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Sample records for case ectopie renale

  1. The pathogenesis of renal dysplasia. II. The significance of lateral and medial ectopy of the ureteric orifice.

    PubMed

    Schwarz, R D; Stephens, F D; Cussen, L J

    1981-09-01

    Renal hypoplasia and dysplasia may be primary malformations linked to a panureteric bud deformity or result from damage to the developing nephrons caused by abnormal urodynamic pressures, Kidneys with misplaced ureteric orifices were graded, according to histologic criteria, on the hypodysplasia scale. With lateral ectopy of the ureteric orifices with and without congenital urethral obstruction, the grades correlated with specific orifice positions. The grades of kidneys with caudal ectopy of the ureters indicated a more general correlation. Dysgenesis of the bud and nephrogenic mesenchyme may account for the renal hypodysplasia when the ureteric orifice is found to be ectopic. PMID:7275560

  2. Inappropriate tall stature and renal ectopy in a male patient with X-linked congenital adrenal hypoplasia due to a novel missense mutation in the DAX-1 gene.

    PubMed

    Franzese, Adriana; Brunetti-Pierri, Nicola; Spagnuolo, Maria Immacolata; Spadaro, Raffaella; Giugliano, Michela; Mukai, Tokuo; Valerio, Giuliana

    2005-05-15

    Mutations in DAX-1 gene cause congenital adrenal hypoplasia (AHC). We present a male patient affected by X-linked adrenal hypoplasia congenita due to a novel DAX-1 missense mutation. The mutation V287G affects the C-terminal end of the DAX-1 protein which plays an important role in functioning of the receptor. In addition, our patient presented an inappropriate tall stature and renal ectopy, which have not been described in AHC so far. PMID:15800903

  3. Crossed Renal Ectopia without Fusion: An Uncommon Cause of Abdominal Mass

    PubMed Central

    Ratola, Ana; Almiro, Maria Miguel; Lacerda Vidal, Rita; Neves, Nuno; Bicho, Adelaide; Figueiredo, Sofia

    2015-01-01

    Crossed renal ectopia is a rare congenital anomaly usually associated with fused kidneys (90%). Most cases are asymptomatic and remain undiagnosed. We report an unusual case of nonfused crossed renal ectopia. The 11-year-old adolescent female patient was admitted with abdominal pain, anorexia, weight loss, and periumbilical mass. Although the initial clinical suspicion was a tumoral lesion, abdominal ultrasound and magnetic resonance examination revealed crossed renal ectopia without fusion. The renal ectopy was incidentally diagnosed, as described in 20 to 30% of cases. In this case, the associated nonspecific symptoms were a coincidence. PMID:26290762

  4. Is ventricular ectopy a legitimate target for ablation?

    PubMed Central

    Gumbrielle, T; Bourke, J P; Furniss, S S

    1994-01-01

    Radiofrequency ablation has an established role in the treatment of non-ischaemic ventricular tachycardia. A few patients present with symptomatic but benign ventricular ectopy that can be mapped to the right ventricular outflow tract. The successful use of radiofrequency ablation in a patient with drug resistant, symptomatic ventricular ectopy is reported. Radiofrequency ablation may have a useful role in more benign arrhythmias. PMID:7818971

  5. Renal calculus complicated with squamous cell carcinoma of renal pelvis: Report of two cases.

    PubMed

    Xiao, Jiantao; Lei, Jun; He, Leye; Yin, Guangming

    2015-01-01

    Longstanding renal calculus is a risk factor of squamous cell carcinoma (SCC) of the renal pelvis. It is highly aggressive and usually diagnosed at advanced stages with a poor prognosis. We present two cases of kidney stone complications with renal pelvic SCC. These two patients had a radical nephrectomy and the dissected tissues were renal pelvic SCC. Our cases further emphasize that renal pelvic SCC should be considered in patients with longstanding renal calculus. These cases contribute greatly to an early diagnosis and early treatment, both of which will significantly minimize the damage of, and markedly improve the prognosis of, renal pelvic SCC. PMID:26029303

  6. Renal calculus complicated with squamous cell carcinoma of renal pelvis: Report of two cases

    PubMed Central

    Xiao, Jiantao; Lei, Jun; He, Leye; Yin, Guangming

    2015-01-01

    Longstanding renal calculus is a risk factor of squamous cell carcinoma (SCC) of the renal pelvis. It is highly aggressive and usually diagnosed at advanced stages with a poor prognosis. We present two cases of kidney stone complications with renal pelvic SCC. These two patients had a radical nephrectomy and the dissected tissues were renal pelvic SCC. Our cases further emphasize that renal pelvic SCC should be considered in patients with longstanding renal calculus. These cases contribute greatly to an early diagnosis and early treatment, both of which will significantly minimize the damage of, and markedly improve the prognosis of, renal pelvic SCC. PMID:26029303

  7. Renal Primitive Neuroectodermal Tumor: A Case Report.

    PubMed

    Yang, Cheng; Xu, Hanjiang; Zhou, Jun; Hao, Zongyao; Wang, Jianzhong; Lin, Changmin; Zhang, Li; Zhu, Xia; Liang, Chaozhao

    2015-12-01

    Primitive neuroectodermal tumor (PNET) is a malignant small round cell tumor and typically arises from bone or soft tissue in adolescents and young adults. Renal PNET is extraordinarily rare and exhibits highly aggressive biological behavior with poor prognosis.We present here a new case of renal PNET in a 31-year-old female. The patients were referred to our hospital because of left flank pain with nausea and vomiting for 1 week. A computed tomography scan revealed a 14.7 × 12.7 cm well-defined, unevenly mass lesion with both solid and cystic components and the tumor was not enhanced uniformly.A preoperative diagnosis of cystic renal cell carcinoma and urinary tract infection was made. The patient undergone anti-inflammatory therapy followed by a left radical nephrectomy. Taken with morphological pattern and immunohistochemical markers, a diagnosis of renal PNET was made. Two cycles of combined chemotherapy were executed. At the 14-month follow-up, no evidence of metastasis or recurrence was indicated.This case reminds clinicians that for adolescents and young adults with a suspicious renal mass, a diagnosis of renal PNET should be always considered. An initial surgery followed by radiotherapy and chemotherapy is suggested for the therapeutic management. PMID:26656379

  8. Renal pelvis urothelial carcinoma of the upper moiety in complete right renal duplex: a case report

    PubMed Central

    Zhang, Yiran; Yu, Quanfeng; Zhang, Zhihong; Liu, Ranlu; Xu, Yong

    2015-01-01

    Urothelial carcinoma (UC) originated from renal pelvis is the common tumor of the urinary system, however, neoplasia of the renal pelvis in duplex kidneys is extremely rare, especially in the complete renal and ureteral duplex cases. We present the first case of renal pelvis UC of the upper moiety in a complete right renal duplex. This male patient has bilateral complete renal and ureteral duplex. To the best of our knowledge, this is the first reported case of renal pelvis UC in a complete renal duplex system. After this experience we feel that the diagnosis of renal pelvis UC in duplex kidneys is not so easy, and once the diagnosis is determined, the whole renal duplex units and bladder cuff or ectopic orifice should be excised radically. PMID:26823906

  9. Papillary adenocarcinoma of the renal pelvis with renal calculus: A rare case report

    PubMed Central

    LI, JIANLONG; LI, QING; YU, YI

    2016-01-01

    Papillary adenocarcinoma of the renal pelvis is a rare clinicopathology of a kidney tumor with renal calculus. In the present case report, percutaneous renal biopsy, nephroscope lithotripsy and radical nephroureterectomy within a papillary adenocarcinoma of the renal pelvis accompanied with renal calculus was performed on a 65-year-old patient, also including a report on the patient's data and a literature review. The histopathological features confirmed the diagnosis of papillary adenocarcinoma of the renal pelvis. Tumors of the renal pelvis are uncommon features of urothelial carcinoma, and papillary adenocarcinoma of the renal pelvis is a very unusual entity. The present case report describes papillary adenocarcinoma of the renal pelvis with renal calculus, which has rarely been previously reported. PMID:27123287

  10. Ventricular Ectopy: Impact of Self-reported Stress following Myocardial Infarction

    PubMed Central

    Smith, Patrick J.; Blumenthal, James A.; Babyak, Michael A.; Georgiades, Anastasia; Sherwood, Andrew; Sketch, Michael H.; Watkins, Lana L.

    2007-01-01

    Background Although psychological stress has been implicated in the pathogenesis of ventricular arrhythmias, the relationship between self-reported stress and ventricular ectopy has not been evaluated under naturalistic conditions in acute post-MI patients, a group at elevated risk for arrhythmias. Methods Diary-reported stress was measured during 24-hour Holter monitoring in 80 patients (52 men, 28 women) approximately 12 weeks following MI. In addition, state and trait anxiety were measured using the Spielberger State and Trait anxiety inventory (STAI), administered at the beginning of the 24-hour holter monitoring session. The relationship between diary reported stress, anxiety, and ventricular ectopy was evaluated. Results Mean diary-reported stress (β= .29, p = .01) was associated with total ventricular ectopy. State anxiety was also associated with 24-hour ectopy (β= .24, p = .04); however, trait anxiety was not significantly associated with ectopy. Temporal analyses of the relationship between stress and ectopy showed that diary-reported stress was associated with an increase in the number of VPBs occurring in the following hour (B = 0.74, p < .0001). Conclusions These findings extend existing evidence linking psychological factors to ventricular arrhythmias by demonstrating that psychological stress predicts increased arrhythmic activity during routine daily activities in post-MI patients. PMID:17174651

  11. Renal Angiomyolipoma With Sarcoid Granulomas: Report of a Unique Case.

    PubMed

    Tarjan, Gabor; Kim, George J; Haroon Al Rasheed, Mohamed Rizwan

    2016-05-01

    Angiomyolipoma is a mesenchymal neoplasm characterized by the coexpression of melanocytic and smooth muscle markers. Sarcoidosis is a multisystem disorder of unknown etiology, which presents with characteristic nonnecrotizing granulomas and rarely involves the kidney. The coexistence of renal sarcoidosis with renal neoplasms is exceedingly rare and was reported only with renal cell carcinoma. Renal sarcoidosis associated with a nonepithelial renal neoplasm, such as an angiomyolipoma has never been reported. We present the first reported case of sarcoid granulomas in a renal angiomyolipoma, including morphologic and immunohistochemical features. PMID:26582772

  12. [Acetaminophen (paracetamol) causing renal failure: report on 3 pediatric cases].

    PubMed

    Le Vaillant, J; Pellerin, L; Brouard, J; Eckart, P

    2013-06-01

    Renal failure secondary to acetaminophen poisoning is rare and occurs in approximately 1-2 % of patients with acetaminophen overdose. The pathophysiology is still being debated, and renal acetaminophen toxicity consists of acute tubular necrosis, without complication if treated promptly. Renal involvement can sometimes occur without prior liver disease, and early renal manifestations usually occur between the 2nd and 7th day after the acute acetaminophen poisoning. While therapy is exclusively symptomatic, sometimes serious metabolic complications can be observed. The monitoring of renal function should therefore be considered as an integral part of the management of children with acute, severe acetaminophen intoxication. We report 3 cases of adolescents who presented with acute renal failure as a result of voluntary drug intoxication with acetaminophen. One of these 3 girls developed severe renal injury without elevated hepatic transaminases. None of the 3 girls' renal function required hemodialysis, but one of the 3 patients had metabolic complications after her acetaminophen poisoning. PMID:23628119

  13. [Renal stone ileus in xanthogranulomatous pyelonephritis. A case report].

    PubMed

    Schieroni, R; Dogliani, M; Acanfora, F; Gandini, G; Poy, F; Borello, G; Sancipriano, G

    2002-10-01

    A peculiar case of intestinal occlusion caused by a renal stone in a patient with nephroduodenal fistula due to previous xanthogranulomatous pyelonephritis is reported. Only few cases of nephroduodenal fistula are described in the literature, generally as a single case report or in small series. A nephroduodenal fistula as a result of chronic renal inflammatory disease such as xanthogranulomatous pyelonephritis, is usually associated with renal stones, recurrent urinary tract infections or endocrine disorders. Finally, renal stone as a cause of ileus is an event rarely described in the literature. In the case described, a correct preoperative diagnosis was possible with computerized tomography. During the operation a big renal stone was found and removed from the small bowel, but a limited resection was necessary because of the vascular impairment of the tract. At 8-month follow-up from operation, the patient was in good health, and no symptoms of renal or intestinal diseases were found. PMID:12370672

  14. An Asymptomatic Primary Renal Carcinoid Tumor: A Case Report.

    PubMed

    Linke, Colin S; Shie, Scott

    2016-07-01

    Primary renal carcinoid tumors are exceedingly rare, with less than 100 total cases being documented in world literature. A 32-year old male was referred to our service for a slow-growing, renal mass, which was first diagnosed 9-years prior. The patient was successfully treated with radical nephrectomy. In this article, we present our case report on an asymptomatic primary renal carcinoid tumor. PMID:27335800

  15. Primary Renal Lymphoma Mimicking a Subcapsular Hematoma: A Case Report

    PubMed Central

    Dedekam, Erik; Graham, Jess; Strenge, Karen; Mosier, Andrew D.

    2013-01-01

    Primary renal lymphoma (PRL) is a rare entity with a history of controversy regarding its existence. Lymphomatous involvement of the kidney is more commonly seen secondarily to spread from an adjacent lymphomatous mass, rather than arising primarily from the kidney. PRL can mimic other renal lesions such as renal cell carcinoma, renal abscess, and metastasis; therefore, an early diagnosis is crucial to guide treatment and properly assess prognosis. We present a rare case of a 77 year-old male who presented with hematuria and PRL mimicking a subcapsular hematoma. PMID:24421949

  16. Primary renal lymphoma mimicking a subcapsular hematoma: a case report.

    PubMed

    Dedekam, Erik; Graham, Jess; Strenge, Karen; Mosier, Andrew D

    2013-08-01

    Primary renal lymphoma (PRL) is a rare entity with a history of controversy regarding its existence. Lymphomatous involvement of the kidney is more commonly seen secondarily to spread from an adjacent lymphomatous mass, rather than arising primarily from the kidney. PRL can mimic other renal lesions such as renal cell carcinoma, renal abscess, and metastasis; therefore, an early diagnosis is crucial to guide treatment and properly assess prognosis. We present a rare case of a 77 year-old male who presented with hematuria and PRL mimicking a subcapsular hematoma. PMID:24421949

  17. Case Report: Multifocal biphasic squamoid alveolar renal cell carcinoma

    PubMed Central

    Lopez, Jose Ignacio

    2016-01-01

    A multifocal biphasic squamoid alveolar renal cell carcinoma in a 68-year-old man is reported. Four different peripheral tumor nodules were identified on gross examination. A fifth central tumor corresponded to a conventional clear cell renal cell carcinoma. Biphasic squamoid alveolar renal cell carcinoma is a rare tumor that has been very recently characterized as a distinct histotype within the spectrum of papillary renal cell carcinoma. Immunostaining with cyclin D1 seems to be specific of this tumor subtype. This is the first reported case with multifocal presentation. PMID:27158455

  18. Robotic renal transplantation: first European case.

    PubMed

    Boggi, Ugo; Vistoli, Fabio; Signori, Stefano; D'Imporzano, Simone; Amorese, Gabriella; Consani, Giovanni; Guarracino, Fabio; Melfi, Franca; Mussi, Alfredo; Mosca, Franco

    2011-02-01

    A kidney from a 56-year-old mother was transplanted to her 37-year-old daughter laparoscopically using the daVinci HDSi surgical system. The kidney was introduced into the abdomen through a 7-cm suprapubic incision used also for the uretero-vescical anastomosis. Vascular anastomoses were carried out through a total of three additional ports. Surgery lasted 154 min, including 51 min of warm ischemia of the graft. Urine production started immediately after graft reperfusion. Renal function remains optimal at the longest follow-up of 3 months. The technique employed in this case is discussed in comparison with the only other two contemporary experiences, both from the USA. Furthermore, possible advantages and disadvantages of robotics in kidney transplantation are discussed extensively. We conclude that the daVinci surgical system allows the performance of kidney transplantation under optimal operative conditions. Further experience is needed, but it is likely that solid organ transplantation will not remain immune to robotics. PMID:21091963

  19. Heart rate dynamics distinguish among atrial fibrillation, normal sinus rhythm and sinus rhythm with frequent ectopy.

