Case Reports in Nephrology最新文献_第9页

Profound Metabolic Acidosis due to Metformin Intoxication Requiring Dialysis. 二甲双胍中毒引起的需要透析的深度代谢性酸中毒。

Case Reports in Nephrology Pub Date : 2021-05-24 eCollection Date: 2021-01-01 DOI: 10.1155/2021/9914982

Klodia Hermez, Carla Dudash-Mion

{"title":"Profound Metabolic Acidosis due to Metformin Intoxication Requiring Dialysis.","authors":"Klodia Hermez, Carla Dudash-Mion","doi":"10.1155/2021/9914982","DOIUrl":"https://doi.org/10.1155/2021/9914982","url":null,"abstract":"Metformin-associated lactic acidosis (MALA) is a rare but life-threatening condition with often high mortality rates. Despite this, metformin continues to be one of the most commonly prescribed antihyperglycemic agents in the market. We present a unique case of a 61-year-old female with severe acidosis of pH = 6.72 and lactic acid of 26 mmol/L who presented obtunded after ingestion of an unknown amount of metformin. She was subsequently intubated, became hypotensive, and was initiated on vasopressors. She was swiftly started on a combination of intermittent hemodialysis (IHD) and bicarbonate therapy 7 hours after admission followed by continuous renal replacement therapy (CRRT) as she became more hemodynamically unstable. The patient's renal function improved, and she was discharged 7 days after admission with favorable sequelae. Dialysis is often reported in cases of severe MALA; however, it remains unclear how quickly dialysis should be initiated. This case aims to explore the benefits of quick initiation of extracorporeal measures in the forms of IHD and CRRT with concurrent bicarbonate supplementation. Furthermore, this case demonstrates the importance of clinical suspicion in metabolic acidosis in a patient on metformin therapy.","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39090603","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: 5

A Case of Severe and Refractory Membranous Nephropathy Associated to Mucous Membrane Pemphigoid. 严重难治性膜性肾病伴黏膜类天疱疮1例。

Case Reports in Nephrology Pub Date : 2021-05-11 eCollection Date: 2021-01-01 DOI: 10.1155/2021/9940293

Eric Mereniuk, Laura Sabbah, Jean-Paul Makhzoum

{"title":"A Case of Severe and Refractory Membranous Nephropathy Associated to Mucous Membrane Pemphigoid.","authors":"Eric Mereniuk, Laura Sabbah, Jean-Paul Makhzoum","doi":"10.1155/2021/9940293","DOIUrl":"https://doi.org/10.1155/2021/9940293","url":null,"abstract":"Primary membranous nephropathy (MN) and mucous membrane pemphigoid (MMP) are two autoimmune conditions with well-defined diagnostic and treatment guidelines. MN has been linked to bullous pemphigoid (BP) in certain case reports, though little is known regarding the association of MN and other bullous diseases. The association of MN and MMP has rarely been described, and very little data exist regarding the treatment of this association. We report a case of severe refractory membranous nephropathy secondary to mucous membrane pemphigoid successfully treated with rituximab. A 35-year-old woman with known MMP was referred to our clinic for new-onset generalized edema and proteinuria. MN was confirmed on renal biopsy. Despite therapy with high-dose systemic glucocorticoids, combined with mycophenolate mofetil, and later azathioprine, nephrotic-range proteinuria persisted even at a daily dose of prednisone of 40 mg. The patient was then started on rituximab infusions, which induced remission of both mucous membrane pemphigoid and membranous glomerulonephritis. This suggests that MN can be secondary to MMP, and rituximab may be useful induce remission in cases that are refractory to standard therapy.","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8133855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39034644","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: 3

A Rare Case of Immunotactoid Glomerulopathy Associated with Hodgkin Lymphoma. 免疫因子样肾小球病变合并霍奇金淋巴瘤1例。

Case Reports in Nephrology Pub Date : 2021-05-06 eCollection Date: 2021-01-01 DOI: 10.1155/2021/5527966

