Brown tumor of the thoracic spine presenting with paraplegia in a patient with peritoneal dialysis
AbstractSecondary and tertiary hyperparathyroidism is an important problem of chronic kidney disease. Brown tumor is a benign, unusual, reactive lesion as a result of disturbed bone remodeling, from long-standing increase in parathyroid hormone level. Brown tumors may cause morbidity due to pressure symptoms on neural structures and spontaneous bone fractures. Herein, we presented a peritoneal dialysis patient with tertiary hyperparathyroidism under calcand calcitriol treatment for 4  years due to refusing of the parathyroidectomy operation. She admitted to hospital for sudden onset back pain with difficulty in gait a...
Source: CEN Case Reports - May 14, 2019 Category: Urology & Nephrology Source Type: research

A suspected case of drug-induced tubulointerstitial nephritis by pilocarpine hydrochloride
AbstractA 63-year-old man with pharyngeal cancer had been prescribed pilocarpine hydrochloride for xerostomia after concomitant chemoradiotherapy. After 6  months of taking pilocarpine hydrochloride, he was referred to our hospital due to gradually developing renal insufficiency. The patient underwent detailed urinalysis, blood chemistry analysis, immune-serology testing. A renal biopsy was also performed. He was diagnosed with chronic tubulointersti tial nephritis (TIN) caused by lymphocytic infiltration of the interstitium, tubular atrophy, and interstitial fibrotic changes. Infections, autoimmune diseases, and gene...
Source: CEN Case Reports - May 10, 2019 Category: Urology & Nephrology Source Type: research

Pathological findings of progressive renal involvement in a patient with TAFRO syndrome
AbstractTAFRO syndrome (thrombocytopenia, anasarca, fever, reticulin fibrosis, and organomegaly) is thought of as an atypical type of idiopathic multicentric Castleman ’s disease. Interleukin-6, vascular endothelial growth factor (VEGF), and other cytokines are considered etiological factors. A 45-year-old woman was admitted to hospital with unknown fever and abdominal pain. She had thrombocytopenia, anasarca, proteinuria/hematuria, and slight hepatosplenomegaly . Based on her clinical course and laboratory data, she was diagnosed as having TAFRO syndrome. Kidney biopsy showed a membranoproliferative glomerulonephrit...
Source: CEN Case Reports - May 10, 2019 Category: Urology & Nephrology Source Type: research

Membranous nephropathy caused by rheumatoid arthritis
We describe a 61-year-old woman with RA who showed nephrotic syndrome. She was admitted because of systemic edema and severe arthritis. She had a long history of RA successfully treated with methotrexate (MTX), but discontinued all treatments 4  years before hospitalization. She had never been treated with bucillamine or gold. Laboratory test results were positive for anti-cyclic citrullinated peptide antibody and negative for anti-nuclear antibody. Renal pathologic findings were compatible with MN. Immunofluorescence microscopy showed Ig G, IgA, κ, λ, and C3 along the glomerular capillary wall, whereas d...
Source: CEN Case Reports - April 29, 2019 Category: Urology & Nephrology Source Type: research

A case of acute kidney injury secondary to black cherry concentrate in  a patient with chronic kidney disease secondary to type 2 diabetes mellitus
AbstractThere are many herbal products which are accessible to patients, and they may provide with many health benefits. Nevertheless, some of these supplements can lead to  significant morbidity as they can also have important side effects and impact patient’s organ systems. In this case report, we present a patient with chronic kidney disease secondary to type II diabetes mellitus who develops acute kidney injury and metabolic disturbances secondary to consuming b lack cherry concentrate as a mean to self-manage his gout flare. The most likely mechanism of injury was cyclooxygenase inhibition by anthocyanins, ...
Source: CEN Case Reports - April 8, 2019 Category: Urology & Nephrology Source Type: research

Successful peritoneal dialysis for the end-stage kidney disease associated with Prader –Willi syndrome: a case report
In this report, we experienced o ne case of patient with PWS suffering from ESKD due to DKD who started PD as an initial RRT and succeeded to continue for total of 40 months. The patient was 37-year-old man at the time of initiation of dialysis. PD was chosen for RRT because we suspected that he might have more technical difficult ies for continuing HD. After several episodes of peritonitis, he successfully continues PD without peritonitis for next 27 months until the present time with good support by his family member. To our best knowledge, this is the first reported case of ESKD associated with PWS who was suc...
Source: CEN Case Reports - April 8, 2019 Category: Urology & Nephrology Source Type: research

