Switching from lipoprotein apheresis to evolocumab in FH siblings on hemodialysis: case reports and discussion
AbstractFamilial hypercholesterolemia (FH) and chronic kidney disease, especially end-stage renal disease (ESRD), are common and put patients at a high risk of developing atherosclerotic cardiovascular disease (ASCVD). ESRD concomitant with FH may further increase the risk of ASCVD. Achieving target levels of low-density lipoprotein cholesterol (LDL-C) is difficult owing to the limitations of statin administration due to its side effects in ESRD. Therefore, some FH patients with ESRD require lipoprotein apheresis for the prevention of secondary ASCVD events. Although proprotein convertase subtilisin kexin 9 (PCSK9) inhibit...
Source: CEN Case Reports - June 7, 2021 Category: Urology & Nephrology Source Type: research

LMX1B-associated nephropathy that showed myelin figures on electron microscopy
We present the case of a male withLMX1B-associated nephropathy (LAN) who showed focal segmental glomerulosclerosis (FSGS) on light microscopy, and myelin figures and slight deposits of collagen fibrils on EM, without findings of glomerular basement membrane abnormality suggestive for NPS. A 21-year-old Japanese –Brazilian man was admitted to hospital for an investigation of the cause of proteinuria and decreased renal function. A renal biopsy was performed to investigate the cause of renal damage. Fabry disease was initially considered, based on the presence of myelin figures on EM, but since he had norm al α-g...
Source: CEN Case Reports - June 2, 2021 Category: Urology & Nephrology Source Type: research

Near-sudden unexpected death in a patient with epilepsy undergoing hemodialysis: a case report
We report a case of a successfully revived hemodialysis patient who developed cardiopulmonary arrest after a witnessed convulsive seizure. Electroencephalogram revealed epileptic abnormalities. Therefore, this case could be seizure-induced cardiopulmonary arrest and near-SUDEP. Hence, the possibility of SUDEP should be considered even in hemodialysis patients having conventional coronary risk factors for sudden cardiac death. (Source: CEN Case Reports)
Source: CEN Case Reports - May 26, 2021 Category: Urology & Nephrology Source Type: research

Nivolumab-associated glomerular endothelial injury in a patient with gastric cancer
AbstractA 68-year-old male with gastric cancer was treated with tegafur/gimeracil/oteracil and oxaliplatin for 6  months. Thereafter, he was treated with paclitaxel and ramucirumab for 3 months. However, neither regimen had much effect. Thus, he was treated with nivolumab for 2 months, but he developed proteinuria, microhematuria, and an acute kidney injury. A kidney biopsy revealed occasional swollen endot helial cells and proliferating mesangial cells. Few abnormal findings were seen in the tubules or interstitial tissue. Immunofluorescent staining showed segmental immunoglobulin A and complement component...
Source: CEN Case Reports - May 25, 2021 Category: Urology & Nephrology Source Type: research

Rosuvastatin and Colchicine combined myotoxicity: lessons to be learnt
AbstractStatins and colchicine co-administration consists of a potentially catastrophic drug –drug interaction since it provokes myotoxicity, myopathy and various degrees of rhabdomyolysis. Lipophilic statins and colchicine are biotransformed in the liver, primarily via CYP3A4 enzyme system leading to elevated blood levels of both agents and resulting in increased potential for combined m yotoxicity. Hence, it would be of great clinical importance not only the awareness of this devastating complication but also the more advantageous type of statin that we should choose to achieve the recommended therapeutic goals reg...
Source: CEN Case Reports - May 24, 2021 Category: Urology & Nephrology Source Type: research

Development of osmotic vacuolization of proximal tubular epithelial cells following treatment with sodium-glucose transport protein 2 inhibitors in type II diabetes mellitus patients-3 case reports
In conclusion, in type II diabetes mellitus (T2DM), individuals that remain within their standard weight range, SGLT2 inhibitor treatment does not result in osmotic vacuolization of proximal tubular epithelial cells and AKI. However, treatment with a SGLT2 inhibitor may cause damage of the proximal tu bules resulting in AKI in T2DM individuals who do not remain within their standard weight range, due to an overdose lavage of sugar in the urine and dehydration. (Source: CEN Case Reports)
Source: CEN Case Reports - May 22, 2021 Category: Urology & Nephrology Source Type: research

