Rapid progression to end-stage renal disease in a child with IgA-dominant infection-related glomerulonephritis associated with parvovirus B19
In this study, we report the case of a previously healthy 5-year-old boy with infection-related glomerulonephritis (IRGN) associated with PVB19 that progressed to end-stage renal disease (ESRD). He presented with macrohematuria, nephrotic-range proteinuria, and progressive renal dysfunction despite treatment with methylprednisolone pulse therapy, plasmapheresis, and intravenous immunoglobulin. The kidney biopsy specimens exhibited endocapillary infiltration and mesangiolysis with cellular crescent formation. Immunofluorescence analysis revealed that IgA was dominantly positive in the glomeruli, with some co-localized with ...
Source: CEN Case Reports - September 19, 2020 Category: Urology & Nephrology Source Type: research

A case with somatic and germline mosaicism in COL4A5 detected by multiplex ligation-dependent probe amplification in X-linked Alport syndrome
AbstractX-linked Alport syndrome (XLAS) is a progressive hereditary kidney disease caused by mutations in theCOL4A5 gene encoding the type IV collagen α5 chain. To date, 11 cases having somatic mosaic variants inCOL4A5 have been reported; however, all of them involved single-nucleotide variations (SNVs). Here, we report a female XLAS patient with somatic mosaicism identified by copy number variation (CNV) inCOL4A5. The case was a 35-year-old female, the mother of the proband, whose only clinical symptom was hematuria. The proband, who was the son of this patient, was diagnosed with XLAS by gene testing, which showed ...
Source: CEN Case Reports - September 19, 2020 Category: Urology & Nephrology Source Type: research

A case of acute renal failure with multiple origins of the renal injury
We report a case of 69-year-old woman. In history, type II diabetes mellitus and arterial hypertension admitted to our hospital for the evaluation of leg pain, asthenia, diarrhea, and malaise. She was in the treatment with metformin and ARB. Laboratory data revealed renal failure: serum creatinine (Scr 16.5  mg/dl, BUN 280 mg/dl) hyperkalemia and severe anemia (Hb 7.8 g/dl). Renal ultrasound displayed preserved kidneys size. An X-ray of backbone showed fracture. She underwent hemodialysis in urgency regimen. After some days, urine output began to improve up to 1200 cc/24 h. we find proteinuria in n...
Source: CEN Case Reports - September 19, 2020 Category: Urology & Nephrology Source Type: research

Efficacy of favipiravir for an end stage renal disease patient on maintenance hemodialysis infected with novel coronavirus disease 2019
ConclusionFavipiravir may be an effective option for the treatment of COVID-19-infected patients with ESRD. (Source: CEN Case Reports)
Source: CEN Case Reports - September 17, 2020 Category: Urology & Nephrology Source Type: research

Successful treatment with assisted automated peritoneal dialysis using 4.25% glucose dialysate for an elderly patient with refractory heart failure
AbstractRefractory heart failure is a major cause of mortality and hospitalization, and peritoneal dialysis (PD) is one of the options for controlling volume overload. Although high glucose dialysate enables a large amount of ultrafiltration, the use of 4.25% glucose dialysate is generally avoided, because high glucose exposure leads to peritoneal damage. Here, we describe a patient who was successfully treated with assisted automated PD using 4.25% glucose dialysate for refractory heart failure. An 84-year-old woman developed heart failure due to severe mitral regurgitation with a low left-ventricular ejection fraction of...
Source: CEN Case Reports - September 15, 2020 Category: Urology & Nephrology Source Type: research

List of referees
(Source: CEN Case Reports)
Source: CEN Case Reports - September 14, 2020 Category: Urology & Nephrology Source Type: research

Cervical cancer of the uterus complicated by renal AA amyloidosis
We present the case of a 66-year-old female patient who manifested systemic amyloid A (AA) amyloidosis in the kidney, digestive tract, and cervix of the uterus, secondary to cervical cancer. She exhibited nephrotic syndrome, intractable diarrhea, and mild fever 3  months after she underwent an extended hysterectomy with postoperative cisplatin-based chemotherapy and whole pelvic irradiation. Further examinations revealed AA amyloidosis of the kidney and colon and cytomegalovirus infection in the colon. AA amyloid deposition was positive in the resected tiss ues of uterine cancer. The patient was diagnosed with systemi...
Source: CEN Case Reports - September 10, 2020 Category: Urology & Nephrology Source Type: research

