Complete remission of tip lesion variant focal segmental glomerulosclerosis (FSGS) with the Janus Kinase (JAK) inhibitor tofacitinib
AbstractA 67-year-old woman with transverse myelitis and seizure disorder secondary to suspected central nervous system (CNS) systemic lupus erythematosus (SLE) and seropositive rheumatoid arthritis had two episodes of severe nephrotic syndrome 15 years apart. She underwent a renal biopsy in both episodes, showing tip lesion variant focal segmental glomerulosclerosis (FSGS). The patient responded both times to prednisone treatment, achieving a complete remission within 2 months in the first episode and remission 4 months in the second epi sode. A year after her second episode, the patient had a third episode of severe ...
Source: CEN Case Reports - November 5, 2021 Category: Urology & Nephrology Source Type: research
Takotsubo cardiomyopathy after vaccination for coronavirus disease 2019 in a patient on maintenance hemodialysis
AbstractCoronavirus disease-2019 (COVID-19) has affected more than 220 million individuals since the global pandemic began. There is an urgent need for safe and effective vaccines, and vaccinations, such as mRNA vaccines, have been initiated worldwide. However, the adverse effects of these vaccines remain unclear. We herein present a case of an 80-year-old female on maintenance hemodialysis who developed takotsubo cardiomyopathy 4 days after receiving the first dose of the Pfizer-BioNTech COVID-19 vaccine. There was no obvious trigger for the onset of takotsubo cardiomyopathy other than the COVID-19 vaccination, which wa...
Source: CEN Case Reports - November 3, 2021 Category: Urology & Nephrology Source Type: research
De novo ulcerative colitis after kidney transplantation treated with infliximab
AbstractDiarrhea is a common complication in kidney transplant recipients. Common causes of diarrhea include infection, side effect from medication, rejection, and malignancy. A less common but important cause of diarrhea is de novo inflammatory bowel disease (IBD). This is unexpected, as these patients are already immunosuppressed. Herein, we present the case of a 45-year-old man with end-stage kidney disease because of focal segmental glomerulosclerosis who underwent preemptive kidney transplantation, with his mother as donor. His immunosuppressive regimen included methylprednisolone, mycophenolate mofetil, and tacrolimu...
Source: CEN Case Reports - October 7, 2021 Category: Urology & Nephrology Source Type: research
Moyamoya disease with refractory hypertension associated with peripheral arterial stenosis in the renal parenchyma
AbstractMoyamoya disease (MMD) has long been known to be associated with hypertension. While renal artery stenosis (RAS) is considered one of the causes of hypertension with MMD, most hypertension causes remain unexplained. A boy with MMD was diagnosed with renovascular hypertension (RVH) due to left-sided RAS by angiography. Although nephrectomy on the affected side for unilateral RVH was performed, hypertension poorly improved. Histopathological examination of the resected specimens revealed that the vascular lumen not only of the renal artery but also of peripheral vessels in the renal parenchyma was narrowed. He develo...
Source: CEN Case Reports - October 7, 2021 Category: Urology & Nephrology Source Type: research
Bortezomib-induced glomerular microangiopathy complicated with monoclonal immunoglobulin deposition disease
AbstractA 75-year-old man admitted with IgG λ-type myeloma with creatinine level of 2.3 mg/dL. Serum lactate dehydrogenase level and platelet count were normal. Urinalysis demonstrated massive proteinuria dominated by albuminuria. Weekly bortezomib and dexamethasone therapy were started to treat myeloma but failed to be continued because of rapid deterioration of renal function and increase in proteinuria 1 week after the treatment. His renal function exacerbated to require hemodialysis for a month. There was no clinical evidence of tumor lysis syndrome or thrombocytopenia throughout the course of his acute kidney injur...
Source: CEN Case Reports - October 7, 2021 Category: Urology & Nephrology Source Type: research
Efficacy of oral tolvaptan for severe edema and hyponatremia in a patient with refractory nephrotic syndrome
AbstractTolvaptan (TLV) is a vasopressin V2 receptor antagonist that increases free water excretion. However, there are few reports of the use of TLV in pediatric patients with nephrotic syndrome (NS). The efficacy of TLV for the management of edema and hyponatremia in a 12-year-old boy with refractory NS is demonstrated. In this patient, refractory NS developed at 5 years of age, and remission was maintained with several immunosuppressive agents. He was admitted to hospital due to relapse with oliguria, edema, hypoalbuminemia, and hyponatremia. Infusion of human albumin and furosemide did not increase his urine volume, ...
Source: CEN Case Reports - October 7, 2021 Category: Urology & Nephrology Source Type: research
Importance of the sick day rule: a case of prerenal acute kidney injury after COVID-19 vaccination in a patient with chronic kidney disease
(Source: CEN Case Reports)
Source: CEN Case Reports - October 2, 2021 Category: Urology & Nephrology Source Type: research
List of referees
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Source: CEN Case Reports - September 28, 2021 Category: Urology & Nephrology Source Type: research
Long-term clinical course of immunotactoid glomerulopathy complicated with diffuse large B-cell lymphoma
We report a case of immunotactoid glomerulopathy (ITG) complicated with diffuse large B-cell lymphoma (DLBCL). A 68-year-old woman presented with leg edema and was diagnosed with nephrotic syndrome (NS). Renal biopsy revealed ITG. We treated the patient with prednisolone (20 mg/day) and she achieved complete remission of NS. Steroids were gradually reduced. After 1 year, the patient presented with a breast mass determined on biopsy to be DLBCL. She underwent six cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) therapy. Follow -up revealed complete remission of both DLBCL and ITG...