Radiopacity of sodium zirconium cyclosilicate on CT imaging
AbstractA patient who post-operatively develops hyperkalemia is treated with sodium zirconium cyclosilicate (Lokelma®), a novel agent used for the treatment of non-life-threatening hyperkalemia with reduced side effects as compared with its predecessors. On CT imaging of the chest, abdomen, and pelvis, a radiopaque fluid is noticed despite the patient not having received any oral or intravenous contrast nor any medications or supplements that may appear radiopaque. Based on previous CT imaging of zirconium-based tooth implants and their radiopaque appearance on images, it is hypothesized that the sodium zirconium cyclo...
Source: CEN Case Reports - May 19, 2021 Category: Urology & Nephrology Source Type: research

Authors ’ reply to “m.3243A & gt;G carriers develop syndromic or non-syndromic multisystem phenotypes over time ”
(Source: CEN Case Reports)
Source: CEN Case Reports - May 6, 2021 Category: Urology & Nephrology Source Type: research

Fatal hemoperitoneum due to rupture of mesenteric artery in remission state of microscopic polyangiitis, concomitant with severe hypertension and posterior reversible encephalopathy syndrome: an autopsy case report
AbstractMicroscopic polyangiitis (MPA) is a type of necrotizing vasculitis associated with high levels of myeloperoxidase-specific antineutrophil cytoplasmic antibody (MPO-ANCA). While generally associated with renal dysfunction, MPA can also cause intraabdominal hemorrhage in rare cases. A 66-year-old man was admitted to our hospital for renal dysfunction, numbness, and weight loss for 3  months. He had no significant medical history. Renal biopsy revealed crescentic glomerulonephritis with necrotizing vasculitis, which was associated with a high serum titer of MPO-ANCA, leading to a diagnosis of MPA. Remission-induc...
Source: CEN Case Reports - May 4, 2021 Category: Urology & Nephrology Source Type: research

A case of 17q12 deletion syndrome that presented antenatally with markedly enlarged kidneys and clinically mimicked autosomal recessive polycystic kidney disease
AbstractThe gene encoding hepatocyte nuclear factor 1 β (HNF1B), a transcription factor involved in the development of the kidney and other organs, is located on chromosome 17q12. Heterozygous deletions of chromosome 17q12, which involve 15 genes includingHNF1B, are known as 17q12 deletion syndrome and are a common cause of congenital anomalies of the kidneys and urinary tract (CAKUT) and may also present as a multisystem disorder. Autosomal recessive polycystic kidney disease (ARPKD), on the other hand, is a severe form of polycystic kidney disease caused by mutations inPKHD1 (polycystic kidney and hepatic disease 1)...
Source: CEN Case Reports - May 3, 2021 Category: Urology & Nephrology Source Type: research

Continuous extracorporeal treatments in a dialysis patient with COVID-19
AbstractThe coronavirus disease 2019 (COVID-19) pandemic is now a major global health threat. More than half a year have passed since the first discovery of severe acute respiratory syndrome coronavirus-2 (SARS-CoV2), no effective treatment has been established especially in intensive care unit. Inflammatory cytokine storm caused by SARS-CoV-2 infection has been reported to play a central role in COVID-19; therefore, treatments for suppressing cytokines, including extracorporeal treatments, are considered to be beneficial. However, until today the efficacy of removing cytokines by extracorporeal treatments in patients with...
Source: CEN Case Reports - April 3, 2021 Category: Urology & Nephrology Source Type: research

Chronic kidney disease caused by maternally inherited diabetes and deafness: a case report
AbstractMaternally inherited diabetes and deafness (MIDD) is a mitochondrial genetic disorder with variable clinical presentations, which can delay its diagnosis. Herein, we report the case of a 57-year-old Japanese man with MIDD who developed chronic kidney disease. He developed proteinuria long before his diabetes and deafness; at the age of 36  years, a renal biopsy showed minor glomerular abnormality and electron microscopy showed mild mitochondrial degeneration in the distal tubular epithelial cells. Twenty years later, a second renal biopsy showed nephrosclerosis with interstitial fibrosis and arteriolar hyaline...
Source: CEN Case Reports - April 3, 2021 Category: Urology & Nephrology Source Type: research