Sarcoidosis in the renal allograft of a recipient whose primary disease was autosomal dominant polycystic kidney disease
We report a 55-year-old man with a renal allograft that developed sarcoidosis. His autosomal dominant polycystic kidney disease (ADPKD) progressed to end-stage stage renal disease when he was 52  years old, and he underwent living-donor kidney transplantation at the age of 53 years. His proteinuria worsened at 19 months post-transplantation, and his renal function began to decline at 29 months post-transplantation. A renal allograft biopsy performed at 31 months post-transplantation re vealed non-caseating granulomatous interstitial nephritis. The patient was treated with prednisolone (0.5 mg/...
Source: CEN Case Reports - April 5, 2019 Category: Urology & Nephrology Source Type: research

A relapsing case of pulmonary –renal syndrome after a sequential rise in MPO–ANCA and anti-GBM antibodies
AbstractA 69-year-old woman who presented with severe renal dysfunction and diffuse alveolar hemorrhage was diagnosed with pulmonary –renal syndrome (PRS) based on the coexistence of serum myeloperoxidase (MPO)–antineutrophil cytoplasmic antibodies (ANCA) and anti-glomerular basement membrane (GBM) antibodies (Ab). Hemodialysis was started; plasma exchange and intravenous methylprednisolone pulse therapy were administered fol lowed by oral prednisolone administration. Pulmonary hemorrhage decreased; however, renal dysfunction persisted. On maintenance hemodialysis and prednisolone therapy, MPO–ANCA and an...
Source: CEN Case Reports - April 3, 2019 Category: Urology & Nephrology Source Type: research

A case of secondary IgA nephropathy accompanied by psoriasis treated with secukinumab
AbstractA 60-year-old man was diagnosed with psoriasis 4  years ago. Treatment with adalimumab (a monoclonal anti-TNF-α antibody) became ineffective 1 year ago, and proteinuria and urinary occult blood were detected. Treatment with topical medicine, ultraviolet therapy, and etretinate resulted in remission of psoriasis, and proteinuria and hematuria al so improved. For maintenance of remission, treatment with secukinumab (a human anti-interleukin-17A monoclonal antibody) was initiated. After the induction phase, treatment was changed from once a week to once every 4 weeks. After 5 months, he devel...
Source: CEN Case Reports - April 3, 2019 Category: Urology & Nephrology Source Type: research

Effectiveness of cryofiltration and mizoribine combination with oral steroid therapy in a patient with membranoproliferative glomerulonephritis due to essential cryoglobulinemia
AbstractA 65-year-old male patient with nephrotic syndrome was admitted to our hospital due to worsening systemic edema and purpura on the limbs. He had an impaired renal function, low serum complement level, and elevated rheumatoid factor level. He was positive for cryoglobulin (monoclonal IgM- κ and polyclonal mixed-type IgG), and the results of his kidney biopsy showed a tissue profile of membranoproliferative glomerulonephritis (MPGN). Due to the fact that the secondary cause was unclear, he was diagnosed with MPGN due to essential mixed cryoglobulinemia. On hospital day 20, he was ini tiated on 50 mg/day ...
Source: CEN Case Reports - March 29, 2019 Category: Urology & Nephrology Source Type: research

Correction to: Oliguria due to extensive subcapsular hematoma in renal graft: does surgical intervention ensure better outcomes?
In the original publication of the article, the author name “Nadeem Iqbal” has appeared twice. The corrected author group and affiliations are given in this Correction. The original article has been corrected. (Source: CEN Case Reports)
Source: CEN Case Reports - March 26, 2019 Category: Urology & Nephrology Source Type: research

