Impact of Goreisan upon aquaporin-2-incorporated aquaresis system in patients with congestive heart failure
AbstractWe often encounter patients with congestive heart failure refractory to conventional diuretics therapy, and Kampo Goreisan is receiving great concern to mediate body water balance particularly for such a cohort. However, its detailed biological mechanism remains uncertain. We had two hospitalized patients with congestive heart failure receiving tolvaptan. Following the administration of Goreisan, both urine cyclic adenosine monophosphate concentration and urine aquaporin-2 concentration decreased, accompanied by incremental diluted urine volume. Although further studies are warranted to establish therapeutic strate...
Source: CEN Case Reports - July 27, 2022 Category: Urology & Nephrology Source Type: research
Peritoneal dialysis-related peritonitis caused by Rhodococcus corynebacterioides
AbstractA 57-year-old Japanese man on peritoneal dialysis developed peritoneal dialysis-associated peritonitis caused byRhodococcus corynebacterioides. After the introduction of peritoneal dialysis, he had experienced four episodes of peritonitis, but the causative organism was not identified in any of episode. When he was hospitalized for the fifth episode of peritonitis,Rhodococcus corynebacterioides was detected in the ascitic fluid. He improved after an intraperitoneal administration of vancomycin (VCM) that was used based on the treatment of peritonitis caused byCorynebacterium spp. However, he then had repeated flare...
Source: CEN Case Reports - July 25, 2022 Category: Urology & Nephrology Source Type: research
Denileukin diftitox-induced systemic capillary leak syndrome with acute kidney injury
AbstractSystemic capillary leak syndrome is a rare and life-threatening disorder, characterized by recurrent episodes of unexplained hypotension, hemoconcentration, and hypoalbuminemia. This condition is caused by leakage of plasma and proteins into the extravascular space and can be classified as either idiopathic or secondary. Secondary systemic capillary leak syndrome can result from cancer, infections, medications, or surgery. Systemic capillary leak syndrome frequently develops as a side effect of denileukin diftitox treatment of refractory cutaneous T-cell lymphoma. However, the pathophysiology of this disease is not...
Source: CEN Case Reports - July 23, 2022 Category: Urology & Nephrology Source Type: research
Successful renal recovery from multiple myeloma-associated crystalline light chain cast nephropathy and accompanying acute kidney injury with early use of bortezomib-based therapy: a case report and literature review
AbstractCrystalline light chain cast nephropathy is a rare distinct morphologic variant of light chain cast nephropathy which is the most common renal lesion associated with multiple myeloma. It is often related to high myeloma tumor burden, severe acute kidney injury, and an unfavorable prognosis. A 79-year-old Japanese man was referred to our medical center with anemia, proteinuria, and acute exacerbation of the serum creatinine accompanying anuria. A renal biopsy showed crystalline cast filling the tubular lumens, injured tubular cells, and inflammatory cells infiltration of interstitium. Serum and urine immunofixation ...
Source: CEN Case Reports - July 20, 2022 Category: Urology & Nephrology Source Type: research
Kidney biopsy in patients with antineutrophil cytoplasmic antibody-associated vasculitis with mild renal abnormality
We report two cases of ANCA-associated vasculitis diagnosed by kidney biopsy despite the absence of remarkable urinary abnormality and renal impairment. These patients had fever of unknown origin and were positive for myeloperoxidase (MPO)-ANCA but showed few findings that would suggest small-vessel vasculitis in the kidney. Nevertheless, kidney biopsies revealed small-vessel arteritis, necrotizing glomerulonephritis, and interstitial nephritis. Immunofluorescent antibody tests performed using samples of glomeruli were all negative, suggesting microscopic polyangiitis. Therefore, kidney biopsy may be useful in confirming t...