Collapsing glomerulopathy in a patient with mixed connective tissue disease
We report a case of a 53-year-old female who presented to us w ith acute kidney injury and proteinuria. The patient underwent renal biopsy for further evaluation of her proteinuria, and was diagnosed to have collapsing glomerulopathy. The patient was subsequently diagnosed with MCTD, given her constellation of symptoms and serology titers. The patient was start ed on prednisone with subsequent stabilization of renal function and reduction of proteinuria and continues to be in remission. We report our case to highlight the association between collapsing glomerulopathy and MCTD and the potential role of steroids as first-lin...
Source: CEN Case Reports - April 3, 2021 Category: Urology & Nephrology Source Type: research

A patient with congenital nephrogenic diabetes insipidus due to AVPR2 mutation complicated by persisting polydipsia under hemodialysis treatment
AbstractA 17-year-old boy was referred to our institution for a re-evaluation of congenital nephrogenic diabetes insipidus. A water restriction test revealed no urine concentration or volume reduction and a subsequent pitressin test revealed a lack of an anti-diuretic response. Nephrogenic diabetes insipidus was confirmed, and the patient was treated using trichlormethiazide 4  mg, indomethacin 175 mg, and desmopressin 20 μg. His blood pressure and weight were not controlled owing to polydipsia and polyuria secondary to acquired excessive water drinking behavior. Repeated admissions for weight control wer...
Source: CEN Case Reports - April 3, 2021 Category: Urology & Nephrology Source Type: research

Sarcomatoid renal cell carcinoma with autosomal dominant polycystic kidney disease: a case report and literature review
AbstractDiagnosis of renal cell carcinoma (RCC) in patients with autosomal dominant polycystic kidney disease (ADPKD) is challenging and often delayed due to accompanying multiple renal cysts. Sometimes, it is difficult to distinguish RCC from cyst infection or hemorrhage. We herein present the case of a patient with ADPKD undergoing long-term hemodialysis whose sarcomatoid RCC was difficult to diagnose and was confirmed via nephrectomy. A 53-year-old male, undergoing hemodialysis since 20  years for end-stage renal disease secondary to ADPKD, was admitted to our hospital with a 3-week history of fever at > ...
Source: CEN Case Reports - April 3, 2021 Category: Urology & Nephrology Source Type: research

Diffuse large B cell lymphoma presenting with renal failure and bone lesions in a 46-year-old woman: a case report and review of literature
We describe a 46-year-old woman presenting with a renal failure and a 5-month history of intermittent left knee pain that was previously misdiagnosed with osteoarthritis. It was due to a bilateral primary renal lymphoma (PRL) associated with bone metastasis. Knee MRI showed a permeative lesion and an abnormal signal in the metaphysis and diaphysis of the left proximal tibia with periosteal reaction and surrounding soft tissue swelling. The CT body scan showed a bilateral nephromegaly and multiple lytic bone lesion of aggressive appearance at the right iliac wing and right sacral ala evoking lymphomatous involvement. Node b...
Source: CEN Case Reports - April 3, 2021 Category: Urology & Nephrology Source Type: research

A case of light chain (AL) amyloidosis with heart failure, renal dysfunction, and heparin-induced thrombocytopenia successfully treated with peritoneal dialysis
AbstractA 65-year-old woman was hospitalized for heart failure and pneumonia in a nearby hospital. She had been previously diagnosed as light chain (AL) amyloidosis and treated with melphalan plus dexamethasone (Mel-Dex), and lenalidomide plus dexamethasone (Len-Dex). She started treatment including antimicrobials and diuretics, but her renal function worsened progressively, and she was transferred to our hospital for nephrological care. She was treated with antimicrobials, noradrenaline, dobutamine, and continuous hemodiafiltration. Her general condition gradually stabilized, and she was switched to intermittent hemodialy...
Source: CEN Case Reports - April 3, 2021 Category: Urology & Nephrology Source Type: research

A woman with a dual genetic diagnosis of autosomal dominant tubulointerstitial kidney disease and KBG syndrome
We present a female patient with a dual genetic diagnosis of autosomal dominant tubulointerstitial kidney disease and KBG syndrome. The proband was an 18-year-old woman presenting with intellectual disability, renal insufficiency, and hyperuricemia. Abdominal ultrasonography did not reveal any abnormalities. The patient ’s father had been diagnosed with chronic kidney disease and hyperuricemia in his twenties; however, he had no intellectual disability. Her mother and two younger siblings were not affected. Next generation sequencing (NGS) identified mutations inUMOD (c.796T  >  C) of the proband and her...
Source: CEN Case Reports - April 3, 2021 Category: Urology & Nephrology Source Type: research