    PubMed

    Carrara, Marta; Carozzi, Luca; Moss, Travis J; de Pasquale, Marco; Cerutti, Sergio; Ferrario, Manuela; Lake, Douglas E; Moorman, J Randall

    2015-09-01

    Atrial fibrillation (AF) is usually detected by inspection of the electrocardiogram waveform, a task made difficult when the signal is distorted by noise. The RR interval time series is more frequently available and accurate, yet linear and nonlinear time series analyses that detect highly varying and irregular AF are vulnerable to the common finding of frequent ectopy. We hypothesized that different nonlinear measures might capture characteristic features of AF, normal sinus rhythm (NSR), and sinus rhythm (SR) with frequent ectopy in ways that linear measures might not. To test this, we studied 2722 patients with 24 h ECG recordings in the University of Virginia Holter database. We found dynamical phenotypes for the three rhythm classifications. As expected, AF records had the highest variability and entropy, and NSR the lowest. SR with ectopy could be distinguished from AF, which had higher entropy, and from NSR, which had different fractal scaling, measured as higher detrended fluctuation analysis slope. With these dynamical phenotypes, we developed successful classification strategies, and the nonlinear measures improved on the use of mean and variability alone, even after adjusting for age. Final models using all variables had excellent performance, with positive predictive values for AF, NSR and SR with ectopy as high as 97, 98 and 90%, respectively. Since these classifiers can reliably detect rhythm changes utilizing segments as short as 10 min, we envision their application in noisy settings and in personal monitoring devices where only RR interval time series may be available. PMID:26246162

  20. Urban ectopy in the mountains: Carbon monoxide exposure at high altitude

    SciTech Connect

    Leaf, D.A.; Kleinman, M.T.

    1996-07-01

    Environmental exposure to inhaled carbon monoxide (CO) increases coronary artery disease risk. Sudden cardiac death, a frequent manifestation of coronary artery disease, is usually a result of ventricular dysrhythmia. The effect of exposure to CO at sea level (CO/SL) and simulated high (2.1 km) altitudes (CO/HA) on the incidence of cardiac ectopy in subjects with coronary artery disease was investigated. A double-blind crossover study was conducted, with random-order assignment, and each subject served as his own control. Seventeen men with documented coronary artery disease and stable angina pectoris performed cardiopulmonary exercise stress tests after random exposure to either CO or clean air (CA) at sea level (CA/SL) or at a simulated 2.1-km high altitude (CA/HA). The individual CO and HA exposure conditions were each selected to reduce the percentage of oxygen saturation of the subjects arterial blood by 4%. Subjects blood carboxyhemoglobin levels were increased form an average of 0.62% after clean-air exposure to 3.91% of saturation after CO exposure. The percentage of oxygen saturation in arterial blood was reduced from a baseline level of 98% to approximately 94% after CO/SL or CA/HA and to approximately 90% after CO/HA. Compared with the CA/SL the average incidence of exercise-induced ventricular ectopy was approximately doubled after all exposures and a significant trend (p {le} .05) of increased ectopy with decreased oxygen saturation in arterial blood was observed. Yet, among subjects who were free from ectopy (n=11) on CA/SL, only 2 subjects developed ectopy after CO/HA. No episodes of ventricular tachycardia or fibrillation occurred. The findings indicated that exposure to increased levels of hypoxemia, resulting from hypoxic and/or CO exposures, increased the susceptibility to ventricular ectopy during exercise in individuals with stable angina pectoris; however, this risk was nominal for those without ectopy. 26 refs., 1 fig., 2 tabs.

  1. A Case of Hereditary Leiomyomatosis and Renal Cell Carcinoma

    PubMed Central

    Mehrtens, Sarah; Veitch, David; Kulakov, Elizabeth; Perrett, Conal M.

    2016-01-01

    A 49-year-old lady presented with multiple recurring painful lesions over her thighs, arms, and back. Past medical history included a left sided nephrectomy for renal cell carcinoma and a hysterectomy for multiple uterine fibroids (leiomyomas). Histopathological examination revealed changes consistent with pilar leiomyomas. Gene mutation analysis confirmed a diagnosis of hereditary leiomyomatosis and renal cell carcinoma. Hereditary leiomyomatosis and renal cell carcinoma is an uncommon autosomal dominant condition characterised by the concurrent presentation of cutaneous and uterine leiomyomas. Renal cell carcinoma associated with this condition is more aggressive and a significant cause of mortality. Due to this association with potentially fatal renal cell carcinoma we felt that it was important to highlight this case with an update on pathophysiology and management. PMID:27144040

  2. BCG-related renal granulomas managed conservatively: A case series

    PubMed Central

    Al-Qaoud, Talal; Brimo, Fadi; Aprikian, Armen G.; Andonian, Sero

    2015-01-01

    Introduction: The aim of this case series is to present two cases of renal granulomas discovered incidentally post-intravesical Bacillus Calmette-Guerin (BCG) installations and were managed conservatively. Case reports: The first case is a 68-year-old man with bladder and right ureteral orifice carcinoma in situ. After transurethral resection of the right ureteral orifice and bladder tumours, he received 6 + 3 weekly intravesical installations of BCG and then 6 + 3 weekly intravesical installations of BCG with interferon alpha (IFN) in the presence of an indwelling ureteral stent since he had refused cystoprostatectomy. At the 18-month follow-up, his computed tomography scan showed two right renal masses. Biopsy demonstrated non-necrotizing granulomatosis. Serial follow-up with imaging studies showed complete resolution of these masses without anti-tuberculous medications. The second case is a 74-year old man with left renal high-grade papillary urothelial carcinoma. After ureteral meatotomy and insertion of indwelling ureteral stents, he received 6 weekly intravesical installations of BCG followed by 3 weekly installations of BCG and IFN prior to the definitive management with laparoscopic left nephroureterectomy. Final pathology showed pT1 urothelial carcinoma and an incidental finding of BCG-related renal granulamotosis. The patient has been asymptomatic and did not require anti-tuberculous medications. Conclusions: While these two cases demonstrate the ability of intravesical BCG to reach the renal pelvis, patients with a history of intravesical BCG with incidental renal masses may benefit from renal biopsy. These renal granulomas may resolve without anti-tuberculous medications. PMID:26085879

  3. Two papillary renal cell carcinomas of different origin following renal transplantation (Case report).

    PubMed

    Gerth, Hans-Ulrich; Pohlen, Michele; Thoennissen, Nils-Heinrich; Suwelack, Barbara; Pavenstädt, Hermann-Josef; Störkel, Stefan; Abbas, Mahmoud; Spieker, Tilmann; Thölking, Gerold

    2012-07-01

    Papillary renal cell carcinoma (PRCC) is a rare malignant tumor entity compared to common clear cell renal carcinoma. In the present study, we report a patient who was diagnosed with PRCC twice and successfully treated each time following renal transplantation. The first PRCC was located in the left native kidney two years following transplantation, and the second PRCC was diagnosed in the allograft 13 years following transplantation. The two tumors were completely removed by surgery in stage I of the disease with sufficient conservation of the allograft function. Notably, the tumors had a different origin as indicated by the microsatellite analysis, which reflects the exceptional course of the case. Risk factors for PRCC were identified in our patient. We concluded that high-risk candidates for malignancies in renal transplant recipients should receive shorter ultrasonic screening intervals, which may facilitate early tumor detection and improve outcome rates. PMID:22807965

  4. [A new case of pseudotumoral renal tuberculosis].

    PubMed

    Sarf, I; Dahami, Z; Dakir, M; Aboutaeib, R; el Moussaoui, A; Joual, A; El Mrini, M; Meziane, F; Benjelloun, S

    2001-01-01

    The incidence of urogenital tuberculosis is still frequent and constitutes a current public health problem in Morocco, a country in which tuberculosis is endemic. The clinical presentation of this form of the disease may be misleading. The pseudotumoral type of renal tuberculosis is extremely uncommon, and in this study this disease has been described in a young patient. The radiological findings suggested the possibility of this lesion being renal cancer. The preliminary diagnosis was corrected and a definitive diagnosis of pseudotumor was made following pathological examination of the surgically-removed kidney. PMID:11233318

  5. Acute renal failure following oxalic acid poisoning: a case report

    PubMed Central

    2012-01-01

    Oxalic acid poisoning is being recognized as an emerging epidemic in the rural communities of Sri Lanka as it is a component of locally produced household laundry detergents. Herein we describe a case of a 32 year old female, presenting after direct ingestion of oxalic acid. She then went on to develop significant metabolic acidosis and acute renal failure, requiring dialysis. Renal biopsy revealed acute tubulointerstitial nephritis associated with diffuse moderate acute tubular damage with refractile crystals in some of the tubules. The patient symptomatically improved with haemodialysis and renal functions subsequently returned to normal. PMID:22978510

  6. Spectrum of renal involvement in hematolymphoid neoplasms: Renal biopsy findings of 12 cases

    PubMed Central

    Vankalakunti, M.; Rohan, A.; Vishwanath, S.; Rampure, S.; Bonu, R.; Babu, K.; Ballal, H. S.

    2015-01-01

    Spectrum of causes for renal dysfunction in patients with hematolymphoid malignancy (excluding plasma cell dyscrasia) is varied. A retrospective evaluation of “native” renal biopsies referred to our institute during the period from January 2010 to December 2013 revealed 12 cases. Age ranged between 7 and 69 (median 54.5) years. All patients were males. The neoplasms included non-Hodgkin lymphoma, chronic lymphocytic leukemia, acute lymphoblastic leukemia, Burkitt's lymphoma, intravascular lymphoma, Hodgkin lymphoma and chronic myeloid leukemia. Proteinuria was noted in 66% of the patients (nephrotic range in 5, subnephrotic range in 3). Renal insufficiency was noted in 100% patients. Malignancy-related kidney injury was noted in 75% of the cases. Renal histology showed lymphomatous infiltration (8), membranoproliferative glomerulonephritis (MPGN) (3), intracapillary monoclonal deposit disease (1) and intravascular lymphoma (1). Distribution of lymphomatous infiltration was diffuse in 50% and focal in 50%. We observed that renal dysfunction was predominantly a direct effect, that is, lymphomatous invasion. Paraneoplastic glomerulopathic changes occur in the form of MPGN. Proteinuria of >2 g/day correlated with glomerular disease. PMID:26199470

  7. Renal Sinus Lipomatosis in Transplanted Kidneys: An Unusual Clinical Case

    PubMed Central

    Apicella, Luca; Vallone, Gianfranco; Vitale, Sossio; Garofalo, Gianluca; Russo, Luigi; Gallo, Riccardo; Federico, Stefano; Sabbatini, Massimo

    2011-01-01

    Renal sinus lipomatosis (RSL) represents an abnormal proliferation of the adipose tissue surrounding the renal pelvis of uncertain origin, associated with aging, obesity, steroid excess, infections, and calculosis. It represents a rare complication in transplanted kidneys, and, despite the accurate and prolonged radiological followup of transplanted organs, only a few cases of RSL have been described in graft recipients, with no remarkable effects on renal function. The diagnosis relies on ultrasonography (US), magnetic resonance imaging (MRI), computed tomography (CT), and, finally, percutaneous biopsy. We describe the case of an extensive RSL in a 38-year-old renal transplant recipient, diagnosed by ultrasonography and computed tomography. The patient underwent a radiologic study because of an acute, asymptomatic renal impairment, that led to the diagnosis of a RSL of unusual dimensions, associated with a discrete hydronephrosis. Paradoxically, after a short course of steroids, the recovery of renal function and the partial resolution of calyceal dilatation were observed. The rarity of this affection, the need of a differential diagnosis with fat-containing tumors, and the possibility of parenchymal inflammation associated with RSL, potentially responsive to steroids, are also discussed. PMID:23213599

  8. A case of recurrent renal aluminum hydroxide stone.

    PubMed

    Cakıroglu, Basri; Dogan, Akif Nuri; Tas, Tuncay; Gozukucuk, Ramazan; Uyanik, Bekir Sami

    2014-01-01

    Renal stone disease is characterized by the differences depending on the age, gender, and the geographic location of the patients. Seventy-five percent of the renal stone components is the calcium (Ca). The most common type of the stones is the Ca oxalate stones, while Ca phosphate, uric acid, struvite, and sistine stones are more rarely reported. Other than these types, triamterene, adenosine, silica, indinavir, and ephedrine stones are also reported in the literature as case reports. However, to the best of our knowledge, aluminum hydroxide stones was not reported reported before. Herein we will report a 38-years-old woman with the history of recurrent renal colic disease whose renal stone was determined as aluminum hydroxide stone in type. Aluminum mineral may be considered in the formation of kidney stones as it is widely used in the field of healthcare and cosmetics. PMID:25013740

  9. Renal

    MedlinePlus

    ... term "renal" refers to the kidney. For example, renal failure means kidney failure. Related topics: Kidney disease Kidney disease - diet Kidney failure Kidney function tests Renal scan Kidney transplant

  10. Bilateral hip arthritis in a case of renal osteodystrophy

    PubMed Central

    Vaishya, Raju; Nyokabi, David Ndegwa; Vaish, Abhishek

    2014-01-01

    Chronic renal disease is often associated with secondary hyperparathyroidism (HPP) and rarely with tertiary HPP. Hip arthritis with protrusio acetabuli, secondary to tertiary HPP, is a rare case scenario and has not been described well in the literature. We present a rare case of bilateral hip arthritis with protrusio acetabuli secondary to renal osteodystrophy due to tertiary HPP. The diagnosis and aetiology of hip arthritis and its treatment have been discussed along with a detailed review of literature of skeletal lesions due to HPP. PMID:24554674

  11. Renal metastasis from cervical carcinoma presenting as a renal cyst: A case report

    PubMed Central

    FAN, GANG; XIE, YU; PEI, XIAMING; LEI, JIAN; YE, MINGJI; ZENG, GONGQIAN; LI, FEIPING; XIONG, YINGYING; HAN, WEIQIN

    2015-01-01

    In the present study, the case of a 51-year-old female with a metastatic tumor in the left kidney originating from cervical carcinoma, is reported. The patient had undergone chemoradiotherapy for stage IIB squamous-cell carcinoma of the uterine cervix 3 years earlier. Computed tomography (CT) identified low-density left renal nodules, which were diagnosed post-operatively as renal cysts during the follow-up conducted 2 years later. The next year, the patient was admitted to the Hunan Provincial Tumor Hospital (The Affiliated Tumor Hospital of Xiangya Medical College, Central South University, Changsha, Hunan, China) with a fever of unknown origin, left-sided flank pain and hematuria. CT examination detected irregular low-density nodules in the left kidney and heterogeneous enhancement on enhanced CT. Subsequently, the patient was subjected to a nephrectomy. Post-surgical analysis of subsequent biopsies indicated kidney tumor metastasis originating from cervical carcinoma. Renal metastases are rare in patients with cervical carcinoma. The present study reported a case of renal metastasis originating from cervical carcinoma and also reviewed previous case reports on patients presenting with this unusual type of cancer. PMID:26722238

  12. [Case of renal subcapsular hematoma caused by flexible transurethral lithotripsy].

