>. Nine cases with predominant stain for kappa or lambda light chain were identified by searching the renal pathology laboratory database for the past 10 years. All cases had positive stain for only kappa (six cases) or lambda (three cases) light chain in the nuclei. Eight out of nine cases had positive nuclear IgG stain, and one case had positive nuclear IgA stain. Among cases with positive nuclear IgG staining, six cases were positive for IgG1 subclass, one case was positive for IgG2 subclass, and one case was positive for IgG3 subclass. All patients with positive IgG nuclear stain, who had testing for ANA, had positive ANA. Patients with positive IgG1 subclass did not have monoclonal protein in the serum or urine, but the patient with positive IgG2 subclass and lambda light chain stain in the nuclei had IgG lambda monoclonal gammopathy.</p><p><strong>Conclusions: </strong>We identified a new unique pattern of nuclear stain by immunofluorescence in kidney biopsies that suggests the presence of monoclonal ANA. Workup for underlying monoclonal gammopathy is warranted in such patients.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2021 ","pages":"7006466"},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8497151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39505844","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}
Lalani De Silva, Dinesha Jayasinghe, Priyani Amarathunga
{"title":"<i>Mycoplasma pneumoniae</i> Infection Associated C3 Glomerulopathy Presenting as Severe Crescentic Glomerulonephritis.","authors":"Lalani De Silva, Dinesha Jayasinghe, Priyani Amarathunga","doi":"10.1155/2021/6295543","DOIUrl":"https://doi.org/10.1155/2021/6295543","url":null,"abstract":"<p><p>C3 glomerulopathy (C3GP) is a group of diseases caused by a deregulated complement system, which encompasses both dense deposit disease and C3 glomerulonephritis. Renal manifestations of C3GP are primarily of proliferative glomerulonephritis, and only a few case reports of crescentic glomerulonephritis (CGN) in association with C3GP are available. Here is a case of an adult South-Asian female, who was diagnosed as seropositive acute <i>Mycoplasma pneumoniae</i> infection, with associated systemic manifestations, including immune-type extravascular haemolysis and nephrotic range proteinuria. Subsequent renal biopsy revealed CGN with disrupted Bowman's capsules and necrotizing lesions. Immunofluorescence showed coarse granular mesangial C3 deposits with negative IgM, IgG, IgA, and C1q. The immunomorphological phenotype raised two possibilities including C3GP and infection-related glomerulonephritis (IRGN). Persistent proteinuria with no evidence of resolution even after 6 months of follow-up favoured C3GP over IRGN. The patient proceeded to end-stage renal failure requiring renal replacement despite aggressive immunosuppression. This case illustrates the rare association of CGN with C3GP induced by <i>Mycoplasma pneumoniae</i> infection, highlighting the importance of correct diagnosis as well as timely identification of triggering factors in CGN on patient outcome.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2021 ","pages":"6295543"},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8490074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39516425","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}
Christian Maalouli, Karin Dahan, Arnaud Devresse, Valentine Gillion
{"title":"Mutation in the <i>SLC2A9</i> Gene: A New Family with Familial Renal Hypouricemia Type 2.","authors":"Christian Maalouli, Karin Dahan, Arnaud Devresse, Valentine Gillion","doi":"10.1155/2021/4751099","DOIUrl":"10.1155/2021/4751099","url":null,"abstract":"<p><p>Familial renal hypouricemia is a rare genetic disorder characterized by a defect in renal tubular urate reabsorption. Some patients present with exercise-induced acute kidney injury and nephrolithiasis. Type II is caused by mutations in the <i>SLC2A9</i> gene. Here, we report the case of a young patient who developed acute kidney injury after exercise secondary to familial renal hypouricemia type II. The same mutation was found in other asymptomatic members of his family. We review the medical literature on this condition. This case highlights the importance of considering uric acid disorders in the work-up of acute kidney injury after exercise.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2021 ","pages":"4751099"},"PeriodicalIF":0.0,"publicationDate":"2021-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8486506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39482682","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}
Anwar S Atieh, Omar K Abu Shamma, Mohammad O Abdelhafez, Muath A Baniowda, Samia Abed, Basheer H Babaa, Abdurrahman Hamadah, Kamel A Gharaibeh
{"title":"Acute Severe Hyponatremia following Hysteroscopic Procedure in a Young Patient: A Case Report and Review of the Literature.","authors":"Anwar S Atieh, Omar K Abu Shamma, Mohammad O Abdelhafez, Muath A Baniowda, Samia Abed, Basheer H Babaa, Abdurrahman Hamadah, Kamel A Gharaibeh","doi":"10.1155/2021/7195660","DOIUrl":"https://doi.org/10.1155/2021/7195660","url":null,"abstract":"<p><strong>Background: </strong>Hysteroscopic surgery is a minimally invasive procedure used to diagnose and treat intrauterine pathologies. It requires distension of the uterine cavity for the adequate visualization of the operative field. Glycine (1.5%) is one of the most commonly used solutions because it is nonconductive and also has good optical properties. However, acute hyponatremia is a critical complication that can develop after the absorption of a sufficient amount of the irrigation medium. <i>Case Presentation</i>. We report a case of a 43-year-old female patient who developed acute symptomatic hyponatremia (104 mEq/L) and pulmonary edema secondary to hysteroscopic resection of leiomyoma and hastily approached with rapid sodium correction measures.</p><p><strong>Conclusion: </strong>Multiple strategies can be taken to reduce the risk of fluid absorption and subsequent hyponatremia. Moreover, attention should be paid to the treatment approach for patients with acute hyponatremia following hysteroscopic procedures; rapid correction of acute hyponatremia for such patients might be safe, although there is no consensus in the literature, and further trials are needed.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2021 ","pages":"7195660"},"PeriodicalIF":0.0,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8478601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39474885","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}
