CEN Case Reports最新文献_第8页

Adenovirus infection associated with focal segmental glomerulosclerosis following autologous hematopoietic stem cell transplantation. 腺病毒感染与自体造血干细胞移植后局灶节段性肾小球硬化相关。

IF 1

CEN Case Reports Pub Date : 2026-05-20 DOI: 10.1007/s13730-026-01110-9

Yasser Isaac Arana-Escandón, Paula Eliana Ramírez-Arboleda, Lina María Gaviria-Jaramillo, Mauricio Andrés Álzate-Arias, Oliver Gerardo Perilla-Suarez, María Ximena Lagos-Buitrago, Joaquín Roberto Rodelo-Ceballos, Mayra Alejandra Estacio, Alejandra Taborda-Murillo

{"title":"Adenovirus infection associated with focal segmental glomerulosclerosis following autologous hematopoietic stem cell transplantation.","authors":"Yasser Isaac Arana-Escandón, Paula Eliana Ramírez-Arboleda, Lina María Gaviria-Jaramillo, Mauricio Andrés Álzate-Arias, Oliver Gerardo Perilla-Suarez, María Ximena Lagos-Buitrago, Joaquín Roberto Rodelo-Ceballos, Mayra Alejandra Estacio, Alejandra Taborda-Murillo","doi":"10.1007/s13730-026-01110-9","DOIUrl":"10.1007/s13730-026-01110-9","url":null,"abstract":"Disseminated adenovirus infection is a rare but often fatal complication of hematopoietic stem cell transplantation (HSCT), particularly uncommon in the autologous setting. We report the case of a 59-year-old man with stage IVB diffuse large B-cell lymphoma who underwent autologous HSCT after multiple lines of therapy. Following conditioning regimen, he developed persistent fever, mucositis, dysuria, and gross hematuria, with imaging showing bilateral pyelonephritis, ureteritis, and cystitis. Despite broad-spectrum antibiotics, symptoms persisted. Quantitative PCR revealed rapidly rising adenovirus viremia (> 1,000,000 copies/mL), and renal biopsy demonstrated viral cytopathic changes on light microscopy together with focal segmental glomerulosclerosis (FSGS). The patient progressed to fulminant oliguric renal failure and died before dialysis could be initiated. This case highlights a rare presentation of adenovirus infection with renal involvement consistent with adenovirus-associated nephropathy and concurrent FSGS after autologous HSCT, highlighting the potential convergence of viral, neoplastic, and transplant-related mechanisms in catastrophic renal injury.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":"15 3","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13190899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970737","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 of continuous renal replacement therapy efficacy in severe caffeine intoxication: concentration-dependent variation in caffeine clearance. 重度咖啡因中毒持续肾脏替代治疗的疗效评价：咖啡因清除率的浓度依赖性变化。

IF 1

CEN Case Reports Pub Date : 2026-05-12 DOI: 10.1007/s13730-026-01127-0

Saki Takeda, Haruki Chiba, Takeru Yamazaki, Yasuhiko Tsukada, Makoto Onodera, Ken Iseki, Kazuki Harada

{"title":"Evaluation of continuous renal replacement therapy efficacy in severe caffeine intoxication: concentration-dependent variation in caffeine clearance.","authors":"Saki Takeda, Haruki Chiba, Takeru Yamazaki, Yasuhiko Tsukada, Makoto Onodera, Ken Iseki, Kazuki Harada","doi":"10.1007/s13730-026-01127-0","DOIUrl":"10.1007/s13730-026-01127-0","url":null,"abstract":"Hemodialysis is an effective treatment option for acute caffeine intoxication. However, the efficacy of continuous renal replacement therapy remains a subject of debate. We encountered a case of acute caffeine intoxication that was managed using high-flow continuous hemodiafiltration. To evaluate the effectiveness of high-flow continuous hemodiafiltration, we compared it with other continuous renal replacement therapy approaches in managing cases of caffeine intoxication. In this study, we aimed to elucidate the caffeine-removal ability of continuous renal replacement therapy and assess its effectiveness. Additionally, we aimed to investigate the underlying reasons for the conflicting reports regarding the effectiveness of continuous renal replacement therapy. The time course of the blood caffeine concentration and elimination half-life were used for the evaluation. A woman in her 40s attempted suicide by ingesting an overdose of caffeine hydrate tablets. She presented with sweating, vomiting, tachycardia, sinus tachycardia, and tremors. The serum caffeine concentration in this case decreased from 103 to 50 μg/mL after high-flow continuous hemodiafiltration. The initial symptoms at the time of admission also disappeared post-treatment. Caffeine clearance by continuous renal replacement therapy may vary depending on the blood caffeine concentration, and this concentration-dependent variation may lead to discrepancies in the evaluation of continuous renal replacement therapy. The discrepancies in the ongoing debate regarding the efficacy of continuous renal replacement therapy were likely attributable to the selection of inappropriate comparators. We inferred that continuous renal replacement therapy provides a therapeutic benefit because continuous renal replacement therapy may facilitate caffeine clearance.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":"15 3","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13168395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873530","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