    PubMed

    Watanabe, Ryuta; Inada, Kouji; Azuma, Kouji; Yamashita, Yokihiko; Oka, Akihiro

    2013-09-01

    A 39-year-old man with macroscopic hematuria was admitted to our hospital. A stone, 5 mm in diameter was detected in the right ureteropelvic junction after abdominal computed tomography and plain abdominal radiography. We performed flexible transurethral lithotripsy (f-TUL) and crushed the stone and extracted almost all stone fragments without any complications. However, almost immediately after the operation, the patient began to complain about pain in the right back. In the results of abdominal plain computed tomography right renal subcapsular hematoma was detected. Because active bleeding was not observed in the results of enhanced computed tomography, only conservative treatment was performed. The patient was discharged from the hospital on day 11 of hospitalization. One month after the operation, plain computed tomography was performed and diminished subcapsular hematoma was detected. Renal subcapsular hematoma is assumed to be a unique complication of extracorporeal shock wave lithotripsy. This is the first report of a case of renal subcapsular hematoma caused by f-TUL. The onset of renal subcapsular hematoma following f-TUL could have been caused either because the laser fiber thrust into the renal lithiasis unintentionally or because the internal pressure of the renal pelvis increased substantially during the operation. PMID:24113753

  13. MURCS (Müllerian duct aplasia–renal agenesis–cervicothoracic somite dysplasia): a rare cause of primary amenorrhoea

    PubMed Central

    Kumar, Sunil; Sharma, Shruti

    2016-01-01

    The agenesis of the Müllerian duct is the second most common cause of primary amenorrhoea after Turner syndrome. The abnormal development of Müllerian duct often associates with the urinary tract and skeletal abnormalities. MURCS (Müllerian duct aplasia–renal agenesis–cervicothoracic somite dysplasia) association is a unique and rare developmental disorder with four common features of uterine hypoplasia or aplasia, renal agenesis or ectopy, vertebral anomalies and short stature. We report a case of young female with primary amenorrhoea. She had well-developed secondary sexual characteristics along with multiple congenital developmental abnormalities such as the absence of uterus, ectopic kidney, cervical vertebral fusion, hemivertebrae, scoliosis, cervical rib, facial asymmetry and growth retardation. Our case highlights the rarity and clinical importance of this syndrome. For the evaluation of primary amenorrhoea in a female with well-developed secondary sexual characteristics, congenital anomalies should be ruled out before hormone and karyotype analyses. PMID:27099773

  14. MURCS (Müllerian duct aplasia-renal agenesis-cervicothoracic somite dysplasia): a rare cause of primary amenorrhoea.

    PubMed

    Kumar, Sunil; Sharma, Shruti

    2016-04-01

    The agenesis of the Müllerian duct is the second most common cause of primary amenorrhoea after Turner syndrome. The abnormal development of Müllerian duct often associates with the urinary tract and skeletal abnormalities. MURCS (Müllerian duct aplasia-renal agenesis-cervicothoracic somite dysplasia) association is a unique and rare developmental disorder with four common features of uterine hypoplasia or aplasia, renal agenesis or ectopy, vertebral anomalies and short stature. We report a case of young female with primary amenorrhoea. She had well-developed secondary sexual characteristics along with multiple congenital developmental abnormalities such as the absence of uterus, ectopic kidney, cervical vertebral fusion, hemivertebrae, scoliosis, cervical rib, facial asymmetry and growth retardation. Our case highlights the rarity and clinical importance of this syndrome. For the evaluation of primary amenorrhoea in a female with well-developed secondary sexual characteristics, congenital anomalies should be ruled out before hormone and karyotype analyses. PMID:27099773

  15. Antenatal diagnosis of renal duplication by ultrasonography: report on four cases at a referral center.

    PubMed

    Queiroga, Edward Enéas D; Martins, Marília G; Rios, Lívia T; Araujo Júnior, Edward; Oliveira, Ricardo V; Nardozza, Luciano M; Moron, Antonio F

    2013-01-01

    Duplication of the renal collecting system is the commonest major congenital malformation of the urinary tract, with an incidence of 1% among live births. Antenatal diagnosing of renal duplication and an associated ureterocele is infrequent. We report four cases of prenatally diagnosed unilateral duplication of the renal collecting system. In two of them, the renal duplication was associated with an ectopic ureterocele. PMID:24469664

  16. Rare case of thoracic kidney detected by renal scintigraphy.

    PubMed

    Natarajan, Aravintho; Agrawal, Archi; Purandare, Nilendu; Shah, Sneha; Rangarajan, Venkatesh

    2016-01-01

    Intrathoracic kidney is a rare congenital abnormality with lowest frequency among all renal ectopias. Patients with thoracic kidneys are usually asymptomatic, and the condition is usually discovered incidentally during radiological evaluation for other conditions or during thoracic surgery. We report a case of a 62-year-old male who was referred to our department for renal scintigraphy for a nonvisualized left kidney on ultrasonography report. Both Tc-99m dimercaptosuccinic acid and diethylenetriaminepentaacetic acid scans revealed a left thoracic kidney which was confirmed by CT scan of the thorax and abdomen. PMID:27385896

  17. Rare case of thoracic kidney detected by renal scintigraphy

    PubMed Central

    Natarajan, Aravintho; Agrawal, Archi; Purandare, Nilendu; Shah, Sneha; Rangarajan, Venkatesh

    2016-01-01

    Intrathoracic kidney is a rare congenital abnormality with lowest frequency among all renal ectopias. Patients with thoracic kidneys are usually asymptomatic, and the condition is usually discovered incidentally during radiological evaluation for other conditions or during thoracic surgery. We report a case of a 62-year-old male who was referred to our department for renal scintigraphy for a nonvisualized left kidney on ultrasonography report. Both Tc-99m dimercaptosuccinic acid and diethylenetriaminepentaacetic acid scans revealed a left thoracic kidney which was confirmed by CT scan of the thorax and abdomen. PMID:27385896

  18. [Distal renal tubular acidosis: report of 3 cases].

    PubMed

    Guibaud, P; Parchoux, B; Langue, J; Bouissou, F; Barthe, P; Larbre, F

    1979-06-01

    Three observations of R.T.A. with nerve deafness are reported. Case 1 and 2 concern consanguinous brothers whose parents are not affected, which confirm the syndrom as an autosomal recessive entity. The third, sporadic, case relates to a 13-year-old non consanguinous girl. Metabolic abnormalities and renal evolution with nephrocalcinosis was such as in Albright disease. However a progressive nerve deafness makes distinction. The authors underline the importance of this sometimes difficult distinction for genetic counseling. PMID:541679

  19. Renal squamous cell carcinoma mimicking xanthogranulomatous pyelonephritis: Case report and review of literature.

    PubMed

    Khoo, Hau Wei; Lee, Chau Hung

    2016-06-01

    Primary renal squamous cell carcinoma (SCC) is a rare primary malignancy of the kidney. Diagnosis is usually delayed because of its lack of characteristic clinical and imaging features and inherent aggressive nature. We present a case of primary renal SCC in a 66-year-old woman with bilateral renal calculi and a complex right lower pole renal mass. The diagnosis of primary renal SCC was established based on the histopathology after right nephrectomy. PMID:27257454

  20. Bilateral renal leiomyoma with 5 year follow-up: Case report.

    PubMed

    Goren, Mehmet Resit; Erbay, Gurcan; Ozer, Cevahir; Goren, Vinil; Bal, Nebil

    2015-01-01

    Renal leiomyomas are exceptionally rare benign tumours of the kidney. Although the renal leiomyomas usually do not metastasize, the differential diagnosis between renal leiomyomas and malign lesions (leiomyosarcoma or renal cell carcinoma) cannot be done by radiological examinations, but is possible by histological examination. Surgery is the preferred treatment. After surgery, the prognosis is excellent without recurrence. Although uterine leiomyomas can be multicentric, renal leiomyomas have been single lesions. We report an incidentally detected case of bilateral renal leiomyoma in a 50-year-old woman with a 5-year follow-up. We also review the literature and discuss clinical, radiological and histological features of renal leiomyomas. PMID:26664510

  1. A Case of Lipiduria After Arterial Embolization for Renal Angiomyolipomas

    SciTech Connect

    Ishibashi, Naoya; Mochizuki, Takao; Tanaka, Hiroshi; Okada, Yasuhiro; Kobayashi, Masaki; Takahashi, Motoichiro

    2010-06-15

    We report the case of a 31-year-old woman who suffered lipiduria after selective transcatheter arterial embolization for renal angiomyolipoma (AML). Computed tomography confirmed cystic liquefactive necrosis with fat-fluid level in AML. Although the process by which AML fat tissue excretion occurs is not clear, we speculated that the infarcted AML was connected to the urinary collection duct system and subsequently its adipose component was excreted into the urine.

  2. High-grade Neuroendocrine Carcinoma With Focal Squamous Metaplasia of Renal Pelvis Associated With Renal Calculus: Study of a Case

    PubMed Central

    Huang, Yan-Ping; Chen, Bin; Sun, Xiang-Zhou; Guo, Yan; Yang, Shi-Cong; Deng, Chun-Hua; Huang, Yi-Ran

    2014-01-01

    Mixed neuroendocrine and non-neuroendocrine type of tumor in renal pelvis is rare and presents a high-grade malignancy. We present a case report that a 57-year-old man had no history of small cell cancer but presented a high-grade neuroendocrine carcinoma with focal squamous metaplasia and multiple stones simultaneously in the right renal pelvis. The patient underwent nephroureterocystectomy 9 months before this presentation, with evidence of multiple metastatic tumors in various parts of the body. The case of mixed neuroendocrine tumor with stones in the renal pelvis carries a poor prognosis and poses a therapeutic challenge to urologists. PMID:26952913

  3. RENAL CELL CARCINOMA METASTASIS TO THE SINONASAL CAVITY: CASE REPORT.

    PubMed

    Kovačić, Marijan; Krvavica, Ana; Rudić, Milan

    2015-06-01

    Renal cell carcinoma accounts for 3% of all adult malignant tumors. Common sites of metastases are lungs, bone, liver, brain and adrenal glands. Metastatic disease to the head and neck ranges from 15% to 30%. The 5-year survival rate after nephrectomy is 60%-75%, but with multiorgan metastases the 5-year survival rate is significantly lower, 0-7%. A case is presented of a female patient diagnosed with renal cell carcinoma metastases to the paranasal sinuses, diagnosed and treated at the Department of ENT and Head and Neck Surgery, Zadar General Hospital, Zadar, Croatia. The tumor was surgically removed. Unfortunately, the patient died one year after the procedure due to multiorgan failure. Although metastases of renal cell carcinoma to the head and neck are very rare, it should be first suspected when investigating a metastatic tumor in this region. Surgical excision offers the best hope for long term survival. In case of unresectable tumor, other treatment options should be considered such as radiotherapy, immunotherapy and chemotherapy. PMID:26415321

  4. [Severe infectious keratitis in renal transplant patient: a case report].

    PubMed

    Limaiem, Rim; Mnasri, Heni; El Maazi, Abir; Ammari, Hela; Chaabouni, Afif; Mghaieth, Fatma; El Matri, Leila

    2009-07-01

    Keratitis occurring in renal transplant patients are often severe, with difficult management. We describe the case of a renal transplant patient, 44 year-old man, with history of recurrent herpetic keratitis, which developed an impending corneal perforation. Conjunctival smear showed the presence of amoebic cysts. Anti-amoebic treatment was undertaken in addition with oral aciclovir, and a therapeutic penetrating keratoplasty was performed. An ulceration of the graft occurred within five months. Ocular samples showed the presence of Candida albicans. Despite aggressive antifungal therapy, he required a second therapeutic penetrating keratoplasty for graft perforation. One month later, we noted a recurrence of the ulcer with corneal thinning which evolved to perforation. PMID:19345628

  5. [Case of obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome].

    PubMed

    Horioka, Keiko; Kataoka, Keiko; Ooishi, Hiroko; Tsunematsu, Ryousuke; Okugawa, Kaoru; Kobayashi, Hiroaki; Kato, Kiyoko

    2014-03-01

    We report the case of 23 year-old woman with OHVIRA syndrome (obstructed hemivagina and ipisilateral renal anomaly) discovered during management for right renal failure. Non-specific symptoms such as lower abdominal pain, dysmenorrhea, and genital bleeding sometimes occur with congenital uterine anomalies such as this. It is very difficult to diagnose OHVIRA syndrome accurately without ultrasound and magnetic resonance imaging, and patients can develop severe complications as a result of delays in diagnosis: endometriosis, pelvic adhesions, or infertility can occur through backflow of genital bleeding because of vaginal septum. In our patient we managed to avoid severe complications by surgically resecting the vaginal septum. She was treated within an appropriate time frame and without complications. Fortunately, after the surgery she managed to become pregnant in the left side of the uterus. PMID:25000661

  6. A Case of Metastatic Renal Cell Carcinoma Mimicking Granuloma Pyogenicum

    PubMed Central

    Jin, Won Woo; Chung, Ji Min; Jung, Kyoung Eun; Park, Jong Wook

    2008-01-01

    Renal cell carcinoma (RCC) is well known for its frequent metastasis and particularly to the lungs, liver, bones and brain, but metastasis to the skin is rare. We report here on a case of metastatic RCC in a 73-year-old man who presented with a 1.5 cm sized, moist, beefy-red and exophytic nodule on the scalp. The lesion had grown rapidly for 2 months and it clinically mimicked granuloma pyogenicum. A skin biopsy revealed a solid mass composed of clear cells with clear cytoplasm and oval hyperchromatic nuclei, and they were arranged in an alveolar pattern. As skin metastasis from renal cell carcinoma signals widespread systemic metastasis and a poor prognosis, clinicians should conduct a careful inspection of the skin of a patient with RCC and they should also have a high index of suspicion for finding a primary internal organ malignancy in the RCC patients who present with a skin lesion. PMID:27303209

  7. Diagnostic use of angiotensin converting enzyme (ACE)-inhibited renal scintigraphy in the identification of selective renal artery stenosis in the presence of multiple renal arteries: A case report

    SciTech Connect

    Morton, K.A.; Rose, S.C.; Haakenstad, A.O.; Handy, J.E.; Scuderi, A.J.; Datz, F.L. )

    1990-11-01

    In patients with renovascular hypertension, it is unknown whether the angiotensin converting enzyme-(ACE) inhibited renal scan will identify stenosis of a segmental branch of a single renal artery or of an accessory artery where multiple renal arteries are present. Since multiple renal arteries may be present in approximately 25% of all individuals, it will be important to establish whether the ACE-inhibited renal scan is useful in this population. We report a case of stenosis involving a renal artery in a patient with multiple renal arteries, successfully identified by ACE-inhibited renal scintigraphy.

