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Primary Sclerosing Cholangitis and Amyloid A Amyloidosis: Association or Coincidence?
We describe the case of a patient with primary sclerosing cholangitis (PSC) with development of AA amyloidosis conditioning a nephrotic syndrome, likely secondary to failure to control the chronic inflammatory process. Only two cases in the literature describe the association of this rare disease and the appearance of AA amyloidosis. The treatment of AA amyloidosis consists in treating the underlying inflammatory disorder; to date, few effective treatments are available for PSC. Therefore, and in view of the limited data in the literature, we believe it is important to describe its association.Case Rep Nephrol Dial 2022;12...
Source: Case Reports in Nephrology and Dialysis - October 4, 2022 Category: Urology & Nephrology Source Type: research
Rituximab, Mycophenolic Acid, and Calcineurin Inhibitors Achieve Long-Term Remission in Pediatric Focal Segmental Glomerulosclerosis with Steroid-Resistant and Frequently Relapsing Nephrotic Syndrome: A Report of Two Cases
We report successful treatment of pediatric FSGS with rituximab infusions, followed by maintenance immunosuppression with mycophenolic acid (MPA) and a calcineurin inhibitor (CNI) in 1 patient with refractory steroid-resistant NS (SRNS), and one with frequently relapsing NS (FRNS). Case 1 is a patient with refractory SRNS due to FSGS. MPA and tacrolimus induced complete remission within 6 months following rituximab treatment. Remission was maintained for over 2 years, and the patient ’s kidney function and body height also returned to normal ranges within this time. Case 2 is a patient with FRNS due to FSGS, who was trea...
Source: Case Reports in Nephrology and Dialysis - October 4, 2022 Category: Urology & Nephrology Source Type: research
Hemadsorption: A New Therapeutic Option for Selected Cases of Bromazepam Intoxication
Benzodiazepine ingestion is frequent in patients admitted to ICU for intoxications. Generally, a supportive approach by securing the airway, breathing, and circulation is sufficient. Flumazenil is a well-known antidote for benzodiazepines but does not influence its elimination. Following preclinical data, we applied for the first time in humans a hemadsorption filter in a patient with a bromazepam intoxication. This technique proved to be effective in eliminating bromazepam in a patient with CHILD-C cirrhosis. We conclude that hemadsorption is a viable option to reduce length of ICU stay or intubation in slow metabolizers ...
Source: Case Reports in Nephrology and Dialysis - September 26, 2022 Category: Urology & Nephrology Source Type: research
< b > < i > Butyricimonas virosa < /i > < /b > Peritonitis in Peritoneal Dialysis Patient: A Case Report and Review
Butyricimonas virosa is a Gram-negative bacillus, which was first discovered in rat faeces in 2009. To date, only seven human infections have been reported in literature. To our knowledge, this is the first reported case of peritoneal dialysis (PD)-related peritonitis due toB. virosa. A 65-year-old Chinese man presented to the hospital with complaints of dizziness and vomiting. On admission, the drained peritoneal dialysate was cloudy. He was empirically treated as a case of PD-related peritonitis with intraperitoneal (IP) cefazolin, ceftazidime, and gentamicin.B. virosa was isolated from peritoneal fluid sample and the an...
Source: Case Reports in Nephrology and Dialysis - September 26, 2022 Category: Urology & Nephrology Source Type: research
< b > < i > Actinotignum schaalii < /i > < /b > Can Be an Uropathogen of “Culture-Negative” Febrile Urinary Tract Infections in Children with Urinary Tract Abnormalities
Accurate diagnosis and treatment of febrile urinary tract infections (UTI) during childhood are important for the prevention of renal parenchymal damage and functional loss, and detection of underlying diseases related to chronic kidney disease (CKD).Actinotignum schaalii (A. schaalii)-related febrile UTI in children is rare, and its incidence and risk factors remain unclear. A 3-year-old boy with a history of UTI presented with fever and vomiting. Although the culture of his urine specimen in air was negative,A. schaalii was observed in a 5% carbon dioxide (CO2) culture condition, as well as an anaerobic one. A diagnosis ...
