CEN Case Reports最新文献

Renal and gastrointestinal complications following tosufloxacin therapy for suspected mycoplasma infection in a 10-year-old child. 托氟沙星治疗疑似支原体感染的10岁儿童的肾脏和胃肠道并发症。

IF 0.7

CEN Case Reports Pub Date : 2025-10-01 Epub Date: 2025-06-17 DOI: 10.1007/s13730-025-01007-z

Shigehiro Sainokami, Hirofumi Watanabe, Shoichiro Kanda, Natsuho Adachi, Hiroyuki Tanaka, Keiichi Takizawa, Naoko Sone, Yuko Kajiho, Akiko Kinumaki, Yoshifumi Morita, Teruhiko Yoshida, Makoto Kurano, Yutaka Harita

{"title":"Renal and gastrointestinal complications following tosufloxacin therapy for suspected mycoplasma infection in a 10-year-old child.","authors":"Shigehiro Sainokami, Hirofumi Watanabe, Shoichiro Kanda, Natsuho Adachi, Hiroyuki Tanaka, Keiichi Takizawa, Naoko Sone, Yuko Kajiho, Akiko Kinumaki, Yoshifumi Morita, Teruhiko Yoshida, Makoto Kurano, Yutaka Harita","doi":"10.1007/s13730-025-01007-z","DOIUrl":"10.1007/s13730-025-01007-z","url":null,"abstract":"Tosufloxacin, a fluoroquinolone antibiotic, is increasingly prescribed for pediatric patients, particularly for macrolide-resistant Mycoplasma pneumoniae infections in Japan. While its efficacy is well-documented, adverse effects such as renal impairment and gastrointestinal symptoms have raised growing concerns. We report a case of a 10-year-old girl who developed sequential symptoms following tosufloxacin administration. On the day after starting tosufloxacin, she experienced right-sided flank pain, followed by the onset of gastrointestinal symptoms, including abdominal pain, diarrhea, and vomiting, on the subsequent day. Contrast-enhanced computed tomography revealed increased fatty tissue opacity surrounding the kidney and duodenal wall thickening, suggestive of localized inflammation extending from the kidney to adjacent structures. Urine microscopy demonstrated needle- and sea urchin-shaped drug crystals, strongly implicating tosufloxacin in the development of renal and gastrointestinal symptoms. This case provides the first evidence suggesting that kidney inflammation may contribute to gastrointestinal symptom onset via localized inflammatory extension. The patient's symptoms resolved promptly with the discontinuation of tosufloxacin and supportive care. This report underscores the importance of monitoring pediatric patients for renal and gastrointestinal adverse effects following tosufloxacin administration.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":"713-718"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315965","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 case of autosomal dominant polycystic kidney disease with systemic lupus erythematosus developing after SARS-CoV-2 vaccination. 常染色体显性多囊肾病伴系统性红斑狼疮1例。

IF 0.7

CEN Case Reports Pub Date : 2025-10-01 Epub Date: 2025-05-20 DOI: 10.1007/s13730-025-00999-y

Kensuke Miyauchi, Joichi Usui, Tatsuya Shimizu, Akihisa Hattori, Soichiro Nomura, Takanobu Higashi, Toshiaki Usui, Chie Saito, Hirayasu Kai, Kunihiro Yamagata

{"title":"A case of autosomal dominant polycystic kidney disease with systemic lupus erythematosus developing after SARS-CoV-2 vaccination.","authors":"Kensuke Miyauchi, Joichi Usui, Tatsuya Shimizu, Akihisa Hattori, Soichiro Nomura, Takanobu Higashi, Toshiaki Usui, Chie Saito, Hirayasu Kai, Kunihiro Yamagata","doi":"10.1007/s13730-025-00999-y","DOIUrl":"10.1007/s13730-025-00999-y","url":null,"abstract":"Although SARS-CoV-2 vaccines, particularly mRNA-based formulations, have demonstrated high efficacy and safety, adverse events including autoimmune activity have been reported. We report a case of systemic lupus erythematosus (SLE) following SARS-CoV-2 vaccination in a 52-year-old Japanese female with autosomal dominant polycystic kidney disease (ADPKD). The patient presented with nephrotic syndrome and severe thrombocytopenia and fulfilled the following four criteria for SLE classification: positive antinuclear antibodies, positive anti-ds-DNA antibodies, renal involvement, and reductions in two blood cell lines (leukopenia and thrombocytopenia). The patient responded favorably to prednisolone therapy, although hydroxychloroquine was avoided because of a suspected allergic predisposition. This case underscores the potential for exogenous triggers such as vaccination to induce SLE, highlighting the need for vigilance in managing autoimmune responses, particularly in patients with chronic conditions such as ADPKD. Despite the patient's history of ADPKD, no previous reports have linked this condition to post-vaccine SLE. Concurrent nephrotic syndrome in patients with ADPKD is rare, and the possibility of other treatable glomerular diseases should be considered when this is seen.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":"679-685"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109898","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