Novel Asp511Thr mutation in McArdle disease with acute kidney injury caused by rhabdomyolysis
We present the case of a patient with long-term idiopathic hyperCKemia who, after contracting an upper respiratory tract infection, developed severe rhabdomyolysis and acute kidney injury. Upon hemodialysis, his renal function recovered and CK levels fell to below baseline, and maintenance therapy with vitamin B6 was also started. A molecular diagnosis of McArdle disease was subsequently made. Whole-exome sequencing revealed homozygous c1538delG (p.Asp511Thr fs*28) mutations in the PYGM gene, which was a novel mutation. Therefore, when investigating idiopathic hyperCKemia, glycogen storage disorders should also be consider...
Source: CEN Case Reports - March 21, 2019 Category: Urology & Nephrology Source Type: research

Successful treatment of peritoneal dialysis-related peritonitis caused by Dermacoccus nishinomiyaensis
AbstractA 53-year-old man receiving peritoneal dialysis (PD) for 4  months presented with PD-related peritonitis (abdominal pain, turbid peritoneal dialysate effluent, white blood cell in peritoneal dialysate effluent 5350/µL, C-reactive protein 25.56 mg/dL) caused byDermacoccus (D.)nishinomiyaensis. He was first treated empirically with cefazolin and ceftazidime. After detection ofD. nishinomiyaensis in the peritoneal effluent culture collected on the first day of hospitalization, the antibiotics were changed to amoxicillin and vancomycin. After confirming negative-conversion of peritoneal effluent culture...
Source: CEN Case Reports - March 4, 2019 Category: Urology & Nephrology Source Type: research

A case of posterior reversible encephalopathy syndrome in a patient undergoing automated peritoneal dialysis
AbstractA 44-year-old man undergoing automated peritoneal dialysis (PD) developed headache and dizziness with truncal ataxia and ataxic gait. Severe hypertension (systolic blood pressure/diastolic pressure: 193/83  mm Hg) and lower extremity edema were present, and his PD efficiency (weekly KT/V: 1.49) was inadequate. Magnetic resonance imaging revealed diffuse hyperintensities in the brain stem and bilateral cerebellar hemispheres on fluid-attenuated inversion recovery and apparent diffusion coefficient map ping imaging. Based on these findings, the patient was diagnosed with posterior reversible encephalopathy syndr...
Source: CEN Case Reports - March 4, 2019 Category: Urology & Nephrology Source Type: research

A case of biopsy-proven oxaliplatin-induced acute tubulointerstitial nephritis with thrombocytopenia and anemia
AbstractOxaliplatin, a third-generation platinum agent, has been used for the treatment of colon, pancreatic, and stomach cancers in recent years. It carries a reduced risk of acute kidney injury (AKI) compared to the previous platinum agents, including cisplatin and carboplatin. Several cases of oxaliplatin-induced acute tubular necrosis (ATN) have been reported; however, only one case has been reported as acute tubulointerstitial nephritis (ATIN) histopathologically. Here, we present a case of biopsy-proven and dialysis-dependent ATIN, which dramatically resolved with steroid therapy. The patient was a 67-year-old male w...
Source: CEN Case Reports - March 2, 2019 Category: Urology & Nephrology Source Type: research

Chronological change of renal pathological findings in the proliferative glomerulonephritis with monoclonal IgG deposits considered to have recurred early after kidney transplantation
AbstractProliferative glomerulonephritis with monoclonal immunoglobulin G (IgG) deposits (PGNMID) is a rare disease that recently became recognized. Its pathological findings are characterized by the deposition of a single heavy chain subclass and a single light chain isotype. PGNMID has been proven to recur in renal allografts. Herein, the authors describe the case of a 46-year-old man who presented with nephrotic syndrome and progressive kidney injury following kidney transplantation. One month after transplantation, his clinical condition stabilized; however, the protocol biopsy showed depositions of IgG and complement ...
Source: CEN Case Reports - February 25, 2019 Category: Urology & Nephrology Source Type: research

Collapsing glomerulopathy in a child with LCHAD deficiency: a rare association
We report a rare metabolic disorder, long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency, in a child who developed steroid-resistant nephrotic syndrome at the age of 5  years. Renal biopsy showed features of collapsing glomerulopathy. The child had progressive chronic kidney disease. Alternative immunosuppressants including tacrolimus failed to show any clinical improvement. There have been no reports of children with long-chain 3-hydroxyacyl-CoA dehydrogenase de ficiency developing steroid-resistant nephrotic syndrome and collapsing glomerulopathy. This case highlights the need to monitor renal function and protein...
Source: CEN Case Reports - February 12, 2019 Category: Urology & Nephrology Source Type: research