A classic variant of Fabry disease in a family with the M296I late-onset variant
AbstractFabry disease is an X-linked recessive disease of glycosphingolipid metabolism caused by deficiency or reduced activity of α-galactosidase A. Fabry disease phenotypes are known to consist of a classic variant and a late-onset variant. In patients with Fabry disease, the phenotype is generally considered to be defined (at least partially) by the genotype. However, patients with the classic variant have been encountered in families with mutations that are expected to produce the late-onset variant. Here, we describe a 4-year-old boy with a classic variant of Fabry disease in a family with the M296I late-onset v...
Source: CEN Case Reports - September 9, 2020 Category: Urology & Nephrology Source Type: research

FAT1 biallelic truncating mutation causes a non-syndromic proteinuria in a child
AbstractThe identification of monogenic causes in patients with proteinuria has revealed that the encoded proteins functionally participate in distinct cellular tasks and signaling pathways in the slit diaphragms of the glomerular basement membrane.FAT1 is a member of a small family of vertebrate-cadherin-like genes, which is a crucial component in slit diaphragms and has a vital role in tubular regeneration. Only 5 cases with glomerulonephritis havingFAT1 gene biallelic variants have been reported. However, only one had the biallelic truncating variant, and others had missense variants. Therefore, we need further evidence...
Source: CEN Case Reports - September 9, 2020 Category: Urology & Nephrology Source Type: research

Concurrent minimal change disease and retroperitoneal liposarcoma successfully treated by tumor resection and steroid therapy
AbstractA 54-year-old Japanese woman developed simultaneous abdominal distension and bilateral leg edema. Her medical history and results of periodic medical check-up were unremarkable. Blood tests revealed severe hypoproteinemia and acute kidney injury, and urinalysis revealed 4+ proteinuria and 2+ hematuria. Abdominal computed tomography revealed a large intra-abdominal mass with fat tissue density. She underwent emergency tumor excision, splenectomy, and distal pancreatectomy. However, hypoproteinemia and acute kidney injury worsened. Therefore, she was transferred to the nephrology division for confirmation of diagnosi...
Source: CEN Case Reports - September 9, 2020 Category: Urology & Nephrology Source Type: research

A rare case of emphysematous pyelonephritis caused by Candida parapsilosis and Finegoldia magna complicated by medical care avoidance
We report a rare case of EPN caused by an unfavorable mixed infection of Candida parapsilosis and Finegoldia magna. To our knowledge, this is the first reported case of EPN caused by Finegoldia magna. A 62-year-old male with diabetes mellitus (DM) presented with abdominal pain, shortness of breath, and nausea in which a diagnosis of septic shock was made due to EPN. Our patient first noticed abdominal pain 3 weeks prior to hospital presentation; however, he avoided getting treatment due to a fear of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This patient exhibited deterioration and expired af...
Source: CEN Case Reports - September 9, 2020 Category: Urology & Nephrology Source Type: research

Treatment of renal AA-Amyloidosis associated with human immunodeficiency virus infection: a case report
We present a case of a young adult male who was treated successfully for renal AA-amyloidosis secondary to human immunodeficiency virus (HIV) infection using highly active anti-retroviral therapy (HAART). He presented with lobar pneumonia, acute kidney injury, nephrotic syndrome and newly diagnosed HIV infection and was initiated on HARRT and haemodialysis. Kidney biopsy was consistent with amyloid deposition of the AA-type. His clinical condition improved gradually and after 10  months of therapy, he regained sufficient excretory function to become dialysis independent. Two years later, he remained well, with a recov...
Source: CEN Case Reports - September 5, 2020 Category: Urology & Nephrology Source Type: research

COV İD-19 infection in a membranous nephropathy patient treated with rituximab
AbstractWhile COVID-19 pandemic continues to affect our country and most countries in the world, we have to make some changes both in our social life and our approach to healthcare. We have to struggle with the pandemic on one hand and also try to follow up and treat our patients with chronic diseases in the most appropriate way. In this period, one of our group of patients who are challenging us for follow-up and treatment are those who should start or continue to use immunosuppressive therapy. In order to contribute to the accumulation of knowledge in this area, we wanted to report a patient who was followed up with the ...
Source: CEN Case Reports - September 4, 2020 Category: Urology & Nephrology Source Type: research