Source: CEN Case Reports - July 11, 2022 Category: Urology & Nephrology Source Type: research
Development of an enterocutaneous fistula from an intestinal perforation in a patient with autosomal dominant polycystic kidney disease
AbstractWe herein report a case of enterocutaneous fistula in a patient with autosomal dominant polycystic kidney disease (ADPKD). A 37-year-old Japanese man was admitted to our hospital. Three months prior to transfer to our hospital, he developed intense flank pain with gross hematuria. His serum creatinine had decreased to 7.8 mg/dL and hemodialysis was started, but gross hematuria persisted and he developed hypotension. Upon admission, plain chest radiography did not reveal any free air, but computed tomography (CT) showed generalized ventral subcutaneous air from the head to the lower extremities and enlarged kidney...
Source: CEN Case Reports - July 5, 2022 Category: Urology & Nephrology Source Type: research
Fanconi syndrome in an elderly patient with membranous nephropathy during treatment with the immunosuppressant mizoribine
We report on an 80-year-old man diagnosed with Fanconi syndrome induced by mizoribine after 4 weeks of administration to treat membranous nephropathy. Mizoribine is an oral immunosuppressant that inhibits inosine monophosphate dehydrogenase and is widely used in Japan for the treatment of autoimmune diseases and nephrotic syndrome, as well as after renal transplantation. Acquired Fanconi s yndrome is often caused by drugs (antibacterial, antiviral, anticancer, and anticonvulsant drugs) and is sometimes caused by autoimmune diseases, monoclonal light chain-associated diseases, or heavy metal poisoning. In our patient, hyp...
Source: CEN Case Reports - June 24, 2022 Category: Urology & Nephrology Source Type: research
MPO-ANCA-positive conversion and microscopic polyangiitis development in idiopathic interstitial pneumonia: a case report
AbstractAntineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a systemic autoimmune disease characterized by necrotizing inflammation of the small blood vessels. ANCA-associated vasculitis is subclassified into three variants: granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis, and microscopic polyangiitis (MPA). Myeloperoxidase (MPO) ANCA is a marker antibody for MPA. Interstitial pneumonia (IP) is occasionally complicated with MPA. However, only a few cases of idiopathic IP develop MPO-ANCA-positive conversion and MPA. Therefore, we present a case of a 70-year-old Japanese man w...
Source: CEN Case Reports - June 24, 2022 Category: Urology & Nephrology Source Type: research
Use of rituximab in SARS-CoV-2-positive renal transplant recipient with EBV reactivation and probable haemophagocytic lymphohistiocytosis
We present a case of a rapid clinical recovery in a critically ill kidney transplant recipient with SARS-CoV-2 positivity, Epstein –Barr virus (EBV) reactivation and probable secondary hemophagocytic lymphohistiocytosis (HLH) treated with etoposide-free regimen, based on dexamethasone and a single dose of rituximab. Although rituximab is often a part of EBV-HLH treatment strategy, its use in simultaneous Coronavirus 2019 dise ase (COVID-19) and solid-organ transplantation has not been reported yet. We review the current evidence for the potential of SARS-CoV-2 to trigger EBV reactivation, leading to a severe clinical ill...
Source: CEN Case Reports - June 22, 2022 Category: Urology & Nephrology Source Type: research
Laparoscopic nephron-sparing surgery for horseshoe kidney complicated with renal hemangioma: a case report and literature review
We report a 71-year-old female with imaging examination revealed an unexpected horseshoe kidney malformation and a cystic mass in the right kidney before her bladder cancer surgery. After one and a half years of follow-up, the mass was progressively enlarged, and was classified as Bosniak type III. After evaluating the anatomical structure around the lesion by 3D reconstruction computed tomography, she received cystoscopic right double J ureteral catheter placement combined with retroperitoneal laparoscopic partial nephrectomy of the right kidney. After a 3-month follow-up, no tumor recurrence was observed, with normal kid...