Source: Case Reports in Nephrology and Dialysis - September 26, 2022 Category: Urology & Nephrology Source Type: research
More Drug Monitoring and Less CT Scans of the Brain: Gabapentin Overdose in Two Peritoneal Dialysis Patients
We report 2 patients in which overdose of gabapentin occurred. In 1 patient, severe neurological symptoms prompted an extensive diagnostic work up, while the underlying cause of the clinical presentation was a supra-therapeutic drug level of gabapentin. Consequently, symptoms subsided with the discontinuation of the drug. Indication and drug dose of gabapentin in dialysis patients should be tightly controlled, and drug monitoring used to avoid unintended overdose.Case Rep Nephrol Dial 2022;12:145 –149 (Source: Case Reports in Nephrology and Dialysis)
Source: Case Reports in Nephrology and Dialysis - September 26, 2022 Category: Urology & Nephrology Source Type: research
Severe Bullous Pemphigoid Onset after Jugular Catheter Placement in a Patient on Hemodialysis
Pruritus is highly prevalent in the dialysis population. Its etiology however remains often unclear with uremic pruritus primarily suspected unless compelling evidence of another cause. Although bullous pemphigoid (BP) is considered idiopathic, there are growing data in the literature on BP provoked by different factors, such as medications or surgical procedures. These secondary dermatoses are described as rather mild conditions and more frequent in the elderly Caucasian. We herein describe a newly dialyzed African man of 76 years old, treated by a sulfonylurea such as an antidiabetic drug, who developed a severe BP after...
Source: Case Reports in Nephrology and Dialysis - August 29, 2022 Category: Urology & Nephrology Source Type: research
Vena Cava Superior Syndrome Six Years after Central Venous Catheter Removal in a Patient on Hemodialysis
Vena cava superior (VCS) syndrome is rarely seen as a complication of central-venous-catheter placement. Usually, the syndrome appears when the presence of the catheter causes intraluminal obstruction or thrombosis. In this case report, however, we describe a patient on intermittent hemodialysis who had been free of any venous central line for over 6 years, presented with a VCS syndrome. The CT scan showed an absent VCS without extravascular compression. Previous catheter placement was diagnosed as the case of the VCS syndrome. It is important to realize that VCS syndrome can occur late after removal of central venous cath...
Source: Case Reports in Nephrology and Dialysis - August 29, 2022 Category: Urology & Nephrology Source Type: research
Four Cases of Serum Copper Excess in Patients with Renal Anemia Receiving a Hypoxia-Inducible Factor-Prolyl Hydroxylase Inhibitor: A Possible Safety Concern
Copper is an indispensable trace metal element and is mainly absorbed in the stomach and small intestine and excreted into the bile. Hypoxia-inducible factor-prolyl hydroxylase inhibitors (HIF-PHIs) have emerged as a novel approach for renal anemia management. Many intestinal genes, includingdivalent metal transporter 1,duodenal cytochrome B, and copper transporter ATPase7A, related to iron absorption are transactivated by HlF- α, during iron deficiency. We first report 4 cases of patients with renal anemia who showed excess in serum copper level during roxadustat or daprodustat treatment, which were decreased to the norm...
Source: Case Reports in Nephrology and Dialysis - August 19, 2022 Category: Urology & Nephrology Source Type: research
Rifabutin-Induced SIADH and Leucopenia in a Renal Transplant Recipient with Genitourinary Tract Tuberculosis: A Case Report and Review of the Literature
We present a renal transplant patient diagnosed with GU TB, treated with a regime containing rifabutin, who subsequently developed profound hyponatremia and leucopenia. Serum and urine biochemistry was consistent with a diagnosis of the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Both SIADH and leucopenia resolved with rifabutin cessation. This is the first report of biochemically proven, idiosyncratic SIADH and leucopenia associated with the use of rifabutin in the treatment of GU TB in a renal transplant recipient.Case Rep Nephrol Dial 2022;12:117 –123 (Source: Case Reports in Nephrology and Dialysis)
Source: Case Reports in Nephrology and Dialysis - August 19, 2022 Category: Urology & Nephrology Source Type: research
Acute Kidney Injury following Exposure to Formaldehyde-Free Hair-Straightening Products
Formaldehyde-free hair-straightening products are hair-smoothening solutions widely used by professional beauty salons. Formaldehyde-free hair straighteners do not technically contain formaldehyde; however, they contain other chemicals such as glyoxyloyl carbocysteine which releases formaldehyde upon contact with heat. Moreover, its by-product glyoxylate may convert to oxalate; both compounds have potential nephrotoxic effect. Here, we report a case of a 41-year-old woman who presented to the emergency room with weakness, nausea, vomiting, and stage 3 acute kidney injury (AKI) according to Kidney Disease: Improving Global ...