  8. Renal tuberculosis and iliopsoas abscess: Two case reports

    PubMed Central

    WEI, HONG-LAN; WANG, LEI; DU, XING-GUO; WU, YANG; LI, HUA; CAI, YUAN; SONG, XIAO-HONG; LI, CHENG-XU; DONG, LI-PING; LIU, ZHI-FEN; ZHAO, XIA; DONG, JUN-WU

    2014-01-01

    The urinary system is the second most commonly affected site of extrapulmonary tuberculosis (TB). Due to the diverse and atypical clinical manifestations of urinary TB, the disease is easy to misdiagnose. In the present study, two cases of renal TB are reported, which had completely different clinical manifestations. The first case is a female who presented with loin pain and fever. Purified protein derivative (PPD) and TB antibody tests were negative and computed tomography (CT) scans showed a low density focus in the right kidney with an iliopsoas abscess. The typical CT findings indicated renal tuberculosis. Anti-TB drugs were effective proved the diagnosis. The second case is a male who presented with intermittent gross hematuria. Acid-fast bacilli in urine and TB antibody tests were positive. CT scans revealed a low density focus in the unilateral kidney with a slight expansion of the pelvis, calices and ureter. The patients were treated with the anti-TB drugs and the clinical manifestations disappeared. The diagnosis of urinary TB is challenging in certain cases; when there is no response to the usual antibiotics in patients with fever or gross hematuria, TB should be suspected. CT is the mainstay for investigating possible urinary TB. PMID:24926373

  9. CT and MRI Findings in a Rare Case of Renal Primitive Neuroectodermal Tumor

    PubMed Central

    Akkaya, Zehra; Peker, Elif; Gulpinar, Basak; Karadag, Hale; Erden, Ayse

    2016-01-01

    Summary Background Primary renal primitive neuroectodermal tumor/extraskeletal Ewing’s sarcoma (PNET/EES) is a very rare renal tumor. Case Report We report a case of primary renal PNET/EES of the kidney in an adult patient and describe its computed tomography and magnetic resonance imaging findings, including diffusion weighted images along with a review of the current medical literature. Conclusions Although very rare, a relatively large renal mass which shows very infiltrative growth pattern on CT and MR imaging and striking diffusion restriction should raise the suspicion of a renal primitive neuroectodermal tumor, in a young adult.

  10. Renal stone in crossed fused renal ectopia and its laparoscopic management: Case report and review of literature

    PubMed Central

    Agrawal, Santosh; Chipde, Saurabh Sudhir; Kalathia, Jaisukh; Agrawal, Rajeev

    2016-01-01

    Management of renal stone in crossed fused renal ectopia (CFRE) is difficult because of abnormal location, malrotation, and its relations with vertebral column and small bowel. Management is not standardized because of the paucity of literature and variable anatomy. We managed an 8-year-old boy with multiple renal stones in right side crossed kidney by laparoscopic pyelolithotomy and nephro pyeloscopy with the help of ureteroscope. Until now, there is only one prior report of laparoscopic pyelolithotomy in CFRE. We share our experience in this case and review the literature regarding the management of kidney stones in this rare anomaly. PMID:27141201

  11. Renal stone in crossed fused renal ectopia and its laparoscopic management: Case report and review of literature.

    PubMed

    Agrawal, Santosh; Chipde, Saurabh Sudhir; Kalathia, Jaisukh; Agrawal, Rajeev

    2016-01-01

    Management of renal stone in crossed fused renal ectopia (CFRE) is difficult because of abnormal location, malrotation, and its relations with vertebral column and small bowel. Management is not standardized because of the paucity of literature and variable anatomy. We managed an 8-year-old boy with multiple renal stones in right side crossed kidney by laparoscopic pyelolithotomy and nephro pyeloscopy with the help of ureteroscope. Until now, there is only one prior report of laparoscopic pyelolithotomy in CFRE. We share our experience in this case and review the literature regarding the management of kidney stones in this rare anomaly. PMID:27141201

  12. Tubulocystic renal cell carcinoma: Report of a rare case

    PubMed Central

    Kakkar, Aanchal; Sharma, Mehar C.; Uppal, Manpreet; Chumber, Sunil

    2015-01-01

    Cystic neoplasms of the kidney are rare, and present a unique diagnostic challenge. We report the case of an elderly male who presented with a large cystic neoplasm, which was a diagnostic dilemma clinically and radiologically. Histopathological examination showed a tumour composed of variably sized tubules lined by atypical cells having large round nuclei with prominent nucleoli. Hobnailing was seen at places. Tumour cells were immunopositive for pancytokeratin, vimentin, CD10, CK19 and AMACR, confirming a diagnosis of tubulocystic renal cell carcinoma (TC-RCC). PMID:26425234

  13. Tubulocystic renal cell carcinoma: Report of a rare case.

    PubMed

    Kakkar, Aanchal; Sharma, Mehar C; Uppal, Manpreet; Chumber, Sunil

    2015-01-01

    Cystic neoplasms of the kidney are rare, and present a unique diagnostic challenge. We report the case of an elderly male who presented with a large cystic neoplasm, which was a diagnostic dilemma clinically and radiologically. Histopathological examination showed a tumour composed of variably sized tubules lined by atypical cells having large round nuclei with prominent nucleoli. Hobnailing was seen at places. Tumour cells were immunopositive for pancytokeratin, vimentin, CD10, CK19 and AMACR, confirming a diagnosis of tubulocystic renal cell carcinoma (TC-RCC). PMID:26425234

  14. Ex vivo reconstruction of the donor renal artery in renal transplantation: a case-control study.

    PubMed

    McLoughlin, Louise C; Davis, Niall F; Dowling, Catherine M; Power, Richard E; Mohan, Ponnusamy; Hickey, David P; Smyth, Gordon P; Eng, Molly M P; Little, Dilly M

    2014-05-01

    Transplantation of renal allografts with anatomic variability or injured vasculature poses a challenge to the transplanting surgeon but can be salvaged for transplantation with ex vivo bench reconstruction of the vasculature. We investigated whether renal allograft function is impaired in these reconstructed allografts; compared to the donor-matched, un-reconstructed allograft. Reconstructed allografts were transplanted into 60 patients at our institution between 1986 and 2012. A control group was selected from the matched pair of the recipient in deceased donor transplantation. We found no significant difference in the overall graft and patient survival rates (P = 1.0, P = 0.178). Serum creatinine levels were not significantly higher in the study group at 1, 3 and 12 months postoperatively. There were two cases of vascular thrombosis in the study group that were not related to the ex vivo reconstruction. A significantly greater proportion of reconstructed patients were investigated with a colour duplex ultrasound postoperatively (0.007). Although we have demonstrated a higher index of suspicion of transplant failure in patients with a reconstructed allograft, this practice has proven to be a safe and useful technique with equivocal outcome when compared to normal grafts; increasing the organ pool available for transplantation. PMID:24851246

  15. A case of bilateral renal arterial thrombosis associated with cryocrystalglobulinaemia

    PubMed Central

    Leung, Nelson; Buadi, Francis K.; Song, Kevin W.; Magil, Alexander B.; Cornell, Lynn D.

    2010-01-01

    Cryocrystalglobulinaemia is an extremely rare complication of monoclonal gammopathy. Its presentation has features of both type I and II cryoglobulinaemia. Although peripheral and digital ischaemia is common, visceral ischaemia is rare. When it does occur, it is usually associated with multiple myeloma and has an extremely poor prognosis. We present a case of bilateral renal artery thrombosis associated with cryocrystalglobulinaemia in a patient without myeloma. More unusual, the cryocrystal protein in this case was associated with fibrinogen, which may have led to increased propensity towards thrombosis. Although the patient was unable to recover his kidney function, he remained alive on dialysis 2 years after the incident. The patient did not have any further ischaemic event despite no definitive therapy. This case represents an unusual presentation for this rare disease. PMID:25949411

  16. Retrocaval ureter and contra lateral renal agenesis – a case report and review of literature

    PubMed Central

    Cardoza, Felix; Shambhulinga, C. K.; Rajeevan, A. T.

    2016-01-01

    ABSTRACT Associated congenital anomalies are seen in 21% of retrocaval ureter patients; among them, associated contralateral renal agenesis is a very rare entity. We report one such case of right circumcaval ureter with left renal agenesis, diagnosed after febrile UTI. Surgical correction with uretero-ureterostomy was successful. In literature very few such cases are reported and only one case with renal failure was reported. Unilateral renal agenesis cases complicated by associated such anomalies need definitive management and lifelong clinical monitoring to diagnose and prevent chronic kidney disease. PMID:27564299

  17. Retrocaval ureter and contra lateral renal agenesis - a case report and review of literature.

    PubMed

    Cardoza, Felix; Shambhulinga, C K; Rajeevan, A T

    2016-01-01

    Associated congenital anomalies are seen in 21% of retrocaval ureter patients; among them, associated contralateral renal agenesis is a very rare entity. We report one such case of right circumcaval ureter with left renal agenesis, diagnosed after febrile UTI. Surgical correction with uretero-ureterostomy was successful. In literature very few such cases are reported and only one case with renal failure was reported. Unilateral renal agenesis cases complicated by associated such anomalies need definitive management and lifelong clinical monitoring to diagnose and prevent chronic kidney disease. PMID:27564299

  18. Pulmonary Renal Syndrome After Streptococcal Pharyngitis: A Case Report.

    PubMed

    Mara-Koosham, Gopi; Stoltze, Karl; Aday, Jeffrey; Rendon, Patrick

    2016-01-01

    Pulmonary renal syndrome is a class of small vessel vasculitides that are characterized by the dual presentation of diffuse alveolar hemorrhage (DAH) and glomerulonephritis. Pulmonary renal syndrome has multiple etiologies, but its development has been rarely reported following infection with group A streptococcus. We present the case of a 36-year-old Native American male who was transferred to our facility due to refractory hypoxic respiratory failure. He had been diagnosed with streptococcal pharyngitis 2 weeks prior to admission. Given the presence of hemoptysis, bronchoscopy was performed and was consistent with DAH. Urinalysis demonstrated hematuria and proteinuria, in the setting of elevated creatinine and blood urea nitrogen. Additionally, antistreptolysin O titer was positive. Given the constellation of laboratory findings and history of streptococcal pharyngitis, the patient was diagnosed with PRS secondary to streptococcal infection. High-dose methylprednisolone was initiated with concomitant plasmapheresis. He was extubated successfully after his respiratory status improved and was eventually discharged home after making a full recovery within 2 weeks after admission. This case illustrates the importance of clinically relevant sequelae of streptococcal infection as well as the appropriate treatment of PRS secondary to streptococcal pharyngitis with plasmapheresis and intravenous corticosteroids. PMID:27231692

  19. Massive renal urothelial carcinoma with renal vein tumor thrombus, pancreatic infiltration and adrenal metastasis: A case report

    PubMed Central

    Li, Tao; Gao, Liang; Wu, Weilu; Chen, Peng; Bu, Siyuan; Wei, Qiang; Yang, Lu

    2016-01-01

    A 49-year-old female patient presented with a massive left renal tumor, recurrent left flank pain and gross hematuria. The tumor was accompanied by a renal vein tumor thrombus, pancreatic infiltration and a solitary adrenal metastasis. Radical nephrectomy, distal pancreatectomy, ipsilateral adrenalectomy and splenectomy were performed. Histopathological examination suggested high-grade urothelial carcinoma (UC); however, tumor recurrence and multiple metastases were detected only 3 months after the surgery, and the patient succumbed during follow-up 1 month later. To the best of our knowledge, this is the first case of renal UC of such advanced stage with renal vein tumor thrombus, pancreatic infiltration and a solitary adrenal metastasis. PMID:27446406

  20. Transperitoneal laparoscopic right radical nephrectomy for renal cell carcinoma and end-stage renal disease: a case report

    PubMed Central

    2009-01-01

    Nephron-sparing surgery (partial nephrectomy) results are similar to those of radical nephrectomy for small (<4 cm) renal tumors. However, in patients with end-stage renal disease, radical nephrectomy emerges as a more efficient treatment for localized renal cell cancer. Laparoscopic radical nephrectomy (LRN) increasingly is being performed. The objective of the present study was to present a case of a patient under hemodialysis who was submitted to LRN for a small renal mass and discuss the current issues concerning this approach. It appears that radical nephrectomy should be the standard treatment in dialysis patients even for small tumors. The laparoscopic technique is associated with acceptable cancer-specific survival and recurrence rate along with shorter hospital stay, less postoperative pain and earlier return to normal activities. PMID:20062705

  1. Usefulness of selective renal artery embolization for urinary fistula following partial nephrectomy: Two case reports

    PubMed Central

    NOHARA, TAKAHIRO; MATSUYAMA, SATOKO; KAWAGUCHI, SHOHEI; MIYAGI, TOHRU; SETO, CHIKASHI; MOCHIZUKI, KENTARO

    2016-01-01

    The present study reported two cases in which selective artery embolization were identified to assist in resolving urinary fistulae following partial nephrectomies. The first case involved a 51-year-old male who received a mini-incision partial nephrectomy with renorrhaphy. Following the operation, urine continued to discharge from the retroperitoneal drain. Selective renal artery embolization of the upper calyx at post-operation day 20 was highly effective and urine output from the drain stopped immediately. Case 2 involved a 66-year-old male, who also suffered from a urinary fistula following a partial nephrectomy. Selective renal artery embolization performed at post-operation day 21 was again effective. In each case, the upper calyx was separated from the renal pelvis. These cases demonstrated that suturing of the collecting system and renal parenchyma may result in the separation of the urine pathway, and that selective renal artery embolization appears to be a highly effective treatment in such cases.