Tubulointerstitial nephritis with predominant monotypic plasma cell infiltration in three cases of Sjögren's syndrome: case reports and literature review. 以单型浆细胞浸润为主的小管间质性肾炎3例Sjögren综合征病例报告及文献复习。

IF 0.7

CEN Case Reports Pub Date : 2025-10-01 Epub Date: 2025-07-11 DOI: 10.1007/s13730-025-01019-9

Hiroaki Miyauchi, Tatsuhiko Azegami, Akinori Hashiguchi, Mika Misaki, Takahisa Kawaguchi, Hironari Hanaoka, Mizuho Muramatsu, Takayoshi Soga, Takashi Ando, Eiji Kubota, Takashin Nakayama, Norifumi Yoshimoto, Akihito Hishikawa, Aika Hagiwara, Yuko Kaneko, Kaori Hayashi

{"title":"Tubulointerstitial nephritis with predominant monotypic plasma cell infiltration in three cases of Sjögren's syndrome: case reports and literature review.","authors":"Hiroaki Miyauchi, Tatsuhiko Azegami, Akinori Hashiguchi, Mika Misaki, Takahisa Kawaguchi, Hironari Hanaoka, Mizuho Muramatsu, Takayoshi Soga, Takashi Ando, Eiji Kubota, Takashin Nakayama, Norifumi Yoshimoto, Akihito Hishikawa, Aika Hagiwara, Yuko Kaneko, Kaori Hayashi","doi":"10.1007/s13730-025-01019-9","DOIUrl":"10.1007/s13730-025-01019-9","url":null,"abstract":"Tubulointerstitial nephritis (TIN) is a common kidney manifestation of Sjögren's syndrome, typically characterized by interstitial infiltration of T and B cells, with plasma cells being more prominent than in other etiologies. While most plasma cell infiltration in TIN is polytypic and the importance of the immunoglobulin isotypes expressed by the infiltrating plasma cells in the pathogenesis is unknown, recent reports have identified rare cases with monotypic IgA-positive plasma cell infiltration accompanied by monoclonal gammopathy of undetermined significance (MGUS). Here, we present three cases of Sjögren syndrome-associated TIN characterized by monotypic plasma cell infiltration. In all cases, the isotype of the infiltrating plasma cells was consistent with that of the predominant serum immunoglobulin. One patient exhibited IgA-type MGUS, one had IgM-type MGUS, and one showed elevated serum IgG levels along with IgG-positive plasma cell infiltration, but without detectable paraproteinemia. Notably, serum immunoglobulin levels decreased in parallel with improvement in kidney function. These findings suggest a potential link between the systemic immunoglobulin profile and local immunopathology of the kidneys in Sjögren's syndrome. Further case accumulation is needed to clarify the clinical significance and pathophysiology of monotypic plasma cell infiltration in TIN associated with Sjögren's syndrome.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":"774-780"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607518","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

Reduction of polycystic kidney and liver volumes in a patient with tolvaptan-resistant autosomal dominant polycystic kidney disease and acromegaly during lanreotide therapy. 在lanreotide治疗期间，托伐普坦耐药常染色体显性多囊肾病和肢端肥大症患者的多囊肾和肝脏体积减少

IF 0.7

CEN Case Reports Pub Date : 2025-10-01 Epub Date: 2025-06-27 DOI: 10.1007/s13730-025-01013-1

Shun Takenaka, Fumihiko Hattanda, Takuro Kawamura, Kanako Watanabe-Kusunoki, Daigo Nakazawa, Hiraku Kameda, Olga Amengual, Tatsuya Atsumi, Saori Nishio