Refractory minimal change disease associated with Mycobacterium marinum infection. 与海洋分枝杆菌感染相关的难治性微小改变疾病。

IF 1

CEN Case Reports Pub Date : 2026-05-12 DOI: 10.1007/s13730-026-01131-4

Yuto Matsui, Kan Katayama, Yuka Mitamura, Keiichi Nagata, Koyo Ohara, Toru Hibi, Yuhei Ito, Naohiro Kawamura, Mayuko Yamakawa, Yuri Oue, Mutsuki Mori, Masahiro Yamawaki, Ryosuke Saiki, Tomohiro Murata, Kaoru Dohi

{"title":"Refractory minimal change disease associated with Mycobacterium marinum infection.","authors":"Yuto Matsui, Kan Katayama, Yuka Mitamura, Keiichi Nagata, Koyo Ohara, Toru Hibi, Yuhei Ito, Naohiro Kawamura, Mayuko Yamakawa, Yuri Oue, Mutsuki Mori, Masahiro Yamawaki, Ryosuke Saiki, Tomohiro Murata, Kaoru Dohi","doi":"10.1007/s13730-026-01131-4","DOIUrl":"10.1007/s13730-026-01131-4","url":null,"abstract":"This case report describes a rare instance of minimal change disease (MCD) associated with Mycobacterium marinum infection. MCD is typically idiopathic but can occasionally occur secondary to infections. The patient was a 61-year-old fisherman with a history of relapsing MCD who developed a subcutaneous abscess in the lower leg while undergoing rituximab and glucocorticoid therapy. Ziehl-Neelsen staining revealed acid-fast bacilli, and culture at 30 °C isolated M. marinum, a slow-growing nontuberculous mycobacterium (NTM) commonly found in aquatic environments. The infection was attributed to the combination of occupational exposure and immunosuppression. Targeted antimicrobial therapy with clarithromycin, minocycline, and rifampicin led to resolution of the abscess and complete remission of MCD, suggesting a causal link between the infection and disease relapse. This case highlights several key clinical considerations. First, secondary infectious causes should be evaluated in patients with treatment-resistant nephrotic syndrome. Second, appropriate laboratory techniques, including optimized culture conditions, are critical for identifying rare NTM. Third, a detailed assessment of lifestyle and occupational exposures can provide essential diagnostic clues. The report underscores the importance of vigilance in atypical or refractory MCD cases and supports the role of targeted antimicrobial therapy in resolving both infection and associated nephrotic syndrome.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":"15 3","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13168420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873509","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

An unusual presentation of dialysis-related amyloidosis: a large tumor extending from the gingiva to the palate. 透析相关淀粉样变的不寻常表现：一个从牙龈延伸到上颚的大肿瘤。

IF 1

CEN Case Reports Pub Date : 2026-05-12 DOI: 10.1007/s13730-026-01129-y

Sachio Iwanari, Mari Tanaka, Toshihisa Akimune, Yuri Suzuki, Akira Morita, Yoshinao Matsuyama, Mako Takayoshi, Hiroto Yamamoto, Yutaro Nishiyama, Shuhei Iwamoto, Akane Murata, Yuki Ishida, Mariko Teragaki, Masaki Ikeda, Hiroya Takeoka