Angiectasia of the parietal pleura in a hemodialysis patient with central venous stenosis and bloody pleural effusion: a case report
AbstractPleural effusion in hospitalized patients with long-term hemodialysis (HD) has been frequently reported. The most common causes of unilateral pleural effusions include hypervolemia, parapneumonic, uremic effusion, and malignancy. In contrast, central venous stenosis (CVS) has rarely been shown to result in pleural effusion. CVS is often diagnosed by percutaneous angiography, yet there are no reports of cases where percutaneous angiography missed CVS and instead intrathoracic endoscopy was performed. Herein, we report a case of CVS with angiectasia of the parietal pleura detected on intrathoracic endoscopy. A 62-yea...
Source: CEN Case Reports - September 2, 2020 Category: Urology & Nephrology Source Type: research

Peritoneal dialysis-related peritonitis complicated with nonocclusive mesenteric ischemia
We describe a case of a 70-year-old woman on PD presented with moderate abdominal pain and low blood pressure, which contributed to the early diagnosis of PD-related peritonitis complicated with NOMI. Increased white cell count of 7150/ μL (neutrophil, 84%) in dialysate effluent was diagnostic of PD-related peritonitis, which was later found to be caused byPseudomonas putida. Computed tomography with contrast performed after administering crystalloids revealed hepatic portal venous gas, pneumatosis intestinalis in the ascending colon, and normal enhancement of the bowel wall and mesenteric arteries, which suggested a re...
Source: CEN Case Reports - August 31, 2020 Category: Urology & Nephrology Source Type: research

Correction to: Retransplantation after post transplant lymphoproliferative disorder: overcoming the obstacles!
In the original publication of the article, while submitting the case report. (Source: CEN Case Reports)
Source: CEN Case Reports - August 19, 2020 Category: Urology & Nephrology Source Type: research

Rupture of a heavily calcified aortic arch in a patient with aortitis syndrome, advanced atherosclerosis, and renal ischemia: a dilemma between appropriate blood pressure control and maintenance of renal perfusion
(Source: CEN Case Reports)
Source: CEN Case Reports - August 12, 2020 Category: Urology & Nephrology Source Type: research

Expression of aquaporin-2 in the collecting duct and responses to tolvaptan
AbstractTolvaptan, a vasopressin type-2 receptor antagonist, is indicated for fluid retention. It is considered that the response to tolvaptan reduces as renal function deteriorates, whereas we sometimes experience “non-responders” to tolvaptan despite well-preserved renal function. While the expression of aquaporin-2 might be a key to response to tolvaptan, detailed mechanism of refractoriness to tolvaptan remains unknown. We experienced two patients with congestive heart failure and diabetic nephropathy, in whom the responses to tolvaptan were uniquely opposite. In one case, immunohistochemical staining showe...
Source: CEN Case Reports - August 10, 2020 Category: Urology & Nephrology Source Type: research

A case of intravascular large B-cell lymphoma with renal involvement presenting with elevated serum ANCA titers
We report the first case of intravascular large B-cell lymphoma (IVLBCL) presenting with vasculitis-like symptoms and elevated serum levels of anti-neutrophil cytoplasmic antibody (ANCA) diagnosed by renal biopsy. The patient exhibited low-grade fever, systemic inflammatory reactions, multiple lung lesions, and persistent proteinuria, which were closely correlated with changes in serum titers of proteinase-3- and myeloperoxidase-ANCA. Preemptive therapy with prednisolone alone partially attenuated these symptoms. Renal biopsy did not reveal histopathological findings suggestive of granulomatous or microscopic polyangiitis....
Source: CEN Case Reports - August 9, 2020 Category: Urology & Nephrology Source Type: research