  2. A Rare Case of Renal Infarct due to Noncompaction Cardiomyopathy: A Case Report and Literature Review

    PubMed Central

    Chen, On; Uppal, Nupur Nippun; Batul, Syeda Atiqa; Moskovits, Norbert; Shetty, Vijay; Shani, Jacob

    2016-01-01

    Left ventricular noncompaction cardiomyopathy is a rare myocardial disorder which results from failure of left ventricle to compact in embryogenesis. We present a case of a 53-year-old female who came because of abdominal pain and was found to have renal infarct secondary to noncompaction cardiomyopathy. PMID:27022488

  3. Magnesium deficiency may be an important determinant of ventricular ectopy in digitalised patients with chronic atrial fibrillation.

    PubMed Central

    Lewis, R; Durnin, C; McLay, J; McEwen, J; McDevitt, D G

    1991-01-01

    Digitalised patients with chronic atrial fibrillation (AF) have a high prevalence of ventricular premature beats (VPB); magnesium deficiency may be a contributory factor. We have used a magnesium loading-test to examine the relationship between ventricular ectopy and magnesium status in 14 digitalised patients with chronic AF. Among seven patients with infrequent VPB (less than 250 24 h-1; mean 107 24 h-1) mean magnesium retention was 10.1% and four subjects retained no significant quantities of magnesium, indicating magnesium repletion. Among the remaining seven patients, mean magnesium retention was significantly higher (33.1%, P less than 0.02) and all patients retained 20% or more of the load given. There was an overall relationship between Mg retention and numbers of VPB (rs = 0.54; P less than 0.05). Magnesium deficiency may be determinant of ventricular ectopy in digitalised patients with chronic AF. PMID:1710915

  4. Idiopathic renal replacement lipomatosis: a case report and review of literature.

    PubMed

    Shah, Vinaya B; Rupani, Asha B; Deokar, Madhavi S; Pathak, Hemant R

    2009-01-01

    Idiopathic renal replacement lipomatosis is a rare condition in which the renal parenchyma, especially the renal sinus is replaced with adipose tissue with increase in perirenal fat. We report a case of renal replacement lipomatosis presenting as a renal mass clinically. The computed tomography scan revealed low density and nodular masses of adipose tissue within the renal parenchyma. The differential diagnosis before surgery was angiomyolipoma, lipoma, and xanthogranulomatous pyelonephritis. After the histological examination and extensive literature search, the diagnosis of renal replacement lipomatosis was made. It is a rare entity and may be missed if not considered due to lack of experience, so we hope that more urologists, radiologists, and pathologists become aware of this entity and recognize it. PMID:19805971

  5. [Crossed renal ectopia with fusion: report of two cases and review of the literature].

    PubMed

    Oliveira, Claudia Maria Costa de; Santos, Daniela Costa de Oliveira; Gomes, Diego Morais; Choukroun, Gabriel; Kubrusly, Marcos

    2012-01-01

    Renal ectopia is one of the most common renal abnormalities of kidney development. However, only a few cases of crossed fused renal ectopia have been reported in the literature. Although crossed renal ectopia is usually clinically silent, they is sometime responsible for infection and urinary stones and may be associated with a high incidence of ureteropelvic junction obstruction, vesicoureteral reflux and renal multicystic dysplasia. We report two new cases of crossed renal ectopia with fusion diagnosed in a context of kidney stones and urinary tract infection and review the mechanism and clinical features of this abnormality. We believe that Nephrologist must be familiar with this abnormality of kidney development, as a number of complications may appear during follow-up. PMID:23099835

  6. A case of anorexia nervosa with acute renal failure resulting from rhabdomyolysis.

    PubMed

    Abe, K; Mezaki, T; Hirono, N; Udaka, F; Kameyama, M

    1990-01-01

    Symptoms of acute renal failure were observed in an anorexia patient who had a history of frequent vomiting. The acute renal failure might have resulted from rhabdomyolysis subsequent to a disturbance of electrolyte balance. This acute renal failure might have resulted in death if not treated. We postulate that even a mild case of anorexia nervosa should be carefully observed to prevent such possible tragedy. PMID:2330820

  7. [Primary vesico-uretero-renal reflux in adults: therapeutic outcome. Apropos of 68 cases].

    PubMed

    Desgrez, J P; Baaklini, J; Ba, M; Verges, J

    1984-02-01

    The authors compare two series of adult patients presenting with primary vesico-uretero-renal reflux. The first series was treated before 1974, and the second, over the past ten years. The salient feature of this comparison is the reduction in the number of renal failures. More systematic investigation of the reflux highlights a greater number of cases which will evolve without further impairment of renal function. This point has a considerable bearing on operative indications. PMID:6529197

  8. Hypercalcemia and renal failure in the course of sarcoidosis--case report.

    PubMed

    Kempisty, Anna; Kuś, Jan

    2012-01-01

    Disturbances of calcium metabolism such as hypercalcemia or/and hypercalciuria in the course of sarcoidosis can be a cause of renal failure in some patients. Life threatening hypercalcemia in sarcoidosis patients is not very frequent. Severe hypercalcemia leading to renal insufficiency is a very rare condition. We present a case of 53-year old man who was admitted to Department of Lung Diseases because of hypercalcemic syndrome and renal failure, and in whom diagnosis of sarcoidosis was made. He was successfully treated with systemic corticosteroids. In this article we present physiological mechanism of hypercalcemia in sarcoidosis patients, mechanism of renal damage and management of these difficult problems. PMID:23109211

  9. Atypical presentations and rare metastatic sites of renal cell carcinoma: a review of case reports

    PubMed Central

    2011-01-01

    Renal cell carcinoma is a potentially lethal cancer with aggressive behavior and a propensity for metastatic spread. Due to the fact that the patterns of metastases from renal cell carcinomas are not clearly defined, there have been several reports of cases of renal cell carcinoma associated with rare metastatic sites and atypical presenting symptoms. The present review focuses on these atypical rare clinical presentations of renal cell carcinomas both at the time of diagnosis of the primary tumor but also in the years after radical nephrectomy. PMID:21888643

  10. Transcatheter ablation of an iatrogenic renal artery pseudoaneurysm with absolute alcohol: A rare case report

    PubMed Central

    Beig, Jahangir; Hafeez, Imran; Tramboo, Nisar Ahmed; Rather, Hilal; Yaqoob, Irfan

    2014-01-01

    A 25 year old male was admitted with features of life threatening renal haemorrhage after undergoing open nephrolithotomy for a staghorn calculus of the right kidney. CECT abdomen and selective renal angiography revealed a 2.5 × 3.0 cm pseudoaneurysm arising from the lower segmental branch of right renal artery, leaking into retroperitoneal space. After an initial failed attempt of transcatheter embolization with N-butyl cyanoacrylate (NBCA) and 10% lipiodol mixture, the pseudoaneurysm was successfully ablated with absolute alcohol. Our case demonstrates that absolute alcohol ablation is a safe and effective modality for controlling haemorrhage from an iatrogenic renal artery pseudoaneurysm. PMID:25634415

  11. Invasive urothelial carcinoma within a calyceal diverticulum associated with renal stones: A case report

    PubMed Central

    NAKANO, TAITO; KITAGAWA, YASUHIDE; IZUMI, KOUJI; IKEDA, HIROKO; NAMIKI, MIKIO

    2015-01-01

    Calyceal diverticula are rare outpouchings of the upper collecting system lying within the renal parenchyma. These often contain stones, however, carcinoma within a calyceal diverticulum is uncommon. The present study reports a case of invasive urothelial carcinoma within a calyceal diverticulum associated with renal stones. A 70-year-old male with a left renal mass identified by abdominal computed tomography was referred to the Department of Urology, Kanazawa University Hospital. Pre-operative diagnosis was difficult owing to an atypical imaging finding of a hypovascular renal mass with calcification. A laparoscopic nephroureterectomy was performed, and the surgical specimens showed invasive high-grade urothelial carcinoma within a calyceal diverticulum, and the calcifications were renal stones consisting of 97% calcium oxalate. Urothelial carcinoma in calyceal diverticula is a rare condition, however, a pre-operative definite diagnosis is difficult and a high potential for invasion of the renal parenchyma is suspected in this disease. PMID:26622866

  12. Dengue virus infection in renal allograft recipients: a case series during 2010 outbreak.

    PubMed

    Prasad, N; Bhadauria, D; Sharma, R K; Gupta, A; Kaul, A; Srivastava, A

    2012-04-01

    Dengue virus infection is an emerging global threat caused by Arbovirus, a virus from Flaviridiae family, which is transmitted by mosquitoes, Aedes aegypti and Aedes albopictus. Renal transplant recipients who live in the endemic zones of dengue infection or who travel to an endemic zone could be at risk of this infection. Despite multiple epidemics and a high case fatality rate in the Southeast Asian region, only a few cases of dengue infection in renal transplant recipients have been reported. Here, we report a case series of 8 dengue viral infection in renal transplant recipients. Of the 8 patients, 3 developed dengue hemorrhagic shock syndrome and died. PMID:22212524

  13. A Rare Intrascrotal Metastases From Renal Cell Carcinoma: A Case Report

    PubMed Central

    Adawi, Essa

    2015-01-01

    Metastatic renal cell carcinoma is potentially a lethal disease with in some cases aggressive behavior. The given fact that the patterns of metastases from RCC are not clearly identified, which may involve some rare metastatic locations. We present a case of 58 years old male presented with painless left scrotal mass, which was discovered to be an intrascrotal metastases appeared 3 years after nephrectomy for ipsilateral renal cell carcinoma. We believe that the rarity of the metastatic site and the intriguing possible mechanism of spread make an interesting case for clinicians and could add more follow-up measures for patients treated from renal cell carcinoma. PMID:26793583

  14. [Percutaneous Nephrolithotripsy for Renal Transplant Lithiasis: A Case Report].

    PubMed

    Oida, Takeshi; Kanemitsu, Toshiyuki; Hayashi, Tetsuya; Fujimoto, Nobumasa; Koide, Takuo

    2016-02-01

    A 54-year-old man was introduced to our hospital for follow-up examinations after renal transplantation. At the initial visit, a 25 mm renal transplant stone was noted, which had enlarged to 32 mm at an examination 1 year later. We first attempted transurethral lithotripsy (TUL), but failed due to ureteral stricture. However, we could completely remove the stone in 2 sessions of percutaneous nephrolithotripsy (PNL). The incidence of urinary lithiasis after renal transplantation ranges from 0.17-1.8%, for which PNL and TUL are frequently used. Although considered to be accompanied with risks of bleeding, bowel injury, and renal dysfunction, PNL is effective for urinary lithiasis after renal transplantation. TUL is less invasive, but access may be difficult when the ureter has an unusual course or ureteral stricture exists, as in our patient. PMID:27018408

  15. Clinico-pathological profile of 22 cases of cystic renal dysplasia.

    PubMed

    Singh, Sompal; Gupta, Ruchika; Nigam, Sonu; Khurana, Nita; Aggarwal, Satish Kumar; Chaturvedi, K Uma; Mandal, Ashish Kumar

    2007-01-01

    Renal dysplasia is one of the major renal developmental anomaly characterized by abnormal structural organization and development of metanephric elements. It is usually detected antenatally or in early childhood. The kidney may be multicystic, aplastic, hypoplastic or duplex. We studied 22 cases of cystic renal dysplasia diagnosed over a period often years to identify the spectrum of morphological changes in dysplastic kidney, with special emphasis on mesenchymal changes. Clinical, radiological and gross morphologicalfeatures were noted. Microscopic features were studied in detail, including the epithelial and mesenchymal changes. Twenty-one of the 22 cases studied were children. One case was a 21-year-old adult, which is a rare age at presentation. Male to female ratio was 1.1:1. One of our patients had contra-lateral ureteric stenosis, a rare anomaly reported with renal dysplasia. Ten patients, all autopsy cases, had multi-system congenital anomalies. As cystic renal dysplasia is not a hereditary disease, it must be differentiated from polycystic kidney disease. Other differential diagnoses are cystic nephroma and cystic partially differentiated nephroblastoma. Histopathological examination is the final diagnostic tool since radiological features alone may not be sufficient to exclude other cystic renal lesions. Cartilage may not be seen in all cases of renal dysplasia. Once diagnosed, other associated anomalies should also be looked for. PMID:17474245

  16. Distal renal tubular acidosis with multiorgan autoimmunity: a case report.

    PubMed

    van den Wildenberg, Maria J; Hoorn, Ewout J; Mohebbi, Nilufar; Wagner, Carsten A; Woittiez, Arend-Jan; de Vries, Peter A M; Laverman, Gozewijn D

    2015-04-01

    A 61-year-old woman with a history of pernicious anemia presented with progressive muscle weakness and dysarthria. Hypokalemic paralysis (serum potassium, 1.4 mEq/L) due to distal renal tubular acidosis (dRTA) was diagnosed. After excluding several possible causes, dRTA was considered autoimmune. However, the patient did not meet criteria for any of the autoimmune disorders classically associated with dRTA. She had very high antibody titers against parietal cells, intrinsic factor, and thyroid peroxidase (despite normal thyroid function). The patient consented to a kidney biopsy, and acid-base transporters, anion exchanger type 1 (AE1), and pendrin were undetectable by immunofluorescence. Indirect immunofluorescence detected diminished abundance of AE1- and pendrin-expressing intercalated cells in the kidney, as well as staining by the patient's serum of normal human intercalated cells and parietal cells expressing the adenosine triphosphatase hydrogen/potassium pump (H(+)/K(+)-ATPase) in normal human gastric mucosa. The dRTA likely is caused by circulating autoantibodies against intercalated cells, with possible cross-reactivity against structures containing gastric H(+)/K(+)-ATPase. This case demonstrates that in patients with dRTA without a classic autoimmune disorder, autoimmunity may still be the underlying cause. The mechanisms involved in autoantibody development and how dRTA can be caused by highly specific autoantibodies against intercalated cells have yet to be determined. PMID:25533600

  17. Ultrasonographic findings of renal dysplasia in cocker spaniels: eight cases.

    PubMed

    Felkai, C; Vörös, K; Vrabély, T; Vetési, F; Karsai, F; Papp, L

    1997-01-01

    A retrospective study of eight young Cocker Spaniels aged 9-24 months was performed to describe the ultrasonographic findings of histologically confirmed renal dysplasia. Ultrasonography revealed kidneys of significantly (p < 0.001) reduced volume in all dogs. During qualitative evaluation, two different types of sonographic alterations could be seen. In one type of the ultrasound alterations, corticomedullary demarcation was distinct and the renal cortex was remarkably thin, which was best seen in the dorsal (frontal) imaging plane. In the other type of the ultrasound appearance, overall increased echogenicity with poor corticomedullary demarcation was noticed, and the kidneys could hardly be separated from their surroundings. These features were best recognised in the sagittal (coronal) imaging plane. In one dog with secondary hypercalcaemia, a hyperechoic corticomedullary area was also seen. Post-mortem histological diagnosis revealed renal dysplasia and secondary fibrosis. Based on ultrasound findings alone, renal dysplasia (renal familial disease) can be suspected when small kidneys with thin echogenic cortex are present in young dogs. An ultrasound image, similar to that of fibrotic kidneys (increased overall echogenicity and reduced corticomedullary definition) cannot be differentiated from chronic inflammatory disease and from end-stage kidneys. Therefore, ultrasound-guided biopsy or post-mortem histology is necessary for the definitive diagnosis of renal dysplasia. This is the first study reporting on the ultrasound appearance of renal dysplasia in Cocker Spaniel dogs. PMID:9557317

  18. [ANEURYSMAL TYPE RENAL ARTERIOVENOUS FISTULA WITH GIANT VENOUS ANEURYSM, MIMICKING RENAL CELL CARCINOMA: A CASE REPORT].