Extensive bilateral renal metastases of non-small cell lung carcinoma caused acute kidney injury resulting in end-stage renal disease
We report a case with these two rarities. A 54-year-old man who had a 6.7  × 6.0 cm-sized tumor in the left upper lobe of the lung in computed tomography was diagnosed as squamous cell lung carcinoma with bronchoscopy with biopsy. His renal function was normal and no proteinuria or hematuria was recognized. He underwent left upper lobectomy and the pathologic examin ation revealed pT4N1M0 stage IIIA disease. Four months after the surgery, a single brain metastasis in the right frontal lobe found in brain magnetic resonance imaging was treated with Gamma Knife radiosurgery. He presented with macrosc...
Source: CEN Case Reports - April 3, 2021 Category: Urology & Nephrology Source Type: research

COVID-19 progression in kidney transplant recipients: a single-center case series
AbstractThe novel coronavirus disease 2019 (COVID-19) is a respiratory infection that has received much attention due to its rapid expansion. Currently, it has been revealed that patients with underlying disease, especially those with kidney disease are more prone to develop complications. Some studies associate kidney transplantation as a risk factor for COVID-19 progression; however, epidemiologic data that demonstrate this are amazingly rare. Considering the importance of the topic, we report on six kidney transplant recipients (median age 47 [41 –55]) with confirmed or clinically suspected COVID-19. The most comm...
Source: CEN Case Reports - March 26, 2021 Category: Urology & Nephrology Source Type: research

A man with immunoglobulin A nephropathy complicated by infection-related glomerulonephritis with glomerular depositions of nephritis-associated plasmin receptor
AbstractA 27-year-old man who developed heavy proteinuria with hematuria and acute kidney injury 2  weeks after a fever was referred to our hospital. Because he had low complements without autoantibodies, we clinically diagnosed him with infection-related glomerulonephritis. The proliferation of mesangial cells and endothelial cells with glomerular deposits of immunoglobulin A and complement 3 w as found. Deposition of glomerular nephritis-associated plasmin receptor, a marker of infection-related glomerulonephritis, was also found. In addition, the distribution of nephritis-associated plasmin receptor deposition almo...
Source: CEN Case Reports - March 23, 2021 Category: Urology & Nephrology Source Type: research

Correction to: Combined light chain crystalline tubulopathy, podocytopathy, and histiocytosis associated with Bence –Jones κ protein diagnosed via immuno-electron microscopy
A correction to this paper has been published: https://doi.org/10.1007/s13730-021-00596-9 (Source: CEN Case Reports)
Source: CEN Case Reports - March 19, 2021 Category: Urology & Nephrology Source Type: research

m.3243A & gt;G carriers develop syndromic or non-syndromic multisystem phenotypes over time
(Source: CEN Case Reports)
Source: CEN Case Reports - March 18, 2021 Category: Urology & Nephrology Source Type: research

Simultaneous catheter removal and reinsertion, is it acceptable in M. abscessus exit site infection?
We report anM.abscessus ESI in a PD patient who underwent SCRR in conjunction with targeted antimicrobial therapy, and developedM. abscessus peritonitis requiring PD catheter removal and conversion to hemodialysis. The patient also developed ESI at the new exit site long after the PD catheter was removed, requiring prolonged antimicrobial therapy. Our case, taken together with available published case reports, highlights the futility of the SCRR approach towards theM. abscessus ESI and makes the cases for early PD catheter removal in these patients. (Source: CEN Case Reports)
Source: CEN Case Reports - March 16, 2021 Category: Urology & Nephrology Source Type: research