Triamterene in lithium-induced nephrogenic diabetes insipidus: a case report
We describe the case of an 81-year-old woman with bipolar treated with lithium and no previous history of diabetes insipidus. She was hospitalized due to disturbance of consciousness and was diagnosed with, hypercalcemia, hyperparathyroidism, and NDI. Parathyroidectomy was contraindicated and parathyroid hormone level was improved insufficiently after cinacalcet initiation, percutaneous ethanol injection therapy was performed for the enlarged parathyroid gland. After improvement in hypercalcemia and unsuccessful indapamide treatment, triamterene was administrated to control polyuria. Lithium is one of the indispensable mai...
Source: CEN Case Reports - August 9, 2020 Category: Urology & Nephrology Source Type: research

Membranous nephropathy with masked polyclonal IgG deposits associated with primary Sj ögren’s syndrome
AbstractTubulointerstitial nephritis and renal tubular acidosis are well-known renal involvements with primary Sj ögren’s syndrome. However, several types of glomerulonephritis such as membranoproliferative glomerulonephritis and membranous nephropathy are also known to develop in patients with this syndrome. We here report a case of membranous nephropathy that developed 8 years after a diagnosis of primary Sjögren’s syndrome in a female patient. Interestingly, the deposition was not identified by routine immunofluorescence using snap frozen tissue, but was revealed by immunofluorescence on forma...
Source: CEN Case Reports - August 7, 2020 Category: Urology & Nephrology Source Type: research

Low-dose corticosteroid with mizoribine might be an effective therapy for elderly-onset ISKDC grade VI IgA vasculitis
We report a case of IgAV in an 89-year-old patient who was admitted to our hospital to investigate a 30-day history of palpable purpura and pitting edema on her leg. A renal biopsy showed membranoproliferative glomerulonephritis with IgA deposits (The International Study of Kidney Disease in Children (ISKDC) grade VI), which is a predictor of a poor prognosis; these findings led to early intervention with low-dose corticosteroid (15  mg/day) and mizoribine. As a result, a complete remission without obvious adverse effects was obtained. Early intervention with low-dose corticosteroid and mizoribine based on renal histo...
Source: CEN Case Reports - August 4, 2020 Category: Urology & Nephrology Source Type: research

Anti-glomerular basement membrane disease complicated with posterior reversible encephalopathy syndrome and subcortical cerebral hemorrhage: a case report and review of the literature
AbstractA 71-year-old woman was hospitalized for the treatment of fatigue, fever, and cough. On admission, she showed increased serum inflammation markers, severe anemia, pulmonary hemorrhage, and advanced acute kidney injury requiring hemodialysis. Her serum anti-glomerular basement membrane (GBM) antibody titer was found to be extremely high on the 7th hospital day. She was eventually diagnosed with anti-GBM disease. She was treated with a combination of corticosteroid pulse therapy, oral prednisolone and cyclophosphamide, and plasma exchange, but continued to require maintenance hemodialysis for end-stage kidney disease...
Source: CEN Case Reports - June 26, 2020 Category: Urology & Nephrology Source Type: research

A rare case of peritonitis in a young woman on peritoneal dialysis
(Source: CEN Case Reports)
Source: CEN Case Reports - June 24, 2020 Category: Urology & Nephrology Source Type: research

Secondary bladder amyloidosis due to Crohn ’s disease: a case report and literature review
We present a case of 54-year old man with secondary bladder amyloidosis due to Crohn ’s disease, that caused gross hematuria and severe anemia, which was managed conservatively by endoscopic transurethral resection, diatermocoagulation, clot evacuation and urinary drainage by bilateral percutaneous nephrostomy, with spontaneous resolution. Secondary bladder amyloidosis is a rare c ondition that presents with severe hematuria, difficult to control with standard management. Owing to chronic nature of the disease, treatment should be aimed to a conservative approach whenever possible. In case of failure, invasive proced...
Source: CEN Case Reports - June 22, 2020 Category: Urology & Nephrology Source Type: research

Fatal SARS-CoV-2 infection in a renal transplant recipient
We report a case of SARS-CoV-2 infection in a kidney transplant recipient with fatal outcomes. (Source: CEN Case Reports)
Source: CEN Case Reports - June 20, 2020 Category: Urology & Nephrology Source Type: research