Remission of light chain proximal tubulopathy in IgG λ-type multiple myeloma by lenalidomide and dexamethasone therapy
AbstractLight chain proximal tubulopathy is a rare manifestation of monoclonal gammopathy. A 73-year-old Japanese woman was noted to have urinary protein and hypertension on health examination and visited the regional clinic. She was noted to have IgG λ M protein and suspected of multiple myeloma. She was referred to us with massive proteinuria (7.5 g/g creatinine) and Bence Jones proteinuria without renal dysfunction. A renal biopsy revealed no glomerular abnormalities, but a tubular cast was observed partially in tubules without tubular atrop hy or a crystalline structure. Direct Fast Scarlet staining was abs...
Source: CEN Case Reports - February 5, 2019 Category: Urology & Nephrology Source Type: research

Direct oral anticoagulant successfully used to treat an adult nephrotic patient complicated with portal vein thrombosis
We report a case of a relapsed steroid-dependent minimal change disease with incidental PVT. A 38-year-old man presented with anasarca. Elevated liver enzymes were discovered during routine blood testing within days after commencing treatment. Although drug-induced liver injuries are frequently observed with mild aminotransferase abnormality during therapy with steroid or immune-suppressive agents, imaging revealed a massive thrombus of the portal vein, which was treated by anticoagulant therapy with edoxaban. Treatment with anticoagulant therapy could normalize liver function. Two months after the initiation of treatment ...
Source: CEN Case Reports - February 5, 2019 Category: Urology & Nephrology Source Type: research

Three months interval therapy of Eculizumab in a patient with atypical hemolytic uremic syndrome with hybrid CFHR1/CFH gene
In conclusion, achievement of successful and maintenance of remission of P-aHUS in this patient who had limited access to Eculizumab raise the attention of the efficacy of Eculizumab at longer time intervals. However, it is time to consider conduct ing a long-term study to learn about the safety and efficacy of this approach, which may have a major financial advantage for patients. (Source: CEN Case Reports)
Source: CEN Case Reports - February 4, 2019 Category: Urology & Nephrology Source Type: research

Massive generalized crystal-storing histiocytosis associated with extracellular crystalline nephropathy: clinical, immunohistochemical, and ultrastructural studies of a unique disorder and review of the literature
We present a case of generalized CSH associated with extracellular crystalline nephropathy with a fulminant and fatal clinical course. Kappa light-chain crystals were found exclusively extracellularly within the tubular lumen, not within the tubular epithelial cells nor the histiocytes, and the massive presence of those precipitates led to the acute renal failure. Consequently, we review the renal involvement in CSH in the literature and discuss the unique mechanism of renal injury in this case. (Source: CEN Case Reports)
Source: CEN Case Reports - February 2, 2019 Category: Urology & Nephrology Source Type: research

A case of apolipoprotein E Toyonaka and homozygous apolipoprotein E2/2 showing non-immune membranous nephropathy-like glomerular lesions with foamy changes
AbstractA 47-year-old Japanese man with mild proteinuria was treated with an ACE inhibitor and antiplatelet agent for 7  years. However, urinary protein levels increased and renal biopsy was performed. Eight out of 20 glomeruli showed global or segmental sclerosis with foamy changes or bubbles, but with a different appearance to typical foam cells or lipoprotein thrombi. “Spike” formation, as observed in membran ous nephropathy (MN), was segmentally detected in methenamine silver-stained sections. In an immunofluorescence study, weak linear patterns for IgG and scanty deposits for C3 were observed in glome...
Source: CEN Case Reports - January 30, 2019 Category: Urology & Nephrology Source Type: research