A case of hypertensive disorders of pregnancy that developed at 9  weeks of gestation
We report a case of a 35-year-old Japanese woman who developed hypertensive disorders of pregnancy (HDP) before 20 weeks of gestation. She presented with hypertension and proteinuria at 9 and 11 weeks of gestation, respectively, and developed nephrotic syndrome at 17 weeks o f gestation. She did not have definite hypertension or urinary abnormalities before pregnancy. The patient was serologically positive for the antinuclear antibody. However, the complement levels were normal and anti-phospholipid antibody was not detected. A renal biopsy performed at 18 weeks of ges tation showed diffuse endotheliosi...
Source: CEN Case Reports - March 15, 2021 Category: Urology & Nephrology Source Type: research

Refractory hypophosphatemia following ferric carboxymaltose administration
In conclusion, clinicians should be aware of iron-induced hypophosphatemia and be cautious when pr escribing intravenous iron. (Source: CEN Case Reports)
Source: CEN Case Reports - March 14, 2021 Category: Urology & Nephrology Source Type: research

Bilateral kidney metastases from adenoid cystic carcinoma of lung: a case report and literature review
We present a case of a 58  years old woman with bilateral renal metastasis from ACC of the right lung after fourteen years from lobectomy and radiotherapy for the primary presentation. The patient underwent bilateral robot-assisted partial nephrectomy in a two-stage approach. Despite its rare incidence and slow growth, ACC metastasis may simulate primary papillary renal carcinoma and occur many years after primary treatment. Therefore, lifelong follow-up, including abdominal imaging, is recommended. (Source: CEN Case Reports)
Source: CEN Case Reports - March 8, 2021 Category: Urology & Nephrology Source Type: research

Rapidly progressive IgA vasculitis-associated nephritis successfully treated with immunosuppressive therapy in an adolescent with chronic granulomatous disease
AbstractChronic granulomatous disease (CGD) is a rare immunodeficiency disorder with genetic defects in the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase complex in phagocytes, leading to recurrent severe infections and granuloma formation. Genitourinary involvement, including obstructive granulomas, infections, nephrotoxicity of anti-infective agents, and amyloidosis, is frequently observed in patients with CGD, whereas the clinical and pathological details of the less commonly reported glomerular disease remain obscure. Here, we report the case of a patient with CGD who developed rapidly progressive IgA vas...
Source: CEN Case Reports - March 8, 2021 Category: Urology & Nephrology Source Type: research

Combined light chain crystalline tubulopathy, podocytopathy, and histiocytosis associated with Bence –Jones κ protein diagnosed via immuno-electron microscopy
AbstractWe herein report a case of a combined crystalline light chain tubulopathy, podocytopathy, histiocytosis, and cast nephropathy in a patient with monoclonal gammopathy of renal significance (MGRS). A 66-year-old female with impaired renal function was referred to our department. Despite intravenous fluid resuscitation, the kidney function worsened progressively; thus, a kidney biopsy was performed. The kidney biopsy revealed light chain proximal tubulopathy (LCPT) with crystals, light chain crystal podocytopathy (LCCP), crystal-storing histiocytosis (CSH), and light chain cast nephropathy (LCCN). Of note, LCCP and CS...
Source: CEN Case Reports - March 5, 2021 Category: Urology & Nephrology Source Type: research

Polyvisceral polycystic disease: a case study and review
AbstractPolycystic kidney disease (PKD) occurs in one per 20,000 births. Presence of cysts in other organs like adrenal, liver and bladder is even rarer. On reviewing the literature, there is evidence of PKD occurring in conjunction with polycystic liver disease but cysts in multiple viscera are, so far, not reported. A fetal autopsy of a 36-week fetus showed the presence of multiple cysts in the kidney, liver, adrenal and bladder. Further histopathology reports confirmed the diagnosis of polycystic kidney disease. The history of a previous intrauterine death, of another child at 28-week gestation, suggests the presence of...
Source: CEN Case Reports - March 4, 2021 Category: Urology & Nephrology Source Type: research

Complete remission of DnaJ homolog subfamily B member 9-positive fibrillary glomerulonephritis following steroid monotherapy in an elderly Japanese woman
AbstractA 74-year-old Japanese woman was referred to our department because of anasarca and massive proteinuria. She was clinically diagnosed with nephrotic syndrome, and renal biopsy showed membranoproliferative glomerulonephritis accompanied by marked glomerular infiltration with macrophages and full-house immunofluorescence glomerular deposition. Furthermore, randomly arranged nonbranching fibrils, approximately 12  nm in diameter, were found by electron microscopy, and immunostaining for DnaJ homolog subfamily B member 9 (DNAJB9), a recently identified diagnostic biomarker of fibrillary glomerulonephritis (FGN), s...
Source: CEN Case Reports - March 3, 2021 Category: Urology & Nephrology Source Type: research