The first case of COVID-19 pneumonia in a hemodialysis patient in Japan
AbstractOn 31 December 2019, cases of pneumonia whose cause was later identified as SARS-CoV-2 were detected in Wuhan City, Hubei Province of China, and now COVID-19 has spread worldwide. On March 1, 2020, a 69-year-old Japanese man who had been on hemodialysis for 3  years was diagnosed as having COVID-19 pneumonia and hospitalized at our Medical Center. Pulmonary CT revealed bilateral multiple consolidation with bilateral pleural effusion. Aggressive weight reduction was needed to improve the patient’s respiratory condition. Hemodialysis therapy was perform ed in isolation with hydroxychloroquine administratio...
Source: CEN Case Reports - June 18, 2020 Category: Urology & Nephrology Source Type: research

Low-density lipoprotein apheresis for PLA2R-related membranous glomerulonephritis accompanied by IgG4-related tubulointerstitial nephritis
We reported the case of a 68-year-old man with IgG4-related tubulointerstitial nephritis combined with antiphospholipase A2 receptor (PLA2R)-related membranous glomerulonephritis, in which distinguishing between idiopathic PLA2R-related and IgG4-related secondary membranous glomerulonephritis was difficult. We diagnosed him as having IgG4-related disease, based on a serum IgG4 level of 170  mg/dL and the presence of IgG4-related parotiditis. On renal biopsy, there was tubulointerstitial nephritis with IgG4-positive plasma cell filtration, which was compatible with IgG4-related disease and membranous glomerulonephritis...
Source: CEN Case Reports - June 16, 2020 Category: Urology & Nephrology Source Type: research

Secondary renal amyloidosis associated with asbestos-related pleuropulmonary diseases
AbstractHere, we present a 67-year-old Japanese man who developed insidious-onset nephrotic syndrome. He had a history of occupational asbestos exposure for about 8  years during his 30s, and was found to have pleural effusion 3 years before his present illness. At that time, repeated cytology testing of his pleural effusion found no malignant cells, and pleural biopsy found fibrous pleuritis without evidence of malignant mesothelioma. Percutaneous kidney bio psy found massive deposits of AA-type amyloid in the glomeruli, small arteries, and medulla. Computed tomography showed a calcified mass in the right lower ...
Source: CEN Case Reports - June 13, 2020 Category: Urology & Nephrology Source Type: research

The case of Kawasaki disease after rituximab infusion triggered by human anti-chimeric antibodies
AbstractRituximab (RTX) is an effective treatment for refractory nephrotic syndrome (NS), but may produce human anti-chimeric antibodies (HACA) which can cause severe infusion reaction or rituximab-induced serum sickness (RISS). RISS presents with a fever, rash, and arthralgia, which typically occurs 7 –21 days after RTX infusion. On the other hand, Kawasaki disease (KD) also presents with fever and rash. There have been no reports of KD developed after RTX infusion. A 6-year-old girl with frequently relapsing NS was admitted to our hospital for fever and rash on day 7 after receiving RTX. Alth ough it was sugge...
Source: CEN Case Reports - June 13, 2020 Category: Urology & Nephrology Source Type: research

A rare case of nephrotic syndrome associated with Dent ’s disease: a case report
AbstractDent ’s disease is a rare X-linked condition caused by a mutation inCLCN5 and OCRL gene, which impair the megalin-cubilin receptor-mediated endocytosis  in kidney’s proximal tubules. Thus, it may manifest as nephrotic-range low-molecular-weight proteinuria (LMWP). On the other hand, glomerular proteinuria, hypoalbuminemia, and edema formation are the key features of nephrotic syndrome that rarely found in Dent’s disease. Here, we reported a ma n in his 30 s with Dent’s disease presented with leg edema for 5 days. The laboratory results revealed hypoalbuminemia and a ...
Source: CEN Case Reports - June 12, 2020 Category: Urology & Nephrology Source Type: research

Bartter syndrome representing digenic-based salt-losing tubulopathies presumably accelerated by renal insufficiency
AbstractBartter syndrome and Gitelman syndrome (GS) are autosomal recessive disorders usually caused by homozygous or compound heterozygous mutations in causative genes. In some patients, these two syndromes cannot be discriminated based on clinical features or mutation type; thus, a single disease concept, salt-losing tubulopathies (SLTs), has been used instead. Despite the existence of several SLT causative genes, cases of digenic heterozygous mutations in two different genes are extremely rare. Here, we report the case of a 36-year-old woman with renal insufficiency and hypokalemia caused by an SLT. To evaluate the SLT ...
Source: CEN Case Reports - June 6, 2020 Category: Urology & Nephrology Source Type: research