{"title":"Reduction of polycystic kidney and liver volumes in a patient with tolvaptan-resistant autosomal dominant polycystic kidney disease and acromegaly during lanreotide therapy.","authors":"Shun Takenaka, Fumihiko Hattanda, Takuro Kawamura, Kanako Watanabe-Kusunoki, Daigo Nakazawa, Hiraku Kameda, Olga Amengual, Tatsuya Atsumi, Saori Nishio","doi":"10.1007/s13730-025-01013-1","DOIUrl":"10.1007/s13730-025-01013-1","url":null,"abstract":"A 35-year-old female was diagnosed with autosomal dominant polycystic kidney disease (ADPKD) in 2002 and referred to the Nephrology department of our hospital for follow-up and management. Treatment with tolvaptan was started in 2016, which failed to reduce her total kidney volume (TKV) and slow the decline in kidney function. In 2018, she experienced bitemporal hemianopia. Examination revealed enlarged fingers, characteristic facial features, and elevated serum insulin-like growth factor 1 (IGF-1) and growth hormone (GH) levels. A pituitary tumor was identified through the brain, and she was subsequently diagnosed with acromegaly. Lanreotide treatment was initiated, effectively reducing IGF-1 and GH serum levels and TKV within six months. After transsphenoidal surgery, lanreotide was discontinued. However, her oral glucose tolerance test after surgery did not show remission (GH nadir > 0.4 ng/mL), and serum GH levels gradually increased. Furthermore, TKV increased and kidney function decreased rapidly. Lanreotide treatment was restarted, resulting in further TKV reduction, suppression of liver volume enlargement and slowing kidney function decline. Compared to tolvaptan, the evidence for the effectiveness of somatostatin analogs in reducing TKV in ADPKD is not sufficiently established. Our case demonstrates that lanreotide effectively suppressed the progression of TKV, liver volume and kidney dysfunction with correlation to IGF-1 or GH in a patient with ADPKD. Our experience indicates that elevated levels of IGF-1 or GH may contribute to increased kidney and liver volume. Herein, we report the first case of tolvaptan-resistant ADPKD with concomitant acromegaly successfully managed with lanreotide.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":"740-745"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511610","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 case of acute tubulointerstitial nephritis with suspected Saikokaryukotsuboreito involvement responding to glucocorticoid therapy. 急性肾小管间质性肾炎疑似Saikokaryukotsuboreito受累1例，经糖皮质激素治疗。

IF 0.7

CEN Case Reports Pub Date : 2025-10-01 Epub Date: 2025-06-26 DOI: 10.1007/s13730-025-01012-2

Shun Ishibashi, Toshiaki Usui, Masaki Baba, Tsuyoshi Tsukada, Kohei Inoue, Shintaro Furuno, Masahiro Niisaka, Soichiro Nomura, Takuya Harada, Tomoki Akiyama, Ryota Ishii, Ryoya Tsunoda, Akiko Fujita, Hirayasu Kai, Naoki Morito, Kaori Mase, Chie Saito, Joichi Usui, Motohiro Sekiya, Kunihiro Yamagata

{"title":"A case of acute tubulointerstitial nephritis with suspected Saikokaryukotsuboreito involvement responding to glucocorticoid therapy.","authors":"Shun Ishibashi, Toshiaki Usui, Masaki Baba, Tsuyoshi Tsukada, Kohei Inoue, Shintaro Furuno, Masahiro Niisaka, Soichiro Nomura, Takuya Harada, Tomoki Akiyama, Ryota Ishii, Ryoya Tsunoda, Akiko Fujita, Hirayasu Kai, Naoki Morito, Kaori Mase, Chie Saito, Joichi Usui, Motohiro Sekiya, Kunihiro Yamagata","doi":"10.1007/s13730-025-01012-2","DOIUrl":"10.1007/s13730-025-01012-2","url":null,"abstract":"Drug-induced kidney injury is a major cause of acute tubulointerstitial nephritis (AIN). The standard treatment for AIN is discontinuation of the causative agent; however, if discontinuation alone is insufficient, glucocorticoid therapy may be effective. A 51-year-old woman was admitted to our hospital with acute kidney injury, presenting with an estimated glomerular filtration rate (eGFR) of 6.3 mL/min/1.73m2. She was diagnosed with AIN after a renal biopsy. Drug-induced lymphocyte stimulation tests were performed on the herbal medicine she had been taking for 5 months, Saikokaryukotsuboreito (comprising Bupleurum root, Pinellia tuber, Scutellaria root, and Ginseng as key ingredients). The test results were positive for all four components. The patient discontinued the causative agent, and her renal function improved with oral glucocorticoid therapy (prednisolone 30 mg/day). After 6 months of treatment, her renal function stabilized, with only minor residual tubular acidosis. This case of AIN induced by Saikokaryukotsuboreito, which responded to glucocorticoid therapy, highlights the potential for recovery with appropriate treatment.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":"732-739"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494893","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