    PubMed

    Nagumo, Yoshiyuki; Komori, Hiroka; Rii, Jyunryo; Ochi, Atsuhiko; Suzuki, Koichiro; Shiga, Naoki; Ota, Tomonori

    2015-04-01

    A 39-year-old man was referred to our clinic for a 7 cm tumor in the right kidney, found by simple CT scan. It was suspected as renal cell carcinoma accompanying tumor emboli in the inferior vena cava by enhanced CT scan. For further evaluation of the tumor emboli, color Doppler ultrasound and enhanced MRI was performed. They showed a large cystic lesion with high velocity turbulent flow and flow voids in T2-weighted imaging, it seemed as giant venous aneurysm of the right renal vein. Subsequently, angiography revealed aneurysmal type renal arteriovenous fistula (AVF), transarterial embolization (TAE) of the arterial feeder with coils was performed on the same day. After 6 months from embolization, there was no recurrences or reinterventions. Color Doppler ultrasound and MRI are beneficial in distinguishing vascular disease from neoplastic disease which may sometimes mimick in other diagnostic imaging studies. In addition TAE seems to be an effective treatment for the AVF. PMID:26415363

  19. Enamel renal syndrome with associated amelogenesis imperfecta, nephrolithiasis, and hypocitraturia: A case report.

    PubMed

    Bhesania, Dhvani; Arora, Ankit; Kapoor, Sonali

    2015-09-01

    Numerous cases of enamel renal syndrome have been previously reported. Various terms, such as enamel renal syndrome, amelogenesis imperfecta and gingival fibromatosis syndrome, and enamel-renal-gingival syndrome, have been used for patients presenting with the dental phenotype characteristic of this condition, nephrocalcinosis or nephrolithiasis, and gingival findings. This report describes a case of amelogenesis imperfecta of the enamel agenesis variety with nephrolithiasis in a 21-year-old male patient who complained of small teeth. The imaging modalities employed were conventional radiography, cone-beam computed tomography, and renal sonography. Such cases are first encountered by dentists, as other organ or metabolic diseases are generally hidden. Hence, cases of amelogenesis imperfecta should be subjected to advanced diagnostic modalities, incorporating both dental and medical criteria, in order to facilitate comprehensive long-term management. PMID:26389061

  20. Outpatient percutaneous nephrolithotomy in a renal transplant patient: World’s first case

    PubMed Central

    McAlpine, Kristen; Leveridge, Michael J.; Beiko, Darren

    2015-01-01

    Percutaneous nephrolithotomy (PCNL) is an established safe and effective surgical treatment option for renal calculi in renal allografts. The advent of tubeless PCNL has led to reports of ambulatory or outpatient PCNL. This case report describes the successful outpatient management of a 49-year-old female with a symptomatic renal pelvic calculus in her transplanted kidney. Tubeless PCNL successfully removed the stone, free of complication, and the patient was discharged 2 hours and 17 minutes after the procedure in stable condition with minimal pain. This is, to the best of our knowledge, the first successful case of outpatient tubeless PCNL in a transplanted kidney. PMID:26029308

  1. Two Cases of Hypophosphatemia with Increased Renal Phosphate Excretion in Legionella Pneumonia

    PubMed Central

    Watanabe, Shuhei; Kono, Keiji; Fujii, Hideki; Nakai, Kentaro; Goto, Shunsuke; Nishi, Shinichi

    2016-01-01

    We encountered 2 cases of hypophosphatemia due to Legionella pneumonia. Both cases showed increased urinary phosphate excretion and renal tubular dysfunction, which ameliorated with recovery from Legionella pneumonia. Serum fibroblast growth factor-23 level was suppressed, whereas serum 1,25(OH)2 vitamin D and parathyroid hormone levels were normal. Delayed elevation of serum 1,25(OH)2 vitamin D levels was observed with improvement in renal tubular function. These findings suggested hypophosphatemia might be mediated by renal tubular dysfunction. PMID:27066493

  2. Case-control study of renal cell carcinoma in relation to occupation, smoking, and alcohol consumption

    SciTech Connect

    Brownson, R.C.

    1988-05-01

    A case-control study based on data from a cancer registry was conducted to evaluate the effects of smoking, alcohol use, and occupation on renal cell cancer risk. Information was obtained for 326 male and female cases and 978 age- and sex-matched controls. Elevated risks were identified for cigarette smokers and for men employed as truck drivers. No relationship between alcohol consumption and renal cancer was observed.

  3. Some Renal Masses Did Not "Read the Book": A Case of a High Grade Hybrid Renal Tumor Masquerading as a Renal Cyst on Non-contrast Imaging.

    PubMed

    Kominsky, Hal D; Parker, Daniel C; Gohil, Dharam; Musial, Rachel; Edwards, Kristin; Kutikov, Alexander

    2015-11-01

    Hybrid renal tumors (HRT) are rare neoplasms that contain both benign and malignant components. Sporadic solitary HRT that contain high-grade malignant pathology appear to be extremely rare [1]. We describe a case at our institution of a tumor that was characterized as a type-2 papillary RCC and atypical oncocytoma hybrid that mimicked a simple cyst on non-contrast computed tomography. PMID:26793558

  4. Ambient particulate air pollution and ectopy--the environmental epidemiology of arrhythmogenesis in Women's Health Initiative Study, 1999-2004.

    PubMed

    Liao, Duanping; Whitsel, Eric A; Duan, Yinkang; Lin, Hung-Mo; Quibrera, P Miguel; Smith, Richard; Peuquet, Donna J; Prineas, Ronald J; Zhang, Zhu-Ming; Anderson, Garnet

    2009-01-01

    The relationships between ambient PM(2.5) and PM(10) and arrhythmia and the effect modification by cigarette smoking were investigated. Data from U.S. Environmental Protection Agency (EPA) air quality monitors and an established national-scale, log-normal kriging method were used to spatially estimate daily mean concentrations of PM at addresses of 57,422 individuals from 59 examination sites in 24 U.S. states in 1999-2004. The acute and subacute exposures were estimated as mean, geocoded address-specific PM concentrations on the day of, 0-2 d before, and averaged over 30 d before the electrocardiogram (ECG) (Lag(0); Lag(1); Lag(2); Lag(1-30)). At the time of standard 12-lead resting ECG, the mean age (SD) of participants was 67.5 (6.9) yr (84% non-Hispanic White; 6% current smoker; 15% with coronary heart disease; 5% with ectopy). After the identification of significant effect modifiers, two-stage random-effects models were used to calculate center-pooled odds ratios and 95% confidence intervals (OR, 95% CI) of arrhythmia per 10 mug/m(3) increase in PM concentrations. Among current smokers, Lag(0) and Lag(1) PM concentrations were significantly associated ventricular ectopy (VE)-the OR (95% CI) for VE among current smokers was 2 (1.32-3.3) and 1.32 (1.07-1.65) at Lag(1) PM(2.5) and PM(10), respectively. The interactions between current smoking and acute exposures (Lag(0); Lag(1); Lag(2)) were significant in relationship to VE. Acute exposures were not significantly associated with supraventricular ectopy (SVE), or with VE among nonsmokers. Subacute (Lag(1-30)) exposures were not significantly associated with arrhythmia. Acute PM(2.5) and PM(10) exposure is directly associated with the odds of VE among smokers, suggesting that they are more vulnerable to the arrhythmogenic effects of PM. PMID:18979352

  5. A rare case of renal hydatidosis in a child with congenital solitary kidney.

    PubMed

    Tirnea, Livius; Minciu, Radu; Olariu, Tudor Rares; Dumitrascu, Victor; Neghina, Adriana Maria; Neghina, Raul

    2014-08-01

    Hydatid cyst of a solitary congenital kidney is a rare entity because of the small percentage of cases with renal hydatidosis and the reduced number of cases with this renal anomaly. We report a case presenting this extremely rare combination and having a favorable outcome. The diagnosis was confirmed based on an association of imagistic techniques and positive serology. The case was managed using a minimal invasive surgical technique (PAIR) that reduced the operative risks. Additionally, an antihelminthic agent (albendazole) was administered. To our knowledge, this is the first case with such comorbidity and treated through percutaneous approach. PMID:25149385

  6. Nodular renal blastoma in kidney with multicystic dysplasia. Report of a case.

    PubMed

    Corsi, A; Boldrini, R; Caione, P; Bosman, C

    1995-04-01

    The clinico-pathologic association of nodular renal blastema, multicystic kidney and obstructive uropathy has been recently identified. We report on a female patient diagnosed as having unilater multicystic dysplasia by prenatal ultrasonography. The patient was nephrectomized at the age of 6 1/2 months. Examination of the resected kidney revealed multiple unilocular cysts in the cortex and hypoplasia of the homolateral ureter; histological study confirmed the presence of multiple cysts limited to the renal cortex, and revealed, among them, multiple cortical metanephric blastema cells islands. Our case supports a relationship between nodular renal blastema, cortical cysts and obstructive uropathy; ureter hypoplasia could cause intraluminal back pressure, with consequent abnormal development of the ampullae, normally endowed in nephronic anlagens induction, cystic tubular ectasia and persistence of nodular renal blastema. The peripheral location of renal nodular blastema and cysts supports a late error in nephrogenesis, at the time of formation of the last generation of nephrons. PMID:8532415

  7. Circumaortic Left Renal Vein-A Rare Case Report

    PubMed Central

    Panagar, Anupama Doddappaiah; Subhash, R. Lakshmi Prabha; Suresh, B.S.; Nagaraj, D.N.

    2014-01-01

    During routine dissection which was carried out for the medical students, a circumaortic left renal vein draining into inferior vena cava was observed. There were 2 renal veins through which the left kidney drained into the inferior vena cava, of which the larger one ran ventral to aorta and the other smaller one ran posterior to aorta and received lumbar veins before opening into inferior vena cava. This is a relatively rare condition which can result in left renal hypertension (LRVH) syndrome which is otherwise called as anterior and posterior nutcracker syndromes. This venous anomaly results from the errors of embryological development. It is of clinical significance, mainly during retroperitoneal surgeries and intra caval interventions. It is also important in conditions which warrant extensive venous dissections, venous reconstructions as in transplantations and invasion of veins by cancerous tissue, resulting in life threatening haemorrhage. PMID:24783096

  8. Renal vein thrombosis in the neonate: a case report and review of the literature.

    PubMed Central

    Anochie, Ifeoma C.; Eke, Felicia

    2004-01-01

    We report a case of bilateral renal vein thrombosis in a neonate, and reviewed available literature. The neonate was a macrosomic male born to a mother with glycosuria in pregnancy. There was delay in commencing breasttfeeding for up to 36 hours due to lack of lactation by themother. Clinical and laboratory examination showed enlarged palpable kidneys and azotemia. Diagnosis of bilateral renal vein thrombosis was confirmed by renal ultrasonography. The child is being managed conservatively. Measures aimed at prevention of the disease because of its poor outcome were highlighted. Images Figure 1 PMID:15622696

  9. A Rare Case of Renal Cell Carcinoma With Leiomyomatous Stroma and Concomitant Ruptured Adrenal Aneurysm.

    PubMed

    Lu, Chuanyong; Nicastri, Anthony; Shao, Charles

    2016-09-01

    Here we report a rare case of coexisting renal cell carcinoma (RCC) with leiomyomatous stroma and a ruptured adrenal aneurysm. The patient was a 75-year-old woman with acute abdominal pain. Imaging studies showed a left peri-renal hematoma and a mass in the left kidney. Left nephrectomy and adrenalectomy were performed. Pathological examination showed a ruptured aneurysm in the left adrenal gland. The renal mass was composed of tubules and acini of epithelial cells and a prominent leiomyomatous stroma. The tumor cells were positive for carbonic anhydrase IX, cytokeratin 7, and negative for AMACR, consistent with clear cell (tubulo) papillary RCC. PMID:27516974

  10. Acute renal infarct without apparent cause: A case report and review of the literature

    PubMed Central

    Decoste, Ryan; Himmelman, Jeffrey G.; Grantmyre, John

    2015-01-01

    Acute renal infarction is a rare clinical entity most commonly occurring as a result of a thromboembolic event in patients with predisposing risk factors. Its non-specific presentation can lead to delayed or missed diagnosis. However, modern imaging technology has allowed for the diagnosis of renal infarction to be made earlier in its clinical course. Due to its rare nature, treatment guidelines do not exist. We report a case of acute renal infarction identified on computed tomography scan in a patient with no known predisposing factors to thromboembolism that was treated through suction thrombectomy. PMID:26085895

  11. A rare case of renal vein thrombosis due to urinary obstruction.

    PubMed

    Jana, Tanima; Orlander, Philip R; Molony, Donald A

    2015-08-01

    Renal vein thrombosis (RVT) is an uncommon condition in adults and may be caused by endothelial damage, stasis, or hypercoagulable states. RVT is commonly identified in patients with nephrotic syndrome or malignancy. We present the case of a 57-yearold man with no past medical history who presented with a 1-month history of abdominal pain, dysuria, and hematuria. Initial laboratory studies were consistent with acute kidney injury (AKI). Imaging revealed bladder distension, enlargement of the prostate, bilateral hydronephrosis, and left renal vein thrombosis extending into the inferior vena cava. His renal failure and presenting symptoms resolved with placement of a Foley catheter and ureteral stent. The patient was discharged on anticoagulation. Here, we report a rare case of RVT that appears to have occurred as a consequence of obstructive uropathy causing massive bladder distention resulting in compression of the renal vein. PMID:25707456

  12. Primary renal carcinoid tumor: case report and review of the literature

    PubMed Central

    Li, Bin; Cui, Tongyue; Ban, Ziqin; Luo, Lei; Sun, Lijiang

    2016-01-01

    Objective The aim of this case report is to discuss the clinicopathological features of a patient with a primary renal carcinoid tumor. Methods We report on the clinical and pathological information of one case of a patient with a primary renal carcinoid tumor as well as review relative literature. Results The patient was diagnosed with a renal tumor when she received physical examination, and exhibited no positive symptoms. The diameter of tumor was 5 cm, the cross surface of the tumor was light yellow and firm, and the central part was soft with hemorrhage and necrosis. Immunohistochemical staining revealed strong and diffuse staining with synaptophysin, chromogranin A, and neuron-specific enolase. Conclusion A primary renal carcinoid tumor is extremely rare. Surgical resection is a preferred therapeutic method. PMID:26966374

  13. Tc-99m glucoheptonate scintigraphy in a case of renal vein thrombosis

    SciTech Connect

    Sfakianakis, G.N.; Zilleruelo, G.; Thompson, T.; Al-Sheikh, W.; Strauss, J.