Candida albicans and Staphylococcus lugdunensis superinfection of liver cysts in a patient with autosomal dominant polycystic kidney disease under prednisolone treatment
We report a case of superinfection of liver cysts caused byCandida albicans andStaphylococcus lugdunensis in a patient with autosomal dominant polycystic kidney disease. A 69-year-old man with chief complaints of headache and blurred vision was admitted to the former institution for the evaluation of suspected temporal arteritis. He was prescribed oral prednisolone (55  mg/day) as a preemptive treatment; however, he became febrile and presented with bilateral flank pain during prednisolone tapering. Blood culture revealed fungemia as a result ofCandida famata infection; thus, micafungin treatment was started. Thereaft...
Source: CEN Case Reports - May 21, 2020 Category: Urology & Nephrology Source Type: research

Comparison of clinical outcomes following early rehabilitation in 3 cases of nephrotic syndrome with different treatment courses
We report on three cases of nephrotic syndrome. Case 1 was a 67-year-old male who showed good progress after steroid treatment. Quadriceps torque and exercise capacity were increased after intervention. Case 2, a 78-year-old male, demonstrated resistance to steroid treatment. Quadriceps torque was decreased and exercise capacity was increased after intervention. Case 3 was an 83-year-old male who received nutrition therapy and diuretics without steroid treatment. Quadriceps torque and exercise capacity were decreased post-intervention.Early rehabilitation should be considered even if the steroid treatment course is differe...
Source: CEN Case Reports - May 10, 2020 Category: Urology & Nephrology Source Type: research

A case report of progressive multifocal leukoencephalopathy during steroid treatment for ANCA-associated renal vasculitis
We report progressive multifocal leukoencephalopathy during steroid treatment of ANCA-RV. When patients show progressive disturbance of consciousness during treatment for ANCA-RV, we need to take PML into consideration for differential diagnosis. (Source: CEN Case Reports)
Source: CEN Case Reports - May 9, 2020 Category: Urology & Nephrology Source Type: research

A case of long-term dasatinib-induced proteinuria and glomerular injury
AbstractA 52-year-old woman was diagnosed with chronic myeloid leukemia. Treatment with dasatinib, a second-generation Bcr –Abl tyrosine kinase inhibitor, was initiated, and complete cytogenetic remission was achieved. Two years later, proteinuria occurred, and the urinary protein level increased gradually in the next 3 years. Moreover, the serum creatinine level increased mildly during this period. The urinary prote in level reached 2.18 g/gCr; hence, a renal biopsy was conducted. Light microscopy revealed mild proliferation of mesangial cells, and immunofluorescence analysis revealed IgG and C3 deposition...
Source: CEN Case Reports - May 9, 2020 Category: Urology & Nephrology Source Type: research

Rapidly progressive glomerulonephritis caused by tegafur/gimeracil/oteracil resulted in diabetes nephropathy, in a patient with minor risk of diabetes nephropathy: a case report
AbstractA 79-year-old Japanese male with a history of type 2 diabetes mellitus (T2DM) for 16  years was admitted to evaluate possible renal disease. The T2DM was well controlled in this patient using nutrition therapy without the need for any diabetes medication, and both diabetes retinopathy and proteinuria were negative. At the age of 78 advanced colorectal cancer (stage IIIa) was diagno sed and laparoscopic-assisted colectomy was performed. Following this procedure, the patient began treatment with tegafur/gimeracil/oteracil (S-1), 80 mg twice daily for 28 days of 42-day cycle. The patient received S-1 fo...
Source: CEN Case Reports - May 7, 2020 Category: Urology & Nephrology Source Type: research

Recurrent macroscopic hematuria in a pediatric patient: is it early to diagnose as having type I hereditary C2 deficiency?
We report here a previously healthy 14-year-old boy presenting recurrent self-limited macroscopic hematuria and persistently low serum C4 levels, diagnosed as having type I hereditary C2 deficiency with confirming a novel heterozygote deletion (c.1567  + 22_1567 + 43del) in C2 gene. He has been remained asymptomatic for the next 18 months. Since the diagnosis of C2 deficiency was made in the absence of organ-threatening involvement such as immune complex-mediated glomerulonephritis, we think that early diagnosis and optimal follow-up may improve life-span of the patients with hereditary ear...
Source: CEN Case Reports - May 5, 2020 Category: Urology & Nephrology Source Type: research