Source: Case Reports in Nephrology and Dialysis - July 11, 2022 Category: Urology & Nephrology Source Type: research
Propylthiouracil-Induced Antineutrophil Cytoplasmic Antibodies-Associated Vasculitis with Renal and Lung Involvement
We described the case of a 44-year-old lady with underlying Graves ’ disease who had cough, blood-streaked sputum, and impaired renal function. A strongly positive anti-myeloperoxidase antibody (#x3e;200 U/mL) along with pauci-immune glomerulonephritis and pulmonary hemorrhage resulted in the diagnosis of PTU-induced AAV, given that the patient had been on PTU fo r 3 years. PTU withdrawal, therapeutic plasma exchanges, and oral cyclophosphamide provided favorable clinical and biochemical outcomes. She remained well on azathioprine 50 mg daily as maintenance therapy and clinically euthyroid with carbimazole 2.5 mg daily. ...
Source: Case Reports in Nephrology and Dialysis - June 17, 2022 Category: Urology & Nephrology Source Type: research
Membranous Nephropathy-Like Apolipoprotein E Deposition Disease with Apolipoprotein E Toyonaka and Homozygous Apolipoprotein E2/2 without Dyslipidemia, with Characteristic Electron-Dense Deposits
Recently, several cases of novel apolipoprotein E (apoE)-related glomerular disease known as membranous nephropathy (MN)-like apoE deposition disease with apoE Toyonaka (Ser197Cys) and homozygous apoE2/2 have been reported. However, the clinical and pathological characteristics are uncertain due to the small number of reports. Here, we report an additional case with various clinical and pathological characteristics. A 28-year-old Japanese man with mild proteinuria and hematuria underwent a kidney biopsy. Examination under a light microscope revealed mesangial proliferation, mesangial matrix expansion, and segmental spike l...
Source: Case Reports in Nephrology and Dialysis - June 10, 2022 Category: Urology & Nephrology Source Type: research
Spontaneous Twin Pregnancy: A Challenging and Exceptional Scenario in a Patient on Maintenance Hemodialysis in Sub-Saharan Africa
Chronic hemodialysis is associated with reduced fertility. Hence, pregnancy remains rare, challenging, and deleterious when unplanned, especially in low-resource countries. Contraception and births are very important in these settings. Though the main modes of contraception have been proposed in the chronic kidney disease (CKD) population, contraception still remains challenging in patients on maintenance hemodialysis. Most doctors, however, overlook contraception because of the low fertility, high rate of amenorrhea, and low libido. Furthermore, patients are less receptive to contraceptive counseling either because of a h...
Source: Case Reports in Nephrology and Dialysis - June 7, 2022 Category: Urology & Nephrology Source Type: research
Urothelial Carcinoma in an Allograft kidney
Patients who have been kidney transplanted have an increased risk of developing cancer. This case report presents a rarely described case in which a patient, who had received a kidney transplant from a deceased donor, was diagnosed with disseminated urothelial carcinoma originating from the allograft. After the removal of the allograft and the immunosuppressive treatment, there was regression in the cancer. Unfortunately, it was not a complete regression of the urothelial cancer and the patient died. This case indicates that there is a risk of getting cancer from the transplanted kidney from a deceased donor, but also that...
Source: Case Reports in Nephrology and Dialysis - May 31, 2022 Category: Urology & Nephrology Source Type: research