Source: CEN Case Reports - September 26, 2021 Category: Urology & Nephrology Source Type: research
Renal hypouricemia in a recipient of living-donor kidney transplantation: a case report and literature review
AbstractHypouricemia in kidney transplant (KT) recipients is rare since they usually have subnormal kidney function which raises serum uric acid level. Recently, interests in pathogenesis of hypouricemia have been increasing due to the understanding of the role of uric acid transporter in renal hypouricemia (RHUC). We herein report the case of RHUC consequently developed in a KT recipient from a living donor with RHUC diagnosed by the detailed urinary and genetic test. A 73-year-old Japanese man underwent KT, and the donor was his wife who had hypouricemia [serum uric acid (S-UA) 0.6 mg/dL]. Nine months after KT, the rec...
Source: CEN Case Reports - September 23, 2021 Category: Urology & Nephrology Source Type: research
Double whammy: anticoagulant-related nephropathy with leukocytoclastic vasculitis due to warfarin
AbstractAnticoagulation-related nephropathy (ARN) is a rare form of acute kidney injury where the use of anticoagulation causes hemorrhage in various compartments of nephron including glomerulus, renal tubules, and interstitial compartment. Also, warfarin-induced vasculitis is an extremely rare condition characterized by the appearance of purpuric lesions on the skin which on biopsy are suggestive of leukocytoclastic vasculitis (LV). We hereby report a case presenting with coexistent warfarin-induced nephropathy and cutaneous vasculitis. A 64-year-old male, on warfarin for 10 years, presented with complaints of palpable ...
Source: CEN Case Reports - September 17, 2021 Category: Urology & Nephrology Source Type: research
Fabry disease associated with multiple myeloma: a case report
We report the case of a 68-year-old woman who was referred to our hospital for the evaluation of thoracic spine tumor with bone destruction. On admission, her serum creatinine (Cr) level was elevated to 12.70 mg/dL from the baseline value of 0.91 mg/dL. Bone marrow aspiration revealed MM. Renal biopsy showed myeloma cast nephropathy, which was the primary cause of acute kidney injury. Renal pathology also showed podocyte swelling and tubule myeloid bodies in a mosaic pattern compatible with female FD. Consequently, the patient was diagnosed as FD based on the germ line mutation in GLA. The patient was treated with borte...
Source: CEN Case Reports - September 16, 2021 Category: Urology & Nephrology Source Type: research
Nivolumab-induced membranous nephropathy in a patient with stage IV lung adenocarcinoma
AbstractImmune check point inhibitors (ICIs) are now increasingly used for cancer therapy. At the same time, by activating the immune system, ICIs induce unique side effects, termed immune-related adverse events (irAEs). Renal irAEs, although uncommon, result in acute tubulointerstitial nephritis. Recently, because of an increase in ICI administration, renal irAEs, including glomerulonephritis, are being increasingly reported. A 69-year-old man presented with nephrotic syndrome after use of the ICI nivolumab. He underwent renal biopsy and was diagnosed with membranous nephropathy (MN) without acute tubulointerstitial nephr...
Source: CEN Case Reports - September 15, 2021 Category: Urology & Nephrology Source Type: research
A case of anti-GBM nephritis following centipede bites and COVID-19 vaccination
AbstractA case of newly developed anti-glomerular basement membrane (GBM) glomerulonephritis (GN) following centipede bites and COVID-19 vaccination is presented. A 70-year-old woman presented for investigation of mild fever, generalized fatigue, and macroscopic hematuria with no past history of renal disease. One year earlier, she had been bitten by a centipede. Based on the governmental policy, she was given the first COVID-19 vaccination, and the second injection was planned 3 weeks later. Accidentally, she was again bitten by a centipede, and the injured site had swollen severely. Based on a physician’s judgment, t...
Source: CEN Case Reports - September 15, 2021 Category: Urology & Nephrology Source Type: research
Successful treatment with denosumab for two cases with hypercalcemia due to vitamin D intoxication and associated acute kidney injury
We report on two cases of hypercalcemia and acute kidney injury because of vitamin D intoxication successfully treated with denosumab. Case 1 is an 83-year-old woman, who was initially treated for 2 weeks with intravenous hydration, steroids and thereafter with furosemide without any effect on serum calcium levels and renal function. Because acute renal failure discouraged us to use intravenous bisphosphonate therapy, we applicated 60 mg denusomab subcutaneously. This led to a prompt reducti on in serum calcium levels and improvement of renal function within 1 week. Case 2 is a 45-year-old athletic woman, who refused t...
Source: CEN Case Reports - September 13, 2021 Category: Urology & Nephrology Source Type: research