Two cases of advanced stage rapidly progressive diabetic nephropathy effectively treated with combination therapy including RAS blocker, GLP-1 receptor agonist and SGLT-2 inhibitor
AbstractWe herein report two cases of advanced stage rapidly progressive diabetic nephropathy that were effectively treated with combination therapy including renin –angiotensin–aldosterone system (RAS) blocker [angiotensin II receptor blocker (ARB)], glucagon-like peptide-1 (GLP-1) receptor agonist and sodium glucose transporter-2 (SGLT-2) inhibitor. A 30-year-old woman with advanced stage diabetic nephropathy [estimated glomerular filtration rate (eGFR): 20.7 mL/min/1.73 m2; proteinuria: 13.2  g/gCr], showing a rapidly progressive pattern (annual eGFR change: − 60.0 mL/min/1.7...
Source: CEN Case Reports - January 20, 2019 Category: Urology & Nephrology Source Type: research

Dabigatran causing severe acute kidney injury in a patient with liver cirrhosis
We report a patient who had a history of alcoholic liver cirrhosis and paroxysmal atrial fibrillation, and received dabigatran 110  mg twice daily for 1 year. He presented with gross hematuria and severe acute kidney injury with an international normalized ratio of 4.09. Dabigatran was stopped and he was put on temporary hemodialysis support. His renal function gradually improved when the hematuria subsided. Renal biopsy late r confirmed the presence of red blood cell casts inside the renal tubules with features of IgA nephropathy. Finally, his renal function returned back to baseline level. As DOAC has been incr...
Source: CEN Case Reports - January 18, 2019 Category: Urology & Nephrology Source Type: research

Oliguria due to extensive subcapsular hematoma in renal graft: does surgical intervention ensure better outcomes?
AbstractA 58-year-old male patient, with end-stage renal disease secondary to hypertension, underwent living-related kidney transplant at our transplant unit. The transplant surgery went uneventful and brisk urine output was recorded. Four hours after the transplant, the output suddenly dropped despite normal central venous pressure. Doppler scan revealed an extensive peri-allograft hematoma and high renal arterial resistive indices (RI). The patient was taken to the operating room where capsulotomy of the subcapsular hematoma was done. Postoperatively, the urine output restored to normal and the patient was sent home on t...
Source: CEN Case Reports - January 16, 2019 Category: Urology & Nephrology Source Type: research

Tolvaptan corrects hyponatremia and relieves the burden of fluid/dietary restriction and hospitalization in hyponatremic patients with terminal lung cancer: a report of two cases
AbstractCase 1: A 45-year-old man, admitted for symptomatic hyponatremia, was diagnosed with advanced small-cell lung cancer and severe hyponatremia due to the syndrome of inappropriate secretion of antidiuretic hormone. In addition to chemotherapy, the patient was treated with increased dietary salt intake (15  g/day), fluid restriction of 500 mL/day, and amino acid supplementation to maintain a urea load of 31 g/day. Due to the difficulty in changing his habit of drinking 2–3 L/day after discharge, tolvaptan was started. This resulted in correction of hyponatremia, which facilitated earlier disc...
Source: CEN Case Reports - January 14, 2019 Category: Urology & Nephrology Source Type: research

Anti-mitochondria antibody-related tubulointerstitial nephritis accompanied by severe hypokalemic paralysis
AbstractA 47-year-old man presented with severe hypokalemic paralysis and respiratory failure. A large amount of potassium was administered along with providing intensive care, and his condition improved. Hypokalemia was attributed to increased urinary potassium excretion. A kidney biopsy was performed to make a definitive histological diagnosis. It revealed acute tubulointerstitial nephritis (TIN). After the diagnosis, prednisolone was administered, and the TIN gradually improved. From the clinical course and laboratory findings, the TIN was presumed to be an autoimmune disorder. Further specific autoantibody tests were p...
Source: CEN Case Reports - January 14, 2019 Category: Urology & Nephrology Source Type: research

Fibrosing cholestatic hepatitis in a kidney transplant recipient with hepatitis C virus
AbstractFibrosing cholestatic hepatitis (FCH) is a fatal disorder that presents as a progressive deterioration of liver function over a period of several weeks to several months. It is caused by the direct cytotoxic effect of the over-expression of viral antigens on hepatocytes in immunosuppressed patients. Our patient was a 59-year-old man with hepatitis C virus (HCV) infection of genotype 2a who had suffered from end-stage renal disease due to diabetic nephropathy and underwent kidney transplantation. His serum total bilirubin levels gradually increased to 20  mg/dl and liver atrophy progressed during several weeks ...
Source: CEN Case Reports - January 2, 2019 Category: Urology & Nephrology Source Type: research