    1985-02-01

    Tc-99m glucoheptonate flow and static studies with computer-assisted analysis provided specific diagnostic information in unilateral renal vein thrombosis complicating a case of nephrotic syndrome. Decreased flow with congestion, a large kidney with parenchymal thickening, pelvocalyceal thinning, good function, and no obstruction in the proper clinical settings indicated the diagnosis of a chronic form of renal vein thrombosis with compensating collateralization. The differential diagnosis is discussed.

  14. Renal Neoplasms With Overlapping Features of Clear Cell Renal Cell Carcinoma and Clear Cell Papillary Renal Cell Carcinoma: A Clinicopathologic Study of 37 Cases From a Single Institution.

    PubMed

    Dhakal, Hari P; McKenney, Jesse K; Khor, Li Yan; Reynolds, Jordan P; Magi-Galluzzi, Cristina; Przybycin, Christopher G

    2016-02-01

    Clear cell papillary renal cell carcinoma (CCPRCC) was recently included in the International Society of Urological Pathology Vancouver Classification of Renal Neoplasia as a subtype of RCC that is morphologically, immunohistochemically, and genetically distinct from both clear cell renal cell carcinoma (CCRCC) and papillary renal cell carcinoma. In our clinical practice we have observed tumors with overlapping histologic features of CCPRCC and CCRCC; therefore, our aim was to describe the morphologic, immunohistochemical, and clinical characteristics of these tumors. We examined a large series of consecutive nephrectomies diagnosed as CCRCC and found 37 tumors with morphologic overlap between CCRCC and CCPRCC, identifying 2 patterns. Pattern 1 tumors (N=19) had areas diagnosable as CCRCC admixed with foci having a prominent linear arrangement of nuclei away from the basement membrane imparting a resemblance to CCPRCC; however, other morphologic features commonly seen in CCPRCC (such as branching acini and cystic spaces with papillary tufts) were not typical and, when present, were focal or poorly developed. Pattern 2 (N=18) tumors had 2 discrete areas, one area with an appearance strongly resembling CCPRCC and the other with higher grade nuclei and features diagnosable as CCRCC, sometimes including rhabdoid differentiation, sarcomatoid differentiation, necrosis, and high-stage disease. Four (21%) of the pattern 1 tumors had grade 3 nuclei in the CCRCC-like areas, and 4 were high stage (pT3a). Of the 16 immunostained pattern 1 tumors, all expressed cytokeratin 7 (CK7) at least focally in the CCPRCC-like areas, strongly and diffusely in 9 (56%) cases; 12 (75%) showed negative to focal and/or weak CK7 expression in the CCRCC-like areas. CD10, α-methylacyl-CoA-racemase, high-molecular-weight cytokeratin, and carbonic anhydrase IX (CA IX) had no significant differential expression between these foci. No cup-like staining pattern was seen with CA IX. Two (11%) patients

  15. Technical considerations for transabdominal aortic reconstruction with renal fusion and ectopia: case series.

    PubMed

    Ilic, Nikola S; Koncar, Igor; Dragas, Marko; Cvetkovic, Slobodan; Pejkic, Sinisa; Kostic, Dusan; Milacic, Velja; Davidovic, Lazar

    2010-01-01

    Aortic diseases associated with renal anomalies can present special challenges during surgery of the abdominal aorta. The aim of this paper is evaluation of morbidity and definition of optimal management according to the clinical histories of 30 patients with horseshoe and ectopic kidneys who underwent surgical procedures on the abdominal aorta over a 20-year period. Twenty-two of them had horseshoe kidney and eight had ectopic kidney. Indications for surgery included aortic aneurysms in 25 patients and aortoiliac occlusive disease in 5. Preoperative diagnostics were performed in all cases by means of computed tomography and angiography (except in the cases with ruptures) associated with duplex ultrasonography. In patients with ectopic kidney a Carrel patch technique was used for the reimplantation of the renal arteries into the body of the bifurcated (four cases) or tubular (four cases) Dacron graft in five (62.5%) cases whereas aortorenal bypass with Dacron graft was obtained in three cases (37.5%). Sixteen patients from the horseshoe kidney group required renal revascularization (reimplantation using Carrel patch in 10 patients and aortorenal bypass using Dacron graft in 6 patients). Two patients, both with ruptured abdominal aortic aneurysms died after the operation. In other cases the average follow up period was 6.2 years (6 months to 17 years). In one case control, angiography after 6 months revealed an occluded left renal artery that was reimplanted by Carrel patch but without repercussions on the renal function. Aortic surgery in patients with renal anomalies can be safely performed without increased mortality. PMID:20822721

  16. Clear cell renal cell carcinoma with vaginal and brain metastases: a case report and literature review

    PubMed Central

    Momah, Tobe; Dhanan, Etwaru; Xiao, Phillip; Kondamudi, Vasantha

    2009-01-01

    There are very few cases of clear cell renal cell carcinoma with metastases to the vagina and brain reported in the literature. Our case study highlights this rare clinical occurrence and its associated complications including pulmonary embolism. In addition we discuss current management guidelines for treating and diagnosing the disease, and how this management improves prognosis.

  17. [Primary distal renal tubular acidosis: a case report].

    PubMed

    Abdallah, Jihene Ben; Charfeddine, Bassem; Braham, Imen; Neffati, Souhir; Othmen, Leila Ben; Letaief, Affef; Smach, Mohamed Ali; Bourfifa, Zoheier; Dridi, Hedi; Limem, Khalifa

    2011-01-01

    The primary distal renal tubular acidosis is characterized biochemically by the inability of the kidney to produce appropriately acid urine in the presence of systemic metabolic acidosis or after acid loading (e.g. ammonium chloride). It is secondary to defective excretion of H(+) by the cells of the collecting duct. We report the observation of the child MC, 4-year-old, for whom the association of polyuria-polydipsia syndrome, a failure to thrive, nephrolithiasis, hypercalciuria, and especially a high urine pH in the presence of metabolic acidosis did evoke diagnosis of distal renal tubular acidosis. An urine acidification test with ammonium chloride was performed, the urinary pH was always higher than 5.5, thus confirming the diagnosis. PMID:21464016

  18. Case report: laparoscopic partial nephrectomy for isolated renal hydatid disease.

    PubMed

    Basiri, A; Nadjafi-Semnani, M; Nooralizadeh, A

    2006-01-01

    A 73-year-old male patient with an isolated calcified hydatid cyst in the lower pole of the right kidney presented with a history of weight loss and cloudy, foul-smelling urine. Laparoscopic partial nephrectomy was performed, at which the cyst was removed en bloc. Six months postoperatively, a CT scan revealed no recurrence of hydatidosis. To our knowledge, this is the first report of laparoscopic partial nephrectomy for the treatment of isolated renal echinococcosis. PMID:16426127

  19. Renal cancer seeding metastases following retroperitoneoscopic-assisted cryoablation: A case report

    PubMed Central

    van de Kamp, Maaike W.; Kortekaas, Bettina; Lagerveld, Brunolf W.

    2015-01-01

    Nephron-sparing laparoscopy is the standard surgical treatment for clinical T1a renal tumours. However, the laparoscopic technique brings in its specific oncological safety concerns. Seeding metastases are reported: peritoneal metastases, port-tract metastases, and (sub-) cutaneous metastases. The method of laparoscopic assisted renal mass cryoablation is marked by the fact that traumatic tumour tissue handling is unavoidable. This case report reviews the rare occasion of seeding metastases in the retroperitoneal space following laparoscopic cryoablation of a small renal mass. The primary tumour showed no focal recurrence as reported by histological examination. The combination of two events as harming the integrity of cancer tissue and gas-circulation leading to the development of metastases in the retroperitoneal cavity is discussed. The combination of iatrogenic harming cancer tissue integrity and CO2-circulation leads to metastases in the retroperitoneal cavity. Therefore, we recommend performing image-guided renal mass biopsies before considering cryoablative surgery. PMID:26425230

  20. Renal oncocytoma: A report of two cases and review of the literature

    PubMed Central

    WANG, YUANTAO; HU, YU; ZHAI, XIUYU; WANG, WEIGANG; DONG, BIAO; ZHOU, HONGLAN

    2016-01-01

    Renal oncocytoma is one of the most unusual benign lesion, which are usually diagnosed postoperatively, since their differentiation from renal cell carcinoma is challenging. The present study reports two cases of renal oncocytoma in a 60-year-old woman and a 46-year-old man. Relevant clinical and pathological data on the two patients were retrieved. The tumors were excised and the patients underwent laparoscopic radical nephrectomy. Typical features of oncocytoma were observed upon histological examination of the excised specimens. The postoperative course of each patient was uneventful and they were discharged 8 and 7 days post-surgery, respectively. In addition, the current study presents the results of a literature review regarding the radiological, immunohistochemical and pathological characteristics of renal oncocytoma. PMID:27347140

  1. Renal aspergillosis after liver transplantation: Clinical and imaging manifestations in two cases

    PubMed Central

    Meng, Xiao-Chun; Jiang, Ting; Yi, Shu-Hong; Xie, Pei-Yi; Guo, Yue-Fei; Quan, Li; Zhou, Jing; Zhu, Kang-Shun; Shan, Hong

    2014-01-01

    Renal aspergillosis (RAsp) is a rare complication in liver transplant (LT) recipients. Here we report RAsp in two LT recipients. In both patients, RAsp occurred more than 90 d after allogenetic orthotropic LT, and all the clinical findings were unspecific. RAsp involved unilateral kidney in Case one and bilateral kidneys in Case two. Both computed tomography (CT) and magnetic resonance imaging (MRI) revealed renal abscesses, with progressively enhanced walls and separations and unenhanced alveolate areas after contrast agent administration. On unenhanced CT images they showed inhomogeneous hypo-attenuation. On fat-suppressed T2-weighted images (T2WIs), the walls and separations of the abscesses showed slightly low signal intensity and the central parts of the lesions showed slightly high signal intensity. Both on CT and MRI, there were some hints of renal infarction or chronic ischemia. Both cases were treated by radical nephrectomy followed by adjuvant antifungal treatment. They all recovered well. PMID:25561822

  2. Bilateral renal cortical necrosis with end-stage renal failure following envenoming by Proatheris superciliaris: a case report.

    PubMed

    Pourreau, François; Pinsard, Michel; Goyffon, Max; Plasse, Florent; Desport, Estelle; Thierry, Antoine; Touchard, Guy; Bridoux, Frank

    2014-06-01

    Acute bilateral renal cortical necrosis (BRCN) has been reported following envenoming by exotic venomous snakes. Proatheris superciliaris is a rare viper with restricted distribution in east Africa. Very little information is available on envenoming by this species. We herein describe the case of a 60-year-old professional wildlife photographer who was bitten on his thumb while photographing an adult specimen of P. superciliaris that he held at home in France. On admission, physical examination revealed severe hypertension and bruising with edema at the bite site. Within the following 24 h, he developed vomiting, diarrhea, acute lumbar pain and anuria. Laboratory tests showed acute kidney injury (serum creatinine 4.6 mg/dL), with thrombocytopenia, anemia and severe coagulopathy. Contrast-enhanced computed tomography scan revealed hypodense areas in the cortex of both kidneys consistent with diffuse BRCN. As no appropriate antivenom existed, only symptomatic care was given to the patient. Coagulation tests returned to normal within 48 h. The patient was placed on chronic hemodialysis, until he underwent successful kidney transplantation 18 months later. In developed countries, severe complications provoked by snake bites tend to be more frequent with the number of trendy exotic pets. Acute kidney injury, including BRCN, is a classic complication of viper bites. The present case of end-stage renal failure related to diffuse BRCN illustrates the potentially devastating effects of envenoming by P. superciliaris. Clinicians in developed countries should be informed about renal disorders and other potentially fatal complications of venomous snake bites and seek urgent expert advice for optimizing clinical management. Education and coaching of envenomed patients and exotic snake owners is mandatory to prevent dramatic accidents. PMID:24709757

  3. McKittrick-Wheelock syndrome: a rare case report of acute renal failure

    PubMed Central

    MOIS, EMIL IOAN; GRAUR, FLORIN; SECHEL, ROXANA; AL-HAJJAR, NADIM

    2016-01-01

    Giant tubular-villous adenoma of the rectum can determine secretory diarrhea, associated with a depleting syndrome of prerenal acute renal failure, hyponatremia, hypokalemia and hypoproteinemia. These symptoms are known as the McKittrick-Wheelock syndrome, and there are about 50 cases reported in literature. We present the case of a 59-year-old woman presented to our emergency department with abdominal pain, prerenal azotemia, and electrolyte disturbances with a background of chronic diarrhea, caused by a giant rectal tumor. Conservative therapy initially improved and normalized renal function, and made surgical resection of the tumor possible. PMID:27152085

  4. A case of bilateral renal cell carcinoma associated with long-term dialysis showing false-positive immunoreactivity for TFE3 as Xp11 translocation renal cell carcinoma.