Keiki Nagaharu, Yuka Sugimoto, Keiki Kawakami

{"title":"A Rare Case of Immunotactoid Glomerulopathy Associated with Hodgkin Lymphoma.","authors":"Keiki Nagaharu, Yuka Sugimoto, Keiki Kawakami","doi":"10.1155/2021/5527966","DOIUrl":"https://doi.org/10.1155/2021/5527966","url":null,"abstract":"Immunotactoid glomerulopathy (ITG) is characterized by Congo red-negative microtubular deposits, and it has been reported as a rare paraneoplastic syndrome due to hematologic malignancies, viral infections, or autoimmune diseases. In hematologic malignancies, multiple myeloma and other mature B-cell malignancies are the most common hematologic malignancies, and Hodgkin lymphoma (HL) is extremely rare. A 59-year-old woman was admitted to our hospital because of a pulmonary mass and proteinuria. Computed tomography-guided lung biopsy confirmed the presence of HL stage IIA. Immunofixation of peripheral blood was positive for immunoglobulin G (IgG) kappa. Renal biopsy showed mesangial proliferation with deposits in the subendothelial lesion and no invasion of the HL. These deposits were positive for IgG3, C3, and kappa light chain but negative for C1q and lambda light chain. Electron microscopy showed randomly aligned tubular structures with a diameter of approximately 50 nm. We diagnosed the patient with immunotactoid nephropathy and HL. After systemic chemotherapy, the patient achieved a complete response and loss of proteinuria. On the contrary, her serum monoclonal gammopathy was observed after chemotherapy. The existence of a monoclonal antibody itself might not be a sufficient factor for ITG in some cases, and an additive trigger is necessary for development.","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38940904","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: 1

Rifampicin-Associated Secondary Minimal Change Disease Presenting with Nephrotic Syndrome in a Pulmonary Tuberculosis Patient. 以肾病综合征为表现的肺结核患者利福平相关继发性微小改变疾病

Case Reports in Nephrology Pub Date : 2021-04-14 eCollection Date: 2021-01-01 DOI: 10.1155/2021/5546942

Satyanand Sathi, Anil Kumar Garg, Manoj Kumar Singh, Virendra Singh Saini, Devinder Vohra

{"title":"Rifampicin-Associated Secondary Minimal Change Disease Presenting with Nephrotic Syndrome in a Pulmonary Tuberculosis Patient.","authors":"Satyanand Sathi, Anil Kumar Garg, Manoj Kumar Singh, Virendra Singh Saini, Devinder Vohra","doi":"10.1155/2021/5546942","DOIUrl":"https://doi.org/10.1155/2021/5546942","url":null,"abstract":"Various extraglomerular disease processes have been associated with drug-induced secondary minimal change disease (MCD). In a majority of cases, preferably, a hypersensitivity reaction appears to be involved, and in some cases, there is direct toxic effect over glomerular capillaries. There are several reports to demonstrate that rifampicin has been associated with various nephrotoxic adverse effects, but rifampicin-induced secondary minimal change disease (MCD) is very rare. Here, we report the case of a young adult male who presented with nephrotic proteinuria with bland urine sediment after one month of initiation of rifampicin treatment for pulmonary tuberculosis. The patient had no proteinuria before the start of antituberculosis treatment. Renal biopsy showed nonproliferative glomerulopathy and immunofluorescence did not show significant glomerular immune deposits. Electron microscopy showed diffuse effacement of visceral epithelial cell foot processes and did not show any presence of glomerular immune complexes and thickening of glomerular basement membrane, promoting the diagnosis of minimal change nephrotic syndrome. The patient got complete remission after discontinuation of rifampicin.","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8060098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38940995","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: 2

A Case of De Novo Antiglomerular Basement Membrane Disease Presenting during Pregnancy. 妊娠期新发抗肾小球基底膜病1例。

Case Reports in Nephrology Pub Date : 2021-03-17 eCollection Date: 2021-01-01 DOI: 10.1155/2021/5539205

F A K Lodhi, T Akcan, J N Mojarrab, S Sajjad, R Blonsky

{"title":"A Case of De Novo Antiglomerular Basement Membrane Disease Presenting during Pregnancy.","authors":"F A K Lodhi, T Akcan, J N Mojarrab, S Sajjad, R Blonsky","doi":"10.1155/2021/5539205","DOIUrl":"https://doi.org/10.1155/2021/5539205","url":null,"abstract":"Background. Acute kidney injury (AKI) requiring dialysis during pregnancy is uncommon. We present a case of a young female diagnosed with antiglomerular basement membrane (anti-GBM) disease during pregnancy. Case Presentation. A 23-year-old woman approximately 15 weeks pregnant experienced weakness, nausea, vomiting, and anorexia for one week and anuria for 48 hours. No known drug allergies and no significant social or family history for kidney or genitourinary disease were reported. Laboratory analysis revealed anemia, life-threatening hyperkalemia, AKI, and elevated antiglomerular basement membrane (GBM) antibodies. Renal biopsy revealed 100% cellular crescents, confirming the diagnosis. The patient was treated using plasmapheresis and methylprednisolone followed by oral steroids, azathioprine, and tacrolimus. At 24 weeks and 4 days of gestation, the patient had hypoxic respiratory failure as well as preterm premature rupture of membranes. Due to the development of infection and lack of renal recovery, immunosuppression was discontinued. At 28 weeks and 0 days of gestation, the patient developed uncontrollable hypertension requiring emergent delivery. Postpartum, her hypertension improved without signs of preeclampsia though still requires dialysis. Discussion. Pregnancy presents a unique challenge for providers treating patients with anti-GBM disease. Fetal safety should be considered and risks thoroughly discussed with the patient when choosing an immunosuppressive regimen for this condition.","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7994079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25574130","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: 1