Clinical usefulness of serum levels of soluble fms-like tyrosine kinase 1/placental growth factor ratio to rule out preeclampsia in women with new-onset lupus nephritis during pregnancy
In conclusion, measurement of the sFlt-1/PlGF ratio may be clinically useful to discriminate lupus nephritis from preeclampsia. (Source: CEN Case Reports)
Source: CEN Case Reports - December 18, 2018 Category: Urology & Nephrology Source Type: research

Sequential nonarteritic anterior ischemic optic neuropathy in patient on chronic hemodialysis
We present a unique case of a patient on chronic hemodialysis who presented with an NAION in the right eye, then 3 months later developed an NAION in the left eye followed in 1 month by second NAION episode in the left eye. Every episode of NAION was accompanied by intradialytic hypotension (drop in systolic blood pressure of over 20  mmHg) where visual loss was noticed at the end of the dialysis session. Clinicians should be aware of association between NAION and hemodialysis and that patients with dialysis-induced hypotension are at particularly increased risk of having NAION. Patients who had dialysis-associated NA...
Source: CEN Case Reports - November 21, 2018 Category: Urology & Nephrology Source Type: research

Adrenal crisis presented as acute onset of hypercalcemia and hyponatremia triggered by acute pyelonephritis in a patient with partial hypopituitarism and pre-dialysis chronic kidney disease
AbstractA 57-year-old woman with pre-dialysis chronic kidney disease (CKD) was hospitalized because of fever and fatigue. On admission, increased inflammatory response and pyuria with bacteriuria were observed. Pyelonephritis was successfully treated with antibiotics, whereas her fatigue continued and she developed progressive hypercalcemia and hyponatremia; serum sodium level, 116  mEq/L and corrected serum calcium level, 13.4 mg/dL. Plasma concentrations of adrenocorticotropic hormone and cortisol and serum luteinizing hormone were under the detection level. Although the reaction of other anterior pituitary hor...
Source: CEN Case Reports - November 19, 2018 Category: Urology & Nephrology Source Type: research

Calcific olecranon bursitis in end-stage renal disease
(Source: CEN Case Reports)
Source: CEN Case Reports - November 12, 2018 Category: Urology & Nephrology Source Type: research

A family case of X-linked Alport syndrome patients with a novel variant in COL4A5
AbstractWe herein report 2 Japanese patients with X-linked Alport syndrome (XLAS), with a novel variant inCOL4A5. Patient 1 was a 16-year-old Japanese girl with a history of microscopic hematuria, without proteinuria, renal dysfunction, deafness, or ocular abnormalities. At 13  years of age, renal biopsy was performed; however, a diagnosis of AS was not considered. When her mother (patient 2) was 40 years of age (3 years after patient 1 underwent a renal biopsy), patient 2 was found to have asymptomatic hematuria, proteinuria, and an increased serum creatinine level, w ithout deafness and ocular abnormalitie...
Source: CEN Case Reports - October 6, 2018 Category: Urology & Nephrology Source Type: research

List of referees
(Source: CEN Case Reports)
Source: CEN Case Reports - October 5, 2018 Category: Urology & Nephrology Source Type: research

Ascorbic acid-induced oxalate nephropathy: a case report and discussion of pathologic mechanisms
We present a patient whose intake of vitamin C supplements (2  g/day), exacerbated by predisposing factors of prior small bowel obstruction and resection, and benign prostate hyperplasia (BPH), resulted in acute kidney injury due to oxalate nephropathy. We review past reports of vitamin C-induced oxalate nephropathy and discuss the underlying precipitating f actors. (Source: CEN Case Reports)
Source: CEN Case Reports - October 1, 2018 Category: Urology & Nephrology Source Type: research

Immunoglobulin A nephropathy secondary to Wilson ’s disease: a case report and literature review
AbstractImmunoglobulin A nephropathy is the most common primary glomerulonephritis worldwide, and it can be associated with liver disease. However, cases of Immunoglobulin A nephropathy secondary to Wilson ’s disease are very rare. A 20-year-old Japanese man presented with microscopic hematuria, proteinuria, and renal dysfunction. A renal biopsy showed mesangial cell proliferation, immunoglobulin A deposition, and electron-dense deposit in the mesangial areas, all of which are consistent with Immuno globulin A nephropathy. Computed tomography of the abdomen showed liver atrophy and splenomegaly, and the diagnosis of ...
Source: CEN Case Reports - September 25, 2018 Category: Urology & Nephrology Source Type: research