Characteristic Renal Histology of a 81-Year-Old Patient with a 30-Year History of Diabetes Mellitus: A Case Report
AbstractA renal histology of an 81-year-old man with a 30-year history of diabetes mellitus (DM), as well as diabetic retinopathy and neuropathy, was examined. The patient ’s blood pressure was controlled within the normal range (less than 140/75 mmHg) using antihypertensive agents including angiotensin receptor blocker. Edematous management was achieved by a strict salt diet (less than 6 g/per day). However, this patient’s glycemic control was poor with HbA1c 8 –10%. Serum creatinine was 0.87 mg/dL and estimated globular filtration rate (eGFR) was 64 ml/min/1.73m2. Urinary protein exc...
Source: CEN Case Reports - May 2, 2020 Category: Urology & Nephrology Source Type: research

Effective improvement of minimal change nephrotic syndrome with uncontrollable high low-density lipoprotein cholesterol level using evolocumab accompanied by the development of acute pancreatitis
AbstractNephrotic syndrome is sometimes refractory; however, it is rarely accompanied by acute pancreatitis. A 47-year-old Japanese woman complaining of limb edema was diagnosed with nephrotic syndrome. Blood and urine examinations suggested minimal change nephrotic syndrome (MCNS), and pulse intravenous methylprednisolone was administered, followed by oral prednisolone. Although proteinuria improved, the patient ’s condition remained unchanged, and diuresis was insufficient. As in patients with other nephrotic syndromes, this patient showed significant dyslipidemia. Atorvastatin was started for remarkable dyslipidem...
Source: CEN Case Reports - May 1, 2020 Category: Urology & Nephrology Source Type: research

A case of proliferative glomerulonephritis with immunoglobulin A1-lambda deposits successfully treated by chemotherapy
AbstractA 74-year-old man presented with nephrotic syndrome and kidney insufficiency. Laboratory tests revealed monoclonal gammopathy of immunoglobulin A-lambda. Renal biopsy revealed diffuse mesangial proliferation and double-contoured basement membranes. Immunofluorescent analyses showed granular deposition of immunoglobulin A and C3 at the capillary walls and mesangial regions. Immunohistochemistry suggested monoclonal deposition of immunoglobulin A1-lambda. Electron microscopic analyses showed finely granular electron-dense deposits at mesangial and subendothelial areas. These findings suggested immunoglobulin A-type p...
Source: CEN Case Reports - April 30, 2020 Category: Urology & Nephrology Source Type: research

Correction to: Dietary potassium restriction attenuates urinary sodium wasting in the generalized form of pseudohypoaldosteronism type 1
In the Original publication of the article, there are two minor errors in Fig.  2 and these include one missing arrow in Fig. 2d and appears as an incorrectly drawn solid lines as dashed line in Fig. 2d. (Source: CEN Case Reports)
Source: CEN Case Reports - April 29, 2020 Category: Urology & Nephrology Source Type: research

Tocilizumab-induced immunocomplex glomerulonephritis: a report of two cases
We report here two cases of membranoproliferative glomerulonephritis that developed during treatment of rheumatoid arthritis with tocilizumab. In both cases, the initial findings were proteinuria and haematuria, followed by development of bilateral lower leg oedema. One of the patients was weakly positive for anti-nuclear antibody; both had hypocomplementaemia. The patients ’ renal impairment gradually resolved with discontinuation of tocilizumab followed by treatment with moderate doses of oral prednisolone. Pathological examination of renal biopsies resulted in diagnoses of immunocomplex glomerulonephritis and immu...
Source: CEN Case Reports - April 27, 2020 Category: Urology & Nephrology Source Type: research

Coexistence of emphysematous cystitis and bilateral emphysematous pyelonephritis: a case report and review of the literature
We report a rare case of a 56-year-old diabetic male suffering from fever, headache and vomiting and in which a diagnosis of septic shock was established due to coexistence of EC and bilateral EPN. The emphysematous diseases improved with a conservative treatment approach using antibiotic therapy and glycemic control, we highlight that the nephrectomy was not necessary in our patient despite the fact that he presented risk factors that predict the failure of conservative treatment. (Source: CEN Case Reports)
Source: CEN Case Reports - April 23, 2020 Category: Urology & Nephrology Source Type: research