Targeting Cytokine Storm in COVID-19: A Role of Online Hemodiafiltration with Asymmetric Cellulose Triacetate in Maintenance Hemodialysis Patients-A Report of 10 Cases. 针对 COVID-19 中的细胞因子风暴：使用三醋酸非对称纤维素进行在线血液滤过在维持性血液透析患者中的作用--10 个病例的报告。

Case Reports in Nephrology Pub Date : 2021-03-12 eCollection Date: 2021-01-01 DOI: 10.1155/2021/5575928

José C De La Flor, Francisco Valga, Alexander Marschall, Tania Monzon, Cristina Albarracín, Elisa Ruiz, Miguel Rodeles

{"title":"Targeting Cytokine Storm in COVID-19: A Role of Online Hemodiafiltration with Asymmetric Cellulose Triacetate in Maintenance Hemodialysis Patients-A Report of 10 Cases.","authors":"José C De La Flor, Francisco Valga, Alexander Marschall, Tania Monzon, Cristina Albarracín, Elisa Ruiz, Miguel Rodeles","doi":"10.1155/2021/5575928","DOIUrl":"10.1155/2021/5575928","url":null,"abstract":"Early reports have suggested that maintenance hemodialysis (MHD) patients could be more susceptible to a severe course of COVID-19. Among the therapeutic approaches, the use of drugs that reduce the cytokine storm characteristic of this disease has been proposed. Some dialyzers, such as the new generation of asymmetric cellulose triacetate (ATA) membranes, could favor the effective elimination of medium-sized molecules and other inflammatory mediators. In this case series, we describe in depth the clinical, analytical, and radiological details, therapeutic aspects, and outcomes of the case series of 10 MHD patients of our dialysis unit, who tested positive for SARS-CoV-2 from 5 October to 30 November 2020. Furthermore, we evaluate the removal of hyperinflammatory parameters with the ATA membrane in postdilution online hemodiafiltration (OL-HDF) in these patients through a variety of biomarkers of systemic inflammation from the diagnosis until stripping. Biochemical blood analysis was carried out at baseline and at days 7 and 14 after diagnosis, respectively. 50% of the patients presented COVID-19 pneumonia and required hospital admission. Median hospitalization time was 21 days. A total of 4 patients developed severe pneumonia (3 of them died) and 1 patient developed moderate pneumonia. Patients who died (n = 3) were more likely to present bilateral pneumonia (100% vs 14.3%) at diagnosis and less reduction in interleukin 6 (IL-6) at day 14, as compared to those who survived. The use of the ATA membrane could be considered a therapeutic option, due to its immunomodulatory effect in MHD patients with SARS-CoV-2 infection, especially at the beginning of the disease, where the inflammatory component is predominant.","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7958139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25501556","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

Evaluation and Transplantation of a SARS-CoV-2 Seropositive Kidney Candidate. SARS-CoV-2血清阳性候选肾脏的评估和移植。

Case Reports in Nephrology Pub Date : 2021-03-08 eCollection Date: 2021-01-01 DOI: 10.1155/2021/6613023

Maya C Graves, Sapna A Mehta, Bonnie E Lonze, Nicole M Ali

引用次数: 0

Refractory Acute Interstitial Nephritis in the Setting of Nivolumab Therapy. 纳武单抗治疗下的难治性急性间质性肾炎。

Case Reports in Nephrology Pub Date : 2021-03-01 eCollection Date: 2021-01-01 DOI: 10.1155/2021/6640154

Antonio Faieta, Tavis Dancik

引用次数: 3

Listeria monocytogenes Peritonitis in a Patient Receiving Continuous Ambulatory Peritoneal Dialysis: A Case Report and Review of the Literature. 连续腹膜透析患者单核细胞增生李斯特菌腹膜炎1例报告及文献复习。

Case Reports in Nephrology Pub Date : 2021-01-28 eCollection Date: 2021-01-01 DOI: 10.1155/2021/6681629

Ho-Kwan Sin, Au Cheuk, William Lee, Ka-Fai Yim, Clara Poon, Ivy Wong, Bosco Lam, Hon-Lok Tang, Samuel K Fung

引用次数: 1

Case Report on Anastomosing Haemangioma: An Unusual Vascular Tumor in Kidney. 吻合性血管瘤:一种罕见的肾脏血管肿瘤。

Case Reports in Nephrology Pub Date : 2021-01-07 eCollection Date: 2021-01-01 DOI: 10.1155/2021/8847998

Chun-Hai Lo, Shui-Ying Cheng

引用次数: 4