Crohn ’s disease following rituximab treatment in a patient with refractory nephrotic syndrome
AbstractRituximab (RTX) is increasingly used for the treatment of refractory nephrotic syndrome due to its inhibitory effect on B cells which extends the period of remission, while lowering the dose of steroids needed for disease management. However, RTX can lead to various side effects, including Crohn ’s disease. Herein, we describe a case of a 15-year-old boy with refractory nephrotic syndrome diagnosed at age 9 years who developed Crohn’s disease following RTX treatment. RTX was initiated in this patient at the age of 13 years 6 months due to occurrence of 12 relapses of nephrotic syndro me o...
Source: CEN Case Reports - September 24, 2018 Category: Urology & Nephrology Source Type: research

An autopsy case of TAFRO syndrome with membranoproliferative glomerulonephritis-like lesions
AbstractTAFRO syndrome (thrombocytopenia, anasarca, myelofibrosis, renal dysfunction, and organomegaly) is an atypical manifestation of multicentric Castleman ’s disease. Although overproduction of interleukin-6, vascular endothelial growth factor, and other cytokines may partially explain the pathophysiology of this rare syndrome, the precise mechanisms underlying the renal dysfunction associated with the condition remain unclear. Here, we describe a c ase of a 69-year-old male with TAFRO syndrome. He was treated with immunosuppressive agents and his renal function improved. Tapering of immunosuppressive agents resu...
Source: CEN Case Reports - September 22, 2018 Category: Urology & Nephrology Source Type: research

Page kidney as a complication after a shock wave lithotripsy: a case report
(Source: CEN Case Reports)
Source: CEN Case Reports - August 29, 2018 Category: Urology & Nephrology Source Type: research

Exome sequencing identifies a novel frameshift variant causing hypomagnesemia with secondary hypocalcemia
This study identified causal mutations in a 2-month-old male patient of hypomagnesemia from a consanguineous marriage. Biochemical analyses indicated the diagnosis of HSH due to primary gastrointestinal loss of magnesium. Whole exome sequencing of the trio (i.e. proband and both parents) was carried out with mean coverage of>  150×. ANNOVAR was used to annotate functional consequences of genetic variation from exome sequencing data. After variant filtering and annotation, a number of single nucleotide variants (SNVs) and 2 bp deletion at exon26:c.4402_4403delCT inTRPM6 gene were identified. This deleti...
Source: CEN Case Reports - August 24, 2018 Category: Urology & Nephrology Source Type: research

NDM-1-producing Enterobacter aerogenes isolated from a patient with a JJ ureteric stent in situ
AbstractUrinary tract infections after JJ stent insertion are among the most common complications, and the associated microorganisms carry more antibiotic resistance determinants than those found in urine prior to stent insertion. In line with the trends in healthcare epidemiology which implicate multi-resistant microorganisms in a plethora of healthcare-associated infections, prosthetic stent material also represents an ideal milieu for biofilm formation and subsequent infection development with resistant bacterial agents. Here we describe a case of a 73-year-old Caucasian woman presenting with urinary tract infection aft...
Source: CEN Case Reports - August 23, 2018 Category: Urology & Nephrology Source Type: research

Severe hypermagnesemia induced by magnesium oxide ingestion: a case series
In this report, we present the cases of four elderly patients with constipation and symptomatic hypermagnesemia caused by MgO ingestion, one of which had a lethal course. All of the patients were older than 65  years and with renal dysfunction. In addition, they had difficulties in expressing their symptoms because of cerebrovascular events or dementia. These cases suggest that hypermagnesemia caused by magnesium-containing cathartics is more likely to develop than previously recognized and that physicia ns should be aware that patients with chronic kidney disease and the elderly are at risk of hypermagnesemia on magn...
Source: CEN Case Reports - August 22, 2018 Category: Urology & Nephrology Source Type: research