{"title":"An unusual presentation of dialysis-related amyloidosis: a large tumor extending from the gingiva to the palate.","authors":"Sachio Iwanari, Mari Tanaka, Toshihisa Akimune, Yuri Suzuki, Akira Morita, Yoshinao Matsuyama, Mako Takayoshi, Hiroto Yamamoto, Yutaro Nishiyama, Shuhei Iwamoto, Akane Murata, Yuki Ishida, Mariko Teragaki, Masaki Ikeda, Hiroya Takeoka","doi":"10.1007/s13730-026-01129-y","DOIUrl":"10.1007/s13730-026-01129-y","url":null,"abstract":"Dialysis-related amyloidosis (DRA) is a clinically significant complication of long-term hemodialysis, primarily affecting the bones and joints. Involvement of oral cavity is uncommon, and almost all reported cases are localized to the tongue. Here, we report a rare case of DRA presenting as a large tumor originating from the maxillary gingiva in a hemodialysis patient. We also review previously reported cases of oral DRA. A 77-year-old Japanese woman with diabetic kidney disease had been receiving maintenance hemodialysis for 11 years. She was referred to our hospital for evaluation of a large tumor extending from the maxillary gingiva to the palate. Although she had been completely edentulous in the maxilla for years, she did not wear dentures. A biopsy specimen from the tumor revealed diffuse subepithelial deposition of eosinophilic, amorphous material, which was positive for direct fast scarlet stain and exhibited apple-green birefringence under polarized light. Immunohistochemistry confirmed the presence of β2-microglobulin, leading to the diagnosis of DRA. The tumor was surgically resected, and no recurrence was noted during follow-up. Our case and literature review suggest that chronic mechanical stimulation in the oral cavity may contribute to the development of oral DRA. These findings highlight the importance of regular oral examinations and the elimination of mechanical irritation in patients receiving maintenance hemodialysis.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":"15 3","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13168372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873524","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

Kidney-limited thrombotic microangiopathy caused by relative hypertension in a hemodynamically vulnerable kidney allograft, mimicking malignant hypertension. 在血流动力学易损的同种异体肾移植中，由相对高血压引起的肾限制性血栓性微血管病，模仿恶性高血压。

IF 1

CEN Case Reports Pub Date : 2026-05-11 DOI: 10.1007/s13730-026-01120-7

Shinnosuke Sugihara, Tatsuhiko Azegami, Shinya Morita, Akinori Hashiguchi, Kaori Hayashi

{"title":"Kidney-limited thrombotic microangiopathy caused by relative hypertension in a hemodynamically vulnerable kidney allograft, mimicking malignant hypertension.","authors":"Shinnosuke Sugihara, Tatsuhiko Azegami, Shinya Morita, Akinori Hashiguchi, Kaori Hayashi","doi":"10.1007/s13730-026-01120-7","DOIUrl":"10.1007/s13730-026-01120-7","url":null,"abstract":"Malignant hypertension is traditionally defined as severe systemic blood pressure elevation accompanied by end-organ damage. In kidney transplant recipients, however, kidney allografts may be particularly vulnerable to hypertensive injury even at lower blood pressure levels, owing to impaired autoregulation associated with denervation and calcineurin inhibitor exposure. We report a 52-year-old kidney transplant recipient presenting with severe kidney injury (serum creatinine, 4.90 mg/dL) 16 months after transplantation. Although systemic blood pressure remained within the range of 140-170/90-105 mmHg-below the classical threshold of malignant hypertension-an allograft biopsy revealed the lesions suggestive of thrombotic microangiopathy (TMA), including mesangiolysis and edematous intimal thickening of the arteries. After exclusion of antibody-mediated rejection, calcineurin inhibitor toxicity, and primary TMAs, the patient was diagnosed with kidney-limited TMA attributable to relative hypertension producing a malignant hypertension-like phenotype in the setting of graft-specific vulnerability. Given the presumed contribution of the renin-angiotensin system (RAS)-mediated vascular injury, an angiotensin II receptor blocker was initiated despite severe kidney dysfunction, resulting in marked improvement in kidney function and proteinuria. This case illustrates that kidney allografts may develop a malignant hypertension-like pathophysiology with kidney-limited TMA at blood pressure levels below the classical malignant range. Awareness of this discrepancy may help clinicians recognize atypical hypertensive injury in transplant recipients, and early RAS blockade may be considered as a potential strategy to preserve allograft function, even in the setting of severe kidney injury.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":"15 3","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147866884","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