Selective immunoglobulin M deficiency complicated by systemic lupus erythematosus and antiphospholipid syndrome: a case report and review of literature
In conclusion, SIgMD can be complicated by autoimmune disorders. Although rare, we recommend that SLE and APS be considered in patients with SIgMD w ho present with hematuria, proteinuria, and deep vein thrombosis. We also recommend measuring the titers of antinuclear antibodies, double-stranded DNA antibodies, and anti-CLβ2GP1 antibodies. (Source: CEN Case Reports)
Source: CEN Case Reports - February 22, 2021 Category: Urology & Nephrology Source Type: research

Familial juvenile hyperuricemia in early childhood in a boy with a novel gene mutation
AbstractFamilial juvenile hyperuricemic nephropathy (FJHN) is a rare autosomal dominant disease caused by mutations in the uromodulin (UMOD) gene. It is characterized by the development of gout, tubulointerstitial nephropathy, and end-stage renal disease. Here we report a case of FJHN that was diagnosed in early childhood in a boy with a novel gene mutation. At the age of 4  years, the patient was admitted with a diagnosis of purpura nephritis. He was discharged following symptom alleviation. However, hyperuricemia (7–9 mg/dL) and mild renal dysfunction [creatinine-estimated glomerular filtration rate (eGFR...
Source: CEN Case Reports - February 22, 2021 Category: Urology & Nephrology Source Type: research

Nephrotic syndrome relapse in a boy with COVID-19
We describe the clinical course of a child with NS and COVID-19. A 3-year-old boy was admitted with clinical and laboratory findings indicative of NS. Induction therapy with prednisolone (2  mg/kg/day) induced complete remission. While tapering the dose, he was infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). He developed a high fever and periorbital edema. Urinalysis revealed proteinuria (protein-creatinine ratio: 6.3 g/gCr). He was transferred to our hosp ital for the concurrent management of COVID-19 and NS relapse. As proteinuria worsened, the prednisolone dose was increased to 2&nb...
Source: CEN Case Reports - February 22, 2021 Category: Urology & Nephrology Source Type: research

The role of short-term, low dose intravenous ketamine infusion in Calciphylaxis
AbstractCalciphylaxis is a small vessel vasculopathy causing subcutaneous ischemic necrosis. This condition is a recognized complication of end stage renal disease and is associated with severe pain. The mechanism of the pain generated by calciphylaxis is thought to be partly related to tissue ischemia, with a significant neuropathic component associated with neuronal hypoxic injury. The pain can be further exacerbated by the inflammatory process ensuing as a result of calciphylactic lesion infections which are commonly associated with this condition. Obtaining adequate pain relief is a challenging aspect of symptom contro...
Source: CEN Case Reports - February 19, 2021 Category: Urology & Nephrology Source Type: research

Antiphospholipid antibody syndrome-associated renal thrombotic microangiopathy improved not with rivaroxaban but with warfarin in a systemic lupus erythematosus patient without lupus nephritis
AbstractA 34-year-old Japanese woman with systemic lupus erythematosus (SLE) was admitted to our hospital for exacerbation of renal dysfunction, hemolytic anemia and thrombocytopenia. Twenty-two years before admission, she was diagnosed with SLE. Eight years before, lupus anticoagulant (LAC) positivity was detected without any thrombotic findings. Fourteen months before, renal function started to worsen. Three months before, unprovoked left leg swelling appeared. She was diagnosed with deep vein thrombosis (DVT) by ultrasonography. Blood examination revealed mild anemia, thrombocytopenia, and renal dysfunction. Rivaroxaban...
Source: CEN Case Reports - February 17, 2021 Category: Urology & Nephrology Source Type: research

An elderly-onset neuroblastoma concomitant with minimal change nephrotic syndrome: the first autopsy case report
ConclusionsMinimal change nephrotic syndrome is the most common renal manifestation associated with lymphoproliferative malignancies. We here present an extremely rare case of adult-onset neuroblastoma with minimal change nephrotic syndrome. (Source: CEN Case Reports)
Source: CEN Case Reports - February 17, 2021 Category: Urology & Nephrology Source Type: research