Postmortem computed tomography of gas gangrene with aortic gas in a dialysis patient
AbstractRecently, postmortem imaging is sometimes used as an alternative to conventional autopsy. However, there are few case reports of postmortem imaging of dialysis patients. Here, we report a fatal case of gas gangrene involving a 76-year-old man who underwent dialysis. He died suddenly before a diagnosis could be established. Immediately after his death, postmortem computed tomography (PMCT) revealed gas accumulation in his right upper extremity and ascending aorta. Gas gangrene progresses rapidly and may sometimes result in sudden death before it is diagnosed. In this case, PMCT findings were useful to diagnose gas g...
Source: CEN Case Reports - April 22, 2020 Category: Urology & Nephrology Source Type: research

Refractory secondary thrombotic microangiopathy with kidney injury associated with systemic lupus erythematosus in a pediatric patient
AbstractThrombotic microangiopathy (TMA) is generally diagnosed through clinical features characterized as microangiopathic hemolytic anemia, thrombocytopenia, and multiple organ injury, as well as by pathological findings such as vascular damage and endothelial cell injury. Rheumatic and autoimmune diseases could be accompanied by secondary TMA; in fact, systemic lupus erythematosus (SLE) is a common disease associated with secondary TMA, and SLE complicated with TMA has been reported to have a poor prognosis. Although TMA occurs rarely in pediatric SLE patients, it often leads to severe clinical conditions. Here, we repo...
Source: CEN Case Reports - April 18, 2020 Category: Urology & Nephrology Source Type: research

In response to the comment on “Sequential nonarteritic anterior ischemic optic neuropathy in patient on chronic hemodialysis”
(Source: CEN Case Reports)
Source: CEN Case Reports - April 13, 2020 Category: Urology & Nephrology Source Type: research

Nintedanib-induced glomerular microangiopathy: a case report
AbstractNintedanib, a triple tyrosine kinase inhibitor of vascular endothelial growth factor receptor, platelet-derived growth factor receptor, and fibroblast growth factor receptor, has been used in idiopathic pulmonary fibrosis and adenocarcinoma in advanced non-small cell lung cancer. Although vascular endothelial growth factor inhibitors have been reported to cause endothelial injury and glomerular microangiopathy, nintedanib-induced glomerular microangiopathy has not been reported. A 68-year-old man with a history of primary aldosteronism, idiopathic pulmonary fibrosis, and pleomorphic carcinoma of the lung developed ...
Source: CEN Case Reports - April 11, 2020 Category: Urology & Nephrology Source Type: research

Ask-Upmark kidney in a girl with neurofibromatosis type 1
AbstractAsk-Upmark kidney (AUK) is a scarred segment of the kidney, characterized by formation of primitive tubular and glomerular structures, and sporadically diagnosed as a cause of hypertension (HTN). A 6-year-old girl with neurofibromatosis type 1 (NF1) and moyamoya syndrome had severe HTN. Based on past history, she had HTN at the age of 1.5  years. Laboratory examination revealed slightly elevated plasma and renal venous renin activity without lateralization. No evidence of pheochromocytoma, or coarctation of the aorta was found. Contrast-enhanced computed tomography (CT) showed an area of hypoperfusion in the u...
Source: CEN Case Reports - April 10, 2020 Category: Urology & Nephrology Source Type: research

The use of diazoxide in the management of spontaneous hypoglycemia in patients with ESRD
AbstractAlthough diabetes remains the number one cause of renal failure nationwide, spontaneous hypoglycemia in patients with CKD has also been described in the absence of exogenous insulin or any other diabetes treatment. Decreased renal gluconeogenesis and impaired renal insulin clearance are underlying mechanisms of hypoglycemia in individuals with ESRD. Diazoxide was originally approved as an anti-hypertensive medication, but also is known to bind ATP-sensitive K channels in the beta cells of the pancreas, ultimately leading to inhibition of insulin release. We detail six cases of ESRD-associated hypoglycemia which res...
Source: CEN Case Reports - April 9, 2020 Category: Urology & Nephrology Source Type: research