Acute tubulointerstitial nephritis following a coronavirus disease 2019 vaccine booster dose: a pediatric case report. 2019冠状病毒病疫苗加强剂后急性肾小管间质性肾炎：一份儿科病例报告

IF 1

CEN Case Reports Pub Date : 2026-05-08 DOI: 10.1007/s13730-026-01126-1

Haruhide Sakaguchi, Daishi Hirano, Yoichi Takemasa, Yuna Hiwatari, Shiho Yoshizawa, Yosuke Shoji, Aya Saito, Chisato Umeda, Saori Miwa, Akira Ito, Kimihiko Oishi

{"title":"Acute tubulointerstitial nephritis following a coronavirus disease 2019 vaccine booster dose: a pediatric case report.","authors":"Haruhide Sakaguchi, Daishi Hirano, Yoichi Takemasa, Yuna Hiwatari, Shiho Yoshizawa, Yosuke Shoji, Aya Saito, Chisato Umeda, Saori Miwa, Akira Ito, Kimihiko Oishi","doi":"10.1007/s13730-026-01126-1","DOIUrl":"10.1007/s13730-026-01126-1","url":null,"abstract":"Messenger ribonucleic acid vaccines against coronavirus disease 2019 (COVID-19) have been temporally associated with various renal adverse events, including acute tubulointerstitial nephritis (ATIN). Herein, we present the case of a 14-year-old male who developed biopsy-confirmed ATIN following a booster dose of the BNT162b2 (Pfizer-BioNTech) severe acute respiratory syndrome coronavirus 2 vaccine. Ten days after vaccination, the patient presented with fever, fatigue, and nausea and was referred to our hospital because of impaired kidney function. Kidney biopsy demonstrated diffuse tubulointerstitial inflammation consistent with ATIN, and gallium-67 scintigraphy showed diffuse bilateral kidney uptake. The lymphocyte transformation test (LTT) showed a stronger positive response to the BNT162b2 vaccine than to concomitant medications, suggesting a possible association with vaccination. Corticosteroid therapy led to rapid improvement in kidney function and normalization of tubular injury markers. This case demonstrated that ATIN may rarely occur after booster vaccination, and highlights the potential role of the LTT as a useful tool when multiple possible triggers are present.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":"15 3","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13156369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834170","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

Familial hypomagnesemia with hypercalciuria and nephrocalcinosis treated with living-donor kidney transplantation: case report. 活体肾移植治疗家族性低镁血症伴高钙尿和肾钙质沉着症1例。

IF 1

CEN Case Reports Pub Date : 2026-05-07 DOI: 10.1007/s13730-026-01103-8

Akari Kaba, Keizo Kaku, Kodai Shingaki, Shinsuke Kubo, Yu Hisadome, Hiroshi Noguchi, Kei Nishiyama, Yasuhiro Okabe, Masafumi Nakamura