A case of Stappia indica -induced relapsing peritonitis confirmed by 16S ribosomal RNA gene sequencing analysis in a patient undergoing continuous ambulatory peritoneal dialysis
AbstractA 69-year-old woman with 26-year history of systemic lupus erythematosus and 4-year history of peritoneal dialysis was hospitalized for treatment of bacterial peritonitis. On admission, peritoneal dialysate was collected and subjected to bacterial culture. Cell count in the cloudy peritoneal dialysate was 4194/ μL, and Gram-negative bacilli were detected. Vancomycin (1 g/day) and ceftazidime (1 g/day) were administered intraperitoneally, which resulted in rapid decrease in cell count in the peritoneal dialysate. However, on the 7th hospital day, peritonitis relapsed with abdominal pain and cloudy dialy...
Source: CEN Case Reports - February 15, 2021 Category: Urology & Nephrology Source Type: research

Predominant tubulointerstitial lupus nephritis with preceding pernicious anemia
AbstractPredominant tubulointerstitial nephritis with negligible glomerular lesions is a rare form of lupus nephritis. Although tubulointerstitial changes occur in two-thirds of patients with lupus nephritis, these lesions were mostly accompanied by glomerulonephritis. Predominant tubulointerstitial lupus nephritis has been reported to be only 13 cases in the literature as far as we surveyed. Here, we present a case of a 72-year-old male who had pancytopenia associated with pernicious anemia and later developed a mild proteinuria and renal insufficiency. Although urinary tubulointerstitial markers increased, serological sc...
Source: CEN Case Reports - February 6, 2021 Category: Urology & Nephrology Source Type: research

A case of recurrent anemia due to chronic parvovirus B19 infection in a kidney transplant recipient. Can everolimus make a difference?
We report a case of a kidney transplant recipient with relapsing pure red cell aplasia due to PB19 infection. Our patient was initially managed with standard treatment consisting of intravenous immunoglobulins and minimization of immunosuppressive treatment. However, when this approach became ineffective, conversion from tacrolimus to everolimus was done, with favorable results. This paper explores infection by PB19 in kidney transplant recipients and the potential benefits of a calcineurin inhibitor-free immunosuppression and the antiviral properties of mTOR inhibitors. (Source: CEN Case Reports)
Source: CEN Case Reports - February 4, 2021 Category: Urology & Nephrology Source Type: research

Renal intravascular large B-cell lymphoma predominantly localized in peritubular capillaries
We report on a 70-year-old woman with intravascular large B-cell lymphoma, in whom the renal lesion was localized in the peritubular capillaries. The patient complained of fatigue, general malaise, and unsteadiness when walking. Laboratory tests showed anemia, increased C-reactive protein, and mild renal failure, with a serum creatinine level of 1.31  mg/dL and no remarkable proteinuria or hematuria. Renal biopsy showed intravascular large B-cell lymphoma. The large atypical cells were mainly accumulated within the peritubular capillaries and no large atypical cells were found in the glomeruli. Skin and bone marrow bi...
Source: CEN Case Reports - February 3, 2021 Category: Urology & Nephrology Source Type: research

Two cases of idiopathic multicentric Castleman disease with nephrotic syndrome treated with tocilizumab
We report two cases of idiopathic multicentric Castleman disease (iMCD) with nephrotic syndrome (NS) treated with tocilizumab. Case 1 was a 58-year-old man diagnosed with iMCD prior to the onset of NS. Renal biopsy revealed membranous nephropathy, which was considered to be secondary membranous nephropathy associated with iMCD. Case 2 was a 49-year-old woman diagnosed with iMCD prior to NS. Renal biopsy revealed renal amyloidosis positive for Congo red staining and amyloid A protein immunostaining. In both the cases, the proteinuria improved after the initiation of glucocorticoid and tocilizumab therapy. Tocilizumab may be...
Source: CEN Case Reports - January 24, 2021 Category: Urology & Nephrology Source Type: research