Daniel Guck, Reynaldo Hernandez, Steven Moore, Andry Van de Louw, Philippe Haouzi
{"title":"Rapid Glomerulotubular Nephritis as an Initial Presentation of a Lethal Diquat Ingestion.","authors":"Daniel Guck, Reynaldo Hernandez, Steven Moore, Andry Van de Louw, Philippe Haouzi","doi":"10.1155/2021/4723092","DOIUrl":"https://doi.org/10.1155/2021/4723092","url":null,"abstract":"<p><strong>Introduction: </strong>Diquat is an herbicide that can lead to rapid multiorgan system failure upon toxic ingestion. Although Diquat shares a similar chemical structure with paraquat, diquat is still readily available to the general population, and in contrast to paraquat, it is not regulated. We present a case of an intentional diquat poisoning which emphasizes the necessity of the early recognition due to atypical symptoms within the first 24 hours and certainly enhanced regulatory restrictions on this very toxic compound.</p><p><strong>Case: </strong>A 60-year-old male with a history of severe depression presented to the emergency department after intentional ingestion of a commercial herbicide containing diquat dibromide 2.30%. The earliest manifestations of this acute diquat intoxication comprised a glomerulonephritis and proximal tubular dysfunction. Progressive multiorgan system failure then developed with a significant delay (24-38 hours) including acute renal, liver failure, and then respiratory failure with refractory hypoxemia. Despite maximal supportive care, the end organ failure was lethal. <i>Discussion</i>. Diquat intoxication should be suspected in patient presenting an acute glomerulonephritis with coma. Diquat should undergo the same regulatory restrictions as paraquat-containing compounds.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2021 ","pages":"4723092"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8452446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39440285","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":"The Role of Patiromer in Delaying the Onset of Renal Replacement Therapy in Patients with Advanced Renal Failure.","authors":"Nand K Wadhwa, Jason A Kline, Sreedhar R Adapa","doi":"10.1155/2021/6987456","DOIUrl":"10.1155/2021/6987456","url":null,"abstract":"<p><p>Patients with chronic kidney disease (CKD) are at an increased risk of developing hyperkalemia, which can be potentially life threatening. Hyperkalemia is frequently encountered with renin-angiotensin-aldosterone system inhibitor (RAASi) therapy use in patients with CKD and often results in the underdosing or discontinuation of these drugs. RAASi therapy has been proven to delay the progression of CKD, ameliorate proteinuria, and reduce the overall risk of cardiovascular morbidity and mortality. Patiromer is a sodium-free, potassium-binding polymer used for the treatment of hyperkalemia. We present a case series of four patients with Stage 4 or 5 CKD in whom the initiation of dialysis was delayed with the use of patiromer. For one patient, dialysis was delayed by 18 months, whereas the remaining three patients, in whom hyperkalemia was one of the main complications, remain dialysis independent to date.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2021 ","pages":"6987456"},"PeriodicalIF":0.0,"publicationDate":"2021-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8440084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39424105","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}
Daniele Sforza, Leandro Siragusa, Matteo Ciancio Manuelli, Linda De Luca, Bruno Sensi, Simona Grande, Renato Argirò, Marco Nezzo, Massimo Villa, Michele Grande
{"title":"A Rare Case of Xanthogranulomatous Pyelonephritis with Spontaneous Renocolic Fistula and IVC Thrombosis.","authors":"Daniele Sforza, Leandro Siragusa, Matteo Ciancio Manuelli, Linda De Luca, Bruno Sensi, Simona Grande, Renato Argirò, Marco Nezzo, Massimo Villa, Michele Grande","doi":"10.1155/2021/3604017","DOIUrl":"https://doi.org/10.1155/2021/3604017","url":null,"abstract":"<p><p>Xanthogranulomatous pyelonephritis (XGPN) is a rare disorder affecting the kidney which can fistulise to the colon in exceptional cases. We herein report a case of XGPN with renocolic fistula and large vessel thrombosis presenting with sepsis and pulmonary embolism. Preoperative diagnosis and strategic planning resulted in successful management. A 64-year-old woman presented to the emergency department with abdominal pain and a septic condition, corroborated by venous thromboembolism. Workup diagnosed a left renal abscess with calicocolic fistula. Scintigraphy confirmed a nonfunctioning left kidney. The patient underwent inferior vena cava filter placement and staged surgery. The first, damage control procedure was a loop ileostomy. Ten days later, when the patient's conditions improved, she underwent left nephrectomy and left colectomy with primary anastomosis. Finally, a year later, the ileostomy was closed. At follow-up, the patient was well, with unremarkable renal function. Scrupulous diagnostics, multidisciplinary decision making, and staged intervention have been key to optimal outcome.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2021 ","pages":"3604017"},"PeriodicalIF":0.0,"publicationDate":"2021-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8440069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39424104","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}