{"title":"Familial hypomagnesemia with hypercalciuria and nephrocalcinosis treated with living-donor kidney transplantation: case report.","authors":"Akari Kaba, Keizo Kaku, Kodai Shingaki, Shinsuke Kubo, Yu Hisadome, Hiroshi Noguchi, Kei Nishiyama, Yasuhiro Okabe, Masafumi Nakamura","doi":"10.1007/s13730-026-01103-8","DOIUrl":"10.1007/s13730-026-01103-8","url":null,"abstract":"Familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) is a rare genetic disorder characterized by renal magnesium wasting, hypercalciuria, and progressive renal function decline, often culminating in end-stage renal disease (ESRD). This report presents the case of a successful living-donor kidney transplantation from a mother to her 22-year-old son, who was diagnosed with FHHNC. The patient initially exhibited hematuria at age two years, progressing to recurrent nephrolithiasis and hypercalciuria. Genetic analysis at age nine years confirmed FHHNC because of a CLDN-16 gene mutation. The CLDN-16 gene, which codes for claudin-16, is a crucial protein involved in renal magnesium and calcium reabsorption. While both parents and one sibling were identified as heterozygous carriers of the mutation, only the patient experienced severe symptoms. As his renal function progressively declined, ultimately reaching ESRD, a living-donor transplant was deemed necessary. His mother, with normal renal function and no history of nephrolithiasis, was evaluated as a suitable donor. Post-transplantation, the patient demonstrated rapid improvement in renal function, with magnesium levels stabilizing to baseline without supplementation, indicating effective graft function. This case underscores the complexities of managing FHHNC, particularly regarding kidney transplantation options and outcomes. Given the rarity of FHHNC, this report highlights the critical role of genetic diagnosis, family screening, and timely intervention. Additionally, it contributes to the limited literature on post-transplant outcomes in FHHNC, emphasizing the potential for living-donor transplantation to restore renal function and enhance quality of life in affected patients.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":"15 3","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834244","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

Acute esophageal necrosis in end-stage renal disease. 终末期肾病的急性食管坏死。

IF 1

CEN Case Reports Pub Date : 2026-04-29 DOI: 10.1007/s13730-026-01123-4

Satoshi Ototake, Isao Aoyama

{"title":"Acute esophageal necrosis in end-stage renal disease.","authors":"Satoshi Ototake, Isao Aoyama","doi":"10.1007/s13730-026-01123-4","DOIUrl":"10.1007/s13730-026-01123-4","url":null,"abstract":"Acute esophageal necrosis is a rare but often fatal condition characterized by diffuse black discoloration of the esophageal mucosa. While commonly associated with hemodynamic compromise, or infection, the pathogenesis is often multifactorial. We report a fatal case of acute esophageal necrosis in a man in his 50s with untreated long-standing hypertension and newly diagnosed end-stage renal disease. The patient presented with fatigue, loss of appetite, and respiratory distress and was admitted with pneumonia, pulmonary edema, and advanced renal dysfunction. After the initiation of hemodialysis, the patient’s oxygenation status and loss of appetite improved, allowing the resumption of oral intake on day 5. Despite temporary improvement, the patient occasionally complained of chest discomfort. Although we ruled out cardiac disease, diseases of the upper gastrointestinal tract were not considered in the differential diagnosis. On day 10, due to melena and worsening anemia, an urgent upper gastrointestinal endoscopy was performed, revealing acute esophageal necrosis. At that moment, we suddenly realized that the chest discomfort was especially noticeable after meals and caused by acute esophageal necrosis. We continued supportive therapy, but the patient unfortunately passed away. Autopsy revealed acute necrotizing esophagitis with Candida albicans, end-stage renal disease from untreated hypertension, pulmonary edema, and pneumonia. This case provides valuable insight for nephrologists, emphasizing the need to consider this rare but fatal disease in the differential diagnosis of patients presenting with chest discomfort.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":"15 3","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763630","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

Single-dose rituximab as induction therapy in adult IgA vasculitis with rapidly progressive glomerulonephritis: a case report with peripheral blood CD19⁺ B-cell monitoring. 单剂量利妥昔单抗诱导治疗成人IgA血管炎伴快速进展性肾小球肾炎：外周血CD19 + b细胞监测1例

IF 1

CEN Case Reports Pub Date : 2026-04-29 DOI: 10.1007/s13730-026-01118-1

Naoko Kyoda, Rika Ago, Naoko Masuzawa, Masaki Yanamoto, Masaho Aizawa, Takao Masaki