Bevacizumab-associated glomerular microangiopathy that occurred after postoperative chemotherapy for ovarian cancer
We present a case of a 68-year-old woman who was administered postoperative chemotherapy (carboplatin, paclitaxel, and bevacizumab) for stage IV ovarian cancer. Proteinuria and hypertension appeared after three courses; however, six courses were completed. Then, gemcitabine and carboplatin were administered for recurrence of her cancer. She was diagnosed with nephrotic syndrome after eight courses. Renal biopsy showed accumulation of periodic acid-Schiff (P AS)-positive substances in the capillary walls and para-mesangial areas. Double contouring of basement membranes was also observed. Immunofluorescence microscopy reveal...
Source: CEN Case Reports - January 24, 2021 Category: Urology & Nephrology Source Type: research

Difficulty in managing nephrotic syndrome-associated cerebral venous thrombosis
AbstractThromboembolism is one of the most serious complications of nephrotic syndrome (NS). Although the occurrence of renal vein thrombosis or deep vein thrombosis is well recognized in NS patients, they rarely develop cerebral venous thrombosis (CVT). The mortality rate of CVT patients is still approximately 10%, and 6 –10% of patients who survive have a severe and permanent disability. Herein, we report the case of a 26-year-old woman with multiple thrombotic risk factors, including the presence of NS, use of oral contraceptives, smoking, and alcohol consumption who developed wide-range CVT. Undetermined fracti o...
Source: CEN Case Reports - January 24, 2021 Category: Urology & Nephrology Source Type: research

Hypercalcemia caused by comorbid parathyroid adenoma and pulmonary tuberculosis
We report a valuable case in which the early diagnosis and treatment of tuberculosis and primary hyperparathyroidism prevented the spread of tuberculosis. (Source: CEN Case Reports)
Source: CEN Case Reports - January 24, 2021 Category: Urology & Nephrology Source Type: research

Mycobacterium abscessus exit-site infection in peritoneal dialysis patients: should we ever aim to salvage the catheter?
We report an unusual case in which an asymptomatic end-stage renal disease patient with multiple favorable clinical characteristics, i.e., no apparent immunodeficiency, sensitivity pattern showing possibility of treatment with multiple antibiotics, no evidence of peritonitis, and early clinical response, was treated with a 9-month combination antimicrobial regimen administered orally and intraperitoneally. Despite excellent clinical response with a resolution of the ESI, our patient relapsed quickly, within 30  days of stopping antimicrobial therapy and required PD catheter removal. Our case, taken together with avail...
Source: CEN Case Reports - January 24, 2021 Category: Urology & Nephrology Source Type: research

A case of latent heterozygous Fabry disease in a female living kidney donor candidate
AbstractA 52-year-old woman had been found to have hematuria at her annual checkup 5  years in a row. She hoped to donate her kidney to her husband, so we performed a percutaneous kidney biopsy at our department. It was difficult for us to detect apparent abnormalities under a light microscopic examination, and she was determined to meet the eligibility criteria for living kidney t ransplantation. However, the sample for electron microscopy was not evaluated before kidney donation. She subsequently underwent living kidney transplantation as a donor. A 1-h biopsy revealed swelling and obvious vacuolation of the glomeru...
Source: CEN Case Reports - January 24, 2021 Category: Urology & Nephrology Source Type: research

Successful treatment of two Japanese ESRD cases with severe COVID-19 pneumonia
We report here two Japanese ESRD patients confirmed with severe COVID-19 pneumonia. Case 1 was a 60-year-old man with ESRD due to diabetic nephropathy who were infected with COVID-19 and exhibited acute respiratory distress syndrome (ARDS) requiring mechanical ventilation and intensive care unit (ICU) admission. He was treated with tocilizumab and intravenous immunoglobulin (IVIG). After 6  days of treatment in ICU, he was extubated. Case 2 was a 68-year-old woman undergoing maintenance hemodialysis for 17 years who also exhibited ARDS due to COVID-19. Her clinical course resembles case 1. Our experience of these...
Source: CEN Case Reports - January 24, 2021 Category: Urology & Nephrology Source Type: research

Ultrasound appearance of the lymphomatous infiltration of the kidney
(Source: CEN Case Reports)
Source: CEN Case Reports - January 24, 2021 Category: Urology & Nephrology Source Type: research

Assessment of venous congestion by Doppler ultrasound: a valuable bedside diagnostic tool for the new-age nephrologist
(Source: CEN Case Reports)
Source: CEN Case Reports - January 24, 2021 Category: Urology & Nephrology Source Type: research