Early low-density lipoprotein apheresis for steroid-resistant minimal change disease with acute kidney injury: a case report. 早期低密度脂蛋白单采治疗类固醇抵抗性微小改变疾病伴急性肾损伤1例报告

IF 0.7

CEN Case Reports Pub Date : 2025-10-01 Epub Date: 2025-06-30 DOI: 10.1007/s13730-025-01016-y

Miya Hiramatsu, Masatoshi Inoue, Naoki Kamegai, Ohno Michiya, Junichiro Yamamoto

{"title":"Early low-density lipoprotein apheresis for steroid-resistant minimal change disease with acute kidney injury: a case report.","authors":"Miya Hiramatsu, Masatoshi Inoue, Naoki Kamegai, Ohno Michiya, Junichiro Yamamoto","doi":"10.1007/s13730-025-01016-y","DOIUrl":"10.1007/s13730-025-01016-y","url":null,"abstract":"We report the case of a 75-year-old woman with steroid-resistant minimal change disease (MCD) whose refractory proteinuria and hypoproteinemia were controlled with early low-density lipoprotein apheresis (LDL-A). She was initially treated with steroid therapy, including methylprednisolone pulse. However, her hypoproteinemia, severe proteinuria, accompanied with renal insufficiency persisted despite these therapies. We initiated hemodialysis on day 17, and LDL-A on day 18. After the treatment, we found an improvement in her urine protein excretion, hyperlipidemia, and hypoproteinemia gradually. Her renal function returned to normal. We added cyclosporine A (CyA) after confirming the normal renal function. Her proteinuria was 0.693 g/day on day 350 and she achieved incomplete remission type I. There are few reports of the efficacy of LDL-A in older patients with MCD with acute kidney injury (AKI). In addition, there are only a few reports of cases in which LDL-A was introduced early, as in this case. This case suggests that early LDL-A may be an effective therapy for steroid-resistant MCD with AKI.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":"751-756"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526585","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

Long-term outcomes of kidney transplantation in a transfusion-dependent alpha-thalassemia patient. 输注依赖型α -地中海贫血患者肾移植的长期预后。

IF 0.7

CEN Case Reports Pub Date : 2025-10-01 Epub Date: 2025-07-23 DOI: 10.1007/s13730-025-01022-0

Thoa T Ly, Anh M Bui, Tung V Do, Lan H T Le, Tu T Tran

{"title":"Long-term outcomes of kidney transplantation in a transfusion-dependent alpha-thalassemia patient.","authors":"Thoa T Ly, Anh M Bui, Tung V Do, Lan H T Le, Tu T Tran","doi":"10.1007/s13730-025-01022-0","DOIUrl":"10.1007/s13730-025-01022-0","url":null,"abstract":"The improved survival rates of patients with thalassemia have led to the identification of new complications, including renal diseases. In cases of end-stage kidney disease, kidney transplantation is regarded as the preferred treatment. However, research on kidney transplantation in thalassemia patients remains limited. We present the case of a transfusion-dependent alpha-thalassemia patient who underwent kidney transplantation due to end-stage kidney disease and maintained stable graft function over a 7-year follow-up period. Notably, 7 years post-transplant, the patient demonstrated a creatinine level of 128 µmol/L and a glomerular filtration rate of 64 mL/min/1.73 m2. Despite requiring blood transfusions every 3 months, the patient's renal function remained stable throughout the follow-up period. This case highlights the viability and effectiveness of kidney transplantation as a long-term treatment option for patients with alpha-thalassemia and end-stage kidney disease, as well as the need for further research to better understand the long-term outcomes and challenges in this population.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":"781-785"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689020","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 rare case of coronin-1A deficiency with IgM dominant membranoproliferative glomerulonephritis. 冠状蛋白1a缺乏伴IgM显性膜增生性肾小球肾炎1例。