{"title":"Single-dose rituximab as induction therapy in adult IgA vasculitis with rapidly progressive glomerulonephritis: a case report with peripheral blood CD19⁺ B-cell monitoring.","authors":"Naoko Kyoda, Rika Ago, Naoko Masuzawa, Masaki Yanamoto, Masaho Aizawa, Takao Masaki","doi":"10.1007/s13730-026-01118-1","DOIUrl":"10.1007/s13730-026-01118-1","url":null,"abstract":"Treatment for adult IgA vasculitis (IgAV), particularly severe cases, is not well established, although recent reports have suggested potential efficacy of rituximab (RTX). Here, we report a case highlighting the effectiveness of RTX based on pathophysiological and pathological considerations of IgAV, as well as a treatment protocol that has not been previously described. A 50-year-old man receiving glucocorticoids for cutaneous IgAV developed nephrotic syndrome and acute nephritic syndrome. Renal biopsy showed marked endocapillary and extracapillary proliferation with IgA deposition, consistent with severe IgAV nephritis. Despite glucocorticoid pulse therapy and intravenous cyclophosphamide, rapidly progressive glomerulonephritis ensued, prompting RTX initiation. With reference to peripheral blood CD19± B-cell monitoring, a single-dose RTX induction regimen was selected. Following RTX administration, the patient showed a favorable renal response. This case supports the potential efficacy of RTX in highly active IgAV with systemic symptoms. It suggests that a single-dose RTX induction approach may represent a feasible strategy to balance effective disease control with reduced infection risk in selected patients with severe adult IgAV, for which peripheral blood CD19+ B-cell monitoring may be helpful.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":"15 3","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763666","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

Acute interstitial nephritis due to acute pyelonephritis in a young woman: diagnostic utility of CK7 and CD10 immunostaining. 1例年轻女性急性肾盂肾炎所致急性间质性肾炎：CK7和CD10免疫染色的诊断价值

IF 1

CEN Case Reports Pub Date : 2026-04-29 DOI: 10.1007/s13730-026-01115-4

Naoto Eriguchi, Keiki Shimada, Daisuke Katagiri, Hitomi Otani, Yuri Katayama, Kanako Terakawa, Mikako Koizumi, Harui Bamba, Tomonobu Kajio, Mariko Kawamura, Minami Suzuki, Hideki Miyazaki, Hideki Takano

{"title":"Acute interstitial nephritis due to acute pyelonephritis in a young woman: diagnostic utility of CK7 and CD10 immunostaining.","authors":"Naoto Eriguchi, Keiki Shimada, Daisuke Katagiri, Hitomi Otani, Yuri Katayama, Kanako Terakawa, Mikako Koizumi, Harui Bamba, Tomonobu Kajio, Mariko Kawamura, Minami Suzuki, Hideki Miyazaki, Hideki Takano","doi":"10.1007/s13730-026-01115-4","DOIUrl":"10.1007/s13730-026-01115-4","url":null,"abstract":"Acute Interstitial Nephritis (AIN) is a common cause of acute kidney injury (AKI) and may lead to irreversible renal scarring if the diagnosis is delayed. Although most cases are drug-induced, AIN can also occur in association with acute pyelonephritis (APN). Nevertheless, given that antibiotics are routinely administered for APN, cases of APN-associated AIN may be erroneously classified as drug-induced AIN. Distinguishing these two entities histologically remains challenging; however, their therapeutic strategies differ. We describe a case involving a previously healthy 21-year-old woman who presented with a fever and rapidly progressive renal impairment. Laboratory evaluation revealed serum creatinine and C-reactive protein concentrations of 3.54 mg/dL and 25.06 mg/dL, respectively, prompting an urgent renal biopsy. Histopathological examination by light microscopy demonstrated a diffuse interstitial and tubular inflammatory infiltrate predominantly composed of neutrophils, consistent with AIN. Based on these pathological findings and the clinical course, AIN secondary to APN was suspected. The patient was managed with an intensified antibiotic regimen without corticosteroid therapy, resulting in complete renal recovery. To further refine the diagnosis after hospital discharge, we examined immunostaining patterns across tubular segments. Immunostaining demonstrated a neutrophil-predominant infiltrate in the distal tubules and collecting ducts, which showed a segmental pattern characteristic of APN-related injury. This case highlights the potential utility of immunostaining in distinguishing APN-associated AIN from drug-induced AIN and supports its incorporation into diagnostic evaluation.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":"15 3","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763645","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