Source: CEN Case Reports - June 21, 2022 Category: Urology & Nephrology Source Type: research
A possible role of classical complement pathway activation in the pathogenesis of immunoglobulin G nephropathy: a case report
AbstractImmunoglobulin G (IgG) nephropathy refers to a rare group of diseases characterized by deposits of IgG in the mesangial region. However, IgG nephropathy is controversial as a single disease entity, and its pathogenesis remains to be elucidated. In the present report, we discuss a case of IgG nephropathy in which we observed activation of the classical complement pathway.A 47-year-old woman was admitted to our hospital with nephrotic syndrome. Light-microscopic examination revealed neither proliferative nor sclerotic lesions in the glomeruli. However, unusual and large deposits were observed in the paramesangial are...
Source: CEN Case Reports - June 16, 2022 Category: Urology & Nephrology Source Type: research
Diagnosis of monoclonal immunotactoid glomerulopathy with positive λ chain by immunoelectron microscopy
We report the case of a 73-year-old-man who developed immunotactoid glomerulopathy (ITG). ITG is a rare disease characterized by proliferative glomerulonephritis and capillary wall deposits with a 10 –60 nm diameter microtubular substructure. In monoclonal ITG, immunofluorescence analysis typically exhibits IgG with light chain restriction. Recent reviews recommend distinguishing monoclonal ITG from polyclonal ITG because monoclonal ITG is associated with a higher incidence of hematological d isorders and better responsiveness to clone-directed therapy and renal prognosis. In our case, IgG, IgA, and IgM were negative by...
Source: CEN Case Reports - June 14, 2022 Category: Urology & Nephrology Source Type: research
Marked bilateral global persistent CT nephrogram 48 h after percutaneous coronary intervention with contrast-induced nephropathy requiring transient hemodialysis with severe cardiac dysfunction
AbstractAn iodinated contrast medium (CM) is generally excreted into the urinary tract within 3 min after administration. However, some cases present a persistent kidney nephrogram several hours after administration of CM. This phenomenon seems to be associated with the development and acceleration of contrast-induced nephropathy (CIN). A 74-year-old woman with chronic kidney disease and a v ery low ejection fraction (EF) (11%) was admitted to Sapporo Medical University Hospital because of heart failure. Coronary angiography revealed occlusion of the left anterior descending artery (LAD) on day 21 of admission. Percutane...
Source: CEN Case Reports - June 13, 2022 Category: Urology & Nephrology Source Type: research
Rituximab-induced serum sickness in a girl with nephrotic syndrome
AbstractRituximab (RTX) has been used to treat B cell lineage lymphoma/leukemia or autoimmune or autoinflammatory disorders. RTX therapy has been extensively applied to cases of frequently relapsing nephrotic syndrome (FRNS) and steroid-dependent nephrotic syndrome. Rituximab-induced serum sickness (RISS) has been recognized as a rare severe type-3 hypersensitivity reaction in patients treated with RTX. We herein report a 10-year-old girl with RISS in FRNS. She was diagnosed with RISS based on characteristic symptoms, such as a fever, rash, arthritis, or proteinuria, during RTX therapy associated with a high level of human...
Source: CEN Case Reports - May 20, 2022 Category: Urology & Nephrology Source Type: research
IgA nephropathy with glomerular capillary IgA deposition following SARS-CoV-2 mRNA vaccination: a report of three cases
AbstractIgA nephropathy (IgAN) cases histopathologically showing glomerular capillary IgA deposition represent a rare subtype of primary IgAN. Patients with IgAN categorized to this subtype often exhibit heavy proteinuria, advanced histological findings, and are resistant to therapies. Here, we report three cases of biopsy-proven IgAN with glomerular capillary IgA deposition who presented acute deterioration of urinalysis findings following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccinations. Case 1 was recurrent IgAN. Case 2 and Case 3 were newly diagnosed cases with subclinical microhematuria a...
Source: CEN Case Reports - May 13, 2022 Category: Urology & Nephrology Source Type: research