    PubMed

    Kurisaki-Arakawa, Aiko; Saito, Tsuyoshi; Takahashi, Michiko; Mitani, Keiko; Fukumura, Yuki; Nagashima, Yoji; Argani, Pedrum; Yao, Takashi

    2013-01-01

    Renal carcinomas associated with Xp11.2 translocations/transcription factor 3 (TFE3) gene fusion (Xp11 translocation RCC) are a rare subtype of renal cell carcinoma. A middle-aged Japanese man, who had a medical history of dialysis for more than 12 years, had bilateral renal cancers with a background of acquired cystic disease of the kidney and remarkable deposition of calcium oxalate in the tumorous area. The right renal tumor showed papillary architecture of clear cells with diffuse and strong immunoreactivity for TFE3 and focal and weak positivity for cathepsin K, suggesting a possibility of Xp11 translocation RCC. However, RT-PCR failed to detect any type of the reported fusion genes involving TFE3. Thus, the sample was sent for a TFE3 break-apart FISH assay in a renal tumor consultation service, which reported no evidence of TFE3 gene rearrangement. The right renal tumor was finally diagnosed as papillary renal cell carcinoma with cystic change. We report here a case of bilateral renal cell carcinoma in a patient undergoing long-term dialysis, which showed false-positive immunoreactivity for TFE3 immunostaining. Titration of TFE3 immunohistochemical staining (IHC) should be performed and cross-referenced with the FISH or RT-PCR results to avoid the misinterpretation of TFE3 IHC results. PMID:24228124

  5. Chronic pyelonephritis presenting as a renal sinus tumor with retroperitoneal extension: a case report

    PubMed Central

    2009-01-01

    Introduction Chronic pyelonephritis is associated with progressive renal scarring and occurs, most of the time, in patients with major anatomical anomalies, including urinary tract obstruction, calculi, renal dysplasia or vesicoureteric reflux. We report the computed tomography imaging findings of a patient with chronic pyelonephritis appearing as a renal sinus mass. To our knowledge, it is the first time that such a case has been published in the literature. Case presentation We present a case of a 68-year-old woman who underwent a computed tomography scan of the abdomen in the work-up for recently diagnosed hypertension. A non-enhancing left renal sinus mass was detected extending to the para-aortic space. The initial diagnosis was that of a tumor of the collecting system. Nephro-ureterectomy was performed and the pathology results revealed changes of chronic pyelonephritis. Conclusion Chronic pyelonephritis presenting as a renal sinus mass is reported for the first time in the literature. This may lead to the conclusion that diagnostic ureteropyeloscopy and biopsy should be performed prior to radical surgery for possible upper tract urothelial tumors. PMID:19918288

  6. Congenital solitary kidney with multiple renal arteries: case report using MDCT angiography.

    PubMed

    Matusz, Petru; Miclăuş, Graţian Dragoslav; Banciu, Christian Dragoş; Sas, Ioan; Joseph, Shamfa C; Pirtea, Laurenţiu Cornel; Tubbs, R Shane; Loukas, Marios

    2015-01-01

    A congenital solitary kidney with multiple renal arteries is a rare congenital abnormality that can occur in the presence of multiple other anomalies. We describe an atypical case of a right congenital solitary kidney with three renal arteries (RA) one main RA and two additional renal arteries in a 75-year-old woman with uterine didelphys. The main RA had an intraluminal diameter larger than the diameter of the additional renal arteries (AdRAs) at the origin (0.53 cm for the main RA; 0.49 cm and 0.32 cm for the two AdRAs). Both the AdRAs had a greater length than the main RA (3.51 cm for the main RA; 3.70 cm and 4.77 cm for the two AdRAs). The calculated volume of the kidney was 283 cm³, while the volume of the renal parenchyma was 258 cm³. Knowledge of this variant is extremely important in clinical practice as it has been found to be associated with proteinuria, hypertension and renal insufficiency. PMID:26429179

  7. Diffuse parenchymal form of malakoplakia in renal transplant recipient: a case report.

    PubMed

    Keitel, Elizete; Pêgas, Karla Lais; do Nascimento Bittar, Antonio Eduardo; dos Santos, Auri Ferreira; da Cas Porto, Francisco; Cambruzzi, Eduardo

    2014-06-01

    Malakoplakia is an unusual chronic inflammatory disease related to prior urinary tract infection. It is characterized by the presence of macrophages with foamy cytoplasm exhibiting larger PAS positive inclusions that stain for calcium and iron. Malakoplakia affects renal allograft and is associated with severe morbidity. Herein, the authors report a new case of renal graft malakoplakia in a 23-year-old female patient. The patient received a living-related donor renal transplantation with a high immunological risk. Plasmapheresis and intravenous immunoglobulin (i.v. Ig) treatment, pre- and post-transplant, and induction with rabbit anti-thymocyte globulins were used due to presence of donor specific antibodies and positive B cross match by flow cytometry. The patient had an early urinary tract infection with a good outcome. On Day 36 post-transplant (PO), the patient returned to the clinic with fever, graft pain and acute renal dysfunction leading to hemodialysis. Escherichia coli (E. coli) was present in the blood and urine culture. At the time, the renal biopsy revealed numerous sheets of macrophages with foamy, eosinophilic cytoplasm showing several PAS positive granules and large inclusions that stained strongly with hematoxylin, calcium (von Kossa method) and iron (Prussian blue). The patient was diagnosed with malakoplakia related to a kidney transplant. Despite prolonged treatment with antibiotics, determined by a susceptibility test, the patient did not recover renal function and remained on dialysis. PMID:23195831

  8. Metastatic Renal Cell Carcinoma Presenting as Nasal Mass: Case Report and Review of Literature.

    PubMed

    Mahajan, Ritesh; Mayappa, Nagaraj; Prashanth, V

    2016-09-01

    Sinonasal neoplasms are rare and exceptional site for metastatic tumours and comprising <3 % of all malignant aerodigestive tumours and <1 % of all malignancies. Renal cell carcinoma is known to metastasise to the most unusual sites, the sinonasal region being one of them. We here by present a case of 60 year old male patient who presented with epistaxis and nasal obstruction. Clinical examination and CT scan revealed a tumour in the right nasal cavity and maxillary sinus. The presence of primary renal cell carcinoma was recognized only after surgical removal of metastatic tumour. Very few reports have been presented in literature of metastatic renal cell carcinoma in the sinonasal region. We present this case to document its occurrence; highlight the rarity, presentation and difficulties in diagnosis and treatment along with review of literature. PMID:27508143

  9. Large cystic renal cell carcinoma leading to diagnostic dilemma: a case report.

    PubMed

    Amar, V; Vennapusa, B; Kumar, M Mahendra; Nagaraju, B; Srinivas, G; Bhargav, P R K

    2013-06-01

    Large cystic renal tumours can be confused with hepatic lesions even on crosssectional imaging. Careful clinical, sonographic and imaging analysis is needed for establishing correct diagnosis. We report a case of papillary cystic renal carcinoma in a 60 year old man, which was confused with amoebic liver abcess and was initially drained. Subsequent recurrence of symptoms prompted us to re-evaluate the case and repeat sonography confirmed the extrahepatic origin of mass based on simple observation that the liver and mass were moving separately on inspiration. Later guided aspiration from solid component of the mass confirmed the diagnosis as renal cell carcinoma. He was successfully treated with radical nephrectomy with uneventful post-operative recovery. PMID:24426529

  10. Renal biopsy in patients over 75: 131 cases

    PubMed Central

    Rollino, Cristiana; Ferro, Michela; Beltrame, Giulietta; Quattrocchio, Giacomo; Massara, Carlo; Quarello, Francesco; Roccatello, Dario

    2014-01-01

    Introduction: Demographic analysis shows the ageing of the global population and the consequent increase in the age of hospitalized subjects and of patients starting dialysis. Hence, interest in the feasibility, safety, and usefulness of renal biopsy in elderly patients is growing. We examined the data of 131 patients over the age of 75 who underwent renal biopsy. We analyzed the safety of the procedure, treatment, and outcomes. Results: Histological diagnoses included: membranous glomerulonephritis (GN) 20.6%, crescentic GN 12.9%, IgAGN 10.6%, focal segmental glomerulosclerosis 9.1%, acute GN 4.5%, amyloidosis 9.1%, and acute tubular necrosis 3.8%. Mean glomerular obsolescence was 28.9 ± 27.9%. Mean age of the patients was 78.7 ± 5.73 years. At the time of biopsy, serum creatinine (SCr) was 4.47 ± 2.56 mg/dL and proteinuria was 4.82 ± 6.78 g/day. Targeted treatment was given to 51.9% of patients, 52.9% of whom had a good clinical response. Eight patients had clinically non-relevant side effects (11.7%). A positive response (defined as a more than 50% reduction of SCr, or by partial or complete remission of proteinuria) was observed in 36 patients (52.9%). 76 patients were monitored for 57 ± 9.89 months: 18 patients were on dialysis (follow-up 2.56 ± 3.61 months), 15 died (follow-up 58.5 ± 13.43 months), and 52 remained under nephrologic observation for 36 ± 31 months (SCr was 2.56 ± 0.75 mg/dL and proteinuria was 4.82 ± 6.78 g/day). Conclusion: In our experience, renal biopsy is safe even in very elderly patients; it allowed targeted treatment in 51.9% of patients, 52.9% of whom had a good clinical response, possibly contributing to prolonged patient survival and improved quality of life. PMID:25161113

  11. Molecular Genetic Alterations in Renal Cell Carcinomas With Tubulocystic Pattern: Tubulocystic Renal Cell Carcinoma, Tubulocystic Renal Cell Carcinoma With Heterogenous Component and Familial Leiomyomatosis-associated Renal Cell Carcinoma. Clinicopathologic and Molecular Genetic Analysis of 15 Cases.

    PubMed

    Ulamec, Monika; Skenderi, Faruk; Zhou, Ming; Krušlin, Božo; Martínek, Petr; Grossmann, Petr; Peckova, Kvetoslava; Alvarado-Cabrero, Isabel; Kalusova, Kristyna; Kokoskova, Bohuslava; Rotterova, Pavla; Hora, Milan; Daum, Ondrej; Dubova, Magdalena; Bauleth, Kevin; Slouka, David; Sperga, Maris; Davidson, Whitney; Rychly, Boris; Perez Montiel, Delia; Michal, Michal; Hes, Ondrej

    2016-08-01

    The characteristic morphologic spectrum of tubulocystic renal cell carcinoma (TC-RCC) may include areas resembling papillary RCC (PRCC). Our study includes 15 RCCs with tubulocystic pattern: 6 TC-RCCs, 1 RCC-high grade with tubulocystic architecture, 5 TC-RCCs with foci of PRCC, 2 with high-grade RCC (HGRCC) not otherwise specified, and 1 with a clear cell papillary RCC/renal angiomyoadenomatous tumor-like component. We analyzed aberrations of chromosomes 7, 17, and Y; mutations of VHL and FH genes; and loss of heterozygosity at chromosome 3p. Genetic analysis was performed separately in areas of classic TC-RCC and in those with other histologic patterns. The TC-RCC component demonstrated disomy of chromosome 7 in 9/15 cases, polysomy of chromosome 17 in 7/15 cases, and loss of Y in 1 case. In the PRCC component, 2/3 analyzable cases showed disomy of chromosome 7 and polysomy of chromosome 17 with normal Y. One case with focal HGRCC exhibited only disomy 7, whereas the case with clear cell papillary RCC/renal angiomyoadenomatous tumor-like pattern showed polysomies of 7 and 17, mutation of VHL, and loss of heterozygosity 3p. FH gene mutation was identified in a single case with an aggressive clinical course and predominant TC-RCC pattern. The following conclusions were drawn: (1) TC-RCC demonstrates variable status of chromosomes 7, 17, and Y even in cases with typical/uniform morphology. (2) The biological nature of PRCC/HGRCC-like areas within TC-RCC remains unclear. Our data suggest that heterogenous TC-RCCs may be associated with an adverse clinical outcome. (3) Hereditary leiomyomatosis-associated RCC can be morphologically indistinguishable from "high-grade" TC-RCC; therefore, in TC-RCC with high-grade features FH gene status should be tested. PMID:26447894

  12. Renal failure with a large bladder calculus related to a foreign body: a case report

    PubMed Central

    Minter, Janelle; Chiovaro, Joseph

    2014-01-01

    Key Clinical Message We encountered a patient with renal failure in the setting of long-standing difficulty urinating, which he previously treated with intermittent self-catheterizations. Imaging showed a large urinary calculus in the bladder. This case illustrates the importance of taking a detailed history and the dramatic long-term effects of bladder calculi. PMID:25356243

  13. Haematological manifestations of arthrogryposis-renal dysfunction-cholestasis (ARC) syndrome: a case report.

    PubMed

    Saadah, Omar I; Bokhari, Bayan E; Alshaeri, Taghreed M; Jastaniah, Wasil

    2013-03-01

    Arthrogryposis multiplex congenita, renal dysfunction, and cholestasis (ARC) syndrome is a rare, fatal, multisystem disorder. Bleeding problems, which occur spontaneously and post organ biopsies, have been reported in these patients. We report the case of an infant who had life-threatening spontaneous nasal bleeding. A detailed assessment of her platelet function and morphology is presented. PMID:23622807

  14. Clear cell papillary renal cell carcinoma: a clinicopathologic analysis of 6 cases.

    PubMed

    Yan, Wen-Xiu; Cao, Wen-Rong; Zhao, Jun; Zhang, Wei; Wang, Xue-Li; Yuan, Qian; Dang, Shou-Qin

    2015-01-01

    Clear cell papillary renal cell carcinoma (CCPRCC) is a newly described variant of renal cell carcinoma (RCC) which is composed mainly of cells with clear cytoplasm arranged in cystic and papillary patterns. We report the clinicopathologic features, prognosis and differential diagnosis of 6 Clear Cell Papillary Renal Cell Carcinomas. The clinical information and follow-up data were analyzed. The patients were six males with median age of 52.5 years. Case 1 revealed dense calcification and ossification. Cases 2 and 3 contain a variably prominent smooth muscle stromal component. CA-IX, CK7, PAX-8 and VIM were positive in all cases. TFE3 and AMACR were not expressed in any tumor. CD10 was negative in 5 of 6 cases .The patients were followed for 13~55 months with no local tumor recurrences and tumor metastasis. The CCPRCC was associated with a more favorable outcome. These were low-grade and low-stage renal tumors. No lymph node or distant metastasis of the six tumors. PMID:26191150

  15. The Retroperitoneal Laparoscopic Renal Capsulectomy for Spontaneous Renal Subcapsular Fluid Collection: A Case-Series Report and Literature Review.

    PubMed

    Zhu, Guodong; Wu, Dapeng; Wu, Kaijie; Song, Wenbin; Yang, Zhishang; Zhang, Yue; Zhang, Linlin; He, Dalin

    2016-05-01

    Spontaneous renal subcapsular fluid collection may occur as a rare presentation of nephritic syndrome, and distension of the renal capsula and Gerota fascia due to massive fluid accumulation may cause pain. In addition, hypertension secondary to renal ischemia and activation of renin-angiotensin-aldosterone system may also occur. The objective of this study is to evaluate the surgical outcome of retroperitoneal laparoscopic renal capsulectomy for patients with this disease.We retrospectively analyzed the clinical data of 10 female patients with spontaneous renal subcapsular fluid collection, diagnosed with B ultrasound and enhanced computed tomography (CT) scan. Eight patients first underwent percutaneous renal subcapsular drainage, which seemed to be less effective, and then all patients underwent retroperitoneal laparoscopic renal capsulectomy. The volume of renal subcapsular fluid was documented, the fluid was examined by routine biochemical tests, and the excised renal capsules underwent pathological examination individually. The postoperative drainage time for each patient was documented, and follow-up was conducted 1, 3, 6, 12 months, and 2 years postoperatively.Retroperitoneal laparoscopic renal capsulectomy was successfully performed in all patients with no major complications. The average volume of renal subcapsular fluid was 436 milliliter (mL, 180-880 mL) in light yellow color, and the concentration of creatinine and urea nitrogen was quite similar to that of serum. The pathological findings revealed fibrous dysplasia of the renal capsule with chronic infiltration of inflammatory cells. The average drainage time was 11.5 days (5-30 days) postoperatively. All patients recovered 1 month after the operation and there were no recurrences with a mean follow-up period of 12 months (6-24 months).The reason for spontaneous renal subcapsular fluid collection is unknown, and the aim of treatment is mainly to alleviate symptoms. In our experience, retroperitoneal

  16. Imaging features of left ovarian and renal venous aneurysms: two case reports and literature review.

    PubMed

    Yoo, Jeongin; Park, Sung Bin; Shin, Mack; Lee, Eun Sun; Park, Hyun Jeong; Lee, Jong Beum; Choi, Byung Ihn

    2016-01-01

    Venous aneurysms rarely occur in the visceral veins. We report two extremely rare cases of venous aneurysms, one of the ovarian vein and the other one of the renal vein. The aneurysms were depicted on grayscale and color Doppler ultrasonography as anechoic saccular structures with compressibility and blood flow. Pulsed Doppler ultrasonography