IF 0.7

CEN Case Reports Pub Date : 2025-10-01 Epub Date: 2025-06-04 DOI: 10.1007/s13730-025-01004-2

Zeynep Ural, Betül Ogüt, Gülsüm Kayhan, Ipek Işık Gönül, Ulver Derici

引用次数: 0

NELL-1-positive membranous nephropathy following gastric cancer in an older living kidney donor: a case report. 高龄活体肾供者胃癌后nell -1阳性膜性肾病1例报告。

IF 0.7

CEN Case Reports Pub Date : 2025-10-01 Epub Date: 2025-06-24 DOI: 10.1007/s13730-025-01011-3

Mamiko Hashimoto, Erika Hishida, Yuko Ono, Takuya Murakami, Mami Hirata, Maki Kinoshita, Toshimi Imai, Tetsu Akimoto, Daisuke Nagata

{"title":"NELL-1-positive membranous nephropathy following gastric cancer in an older living kidney donor: a case report.","authors":"Mamiko Hashimoto, Erika Hishida, Yuko Ono, Takuya Murakami, Mami Hirata, Maki Kinoshita, Toshimi Imai, Tetsu Akimoto, Daisuke Nagata","doi":"10.1007/s13730-025-01011-3","DOIUrl":"10.1007/s13730-025-01011-3","url":null,"abstract":"Living kidney transplantation is an established treatment for end-stage kidney disease (ESKD). While rare, the donors may develop de novo glomerular diseases post-donation. We report a case of membranous nephropathy (MN) in an 80-year-old male, diagnosed 9 years post-donation. The patient had a history of early gastric cancer treated with endoscopic submucosal dissection one year post-donation. Routine follow-up revealed asymptomatic proteinuria (4.27 g/gCr). The kidney biopsy demonstrated MN with IgG1/IgG3-dominant deposits and NELL-1 positivity. Recent evidence suggests NELL-1-positive MN may occur independently of malignancy in older individuals. Notably, MN developed 8 years after cancer remission with no evidence of recurrence. The patient achieved complete remission with conservative therapy consisting of an angiotensin receptor blocker and dietary modification. This case underscores the need for vigilant long-term follow-up in older kidney donors and illustrates how early proteinuria detection facilitates timely management of de novo glomerulopathies.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":"719-725"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474073","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

Life-threatening baclofen toxicity in ESRD: a case report. ESRD中危及生命的巴氯芬毒性：一例报告。

IF 0.7

CEN Case Reports Pub Date : 2025-10-01 Epub Date: 2025-06-13 DOI: 10.1007/s13730-025-01005-1

Shogo Taira, Shiori Tamayose, Tasuku Kikumura, Morikuni Nishihira

{"title":"Life-threatening baclofen toxicity in ESRD: a case report.","authors":"Shogo Taira, Shiori Tamayose, Tasuku Kikumura, Morikuni Nishihira","doi":"10.1007/s13730-025-01005-1","DOIUrl":"10.1007/s13730-025-01005-1","url":null,"abstract":"Baclofen, a GABA-B receptor agonist, is widely used to manage spasticity, alcohol use disorders, and chronic hiccups. However, baclofen toxicity is a significant concern, particularly in patients with renal impairment due to its primary renal excretion. This case report describes the diagnostic and management challenges of baclofen toxicity in an 82-year-old man with end-stage renal disease (ESRD) undergoing maintenance hemodialysis. The patient presented with symptoms of vomiting, decreased consciousness, and involuntary movements 5 days after initiating a low dose of baclofen (5 mg/day) for hiccups. Despite the low dosage, the patient exhibited severe neurological symptoms, including atypical athetosis-like involuntary movements, which are not commonly associated with baclofen toxicity. Given his impaired renal clearance, baclofen accumulation was suspected as the underlying cause. Hemodialysis was performed under mechanical ventilation due to concerns about respiratory suppression, leading to significant clinical improvement. The patient was successfully extubated and discharged after 14 days of hospitalization. This case underscores the critical need for heightened vigilance and cautious medication management when prescribing baclofen to patients with renal dysfunction, even at low doses, as they face a significantly elevated risk of toxicity. Early recognition and timely intervention, including hemodialysis, are essential in managing baclofen toxicity in this vulnerable population. Increased awareness of atypical neurological manifestations of baclofen toxicity is crucial for accurate diagnosis and effective treatment.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":"700-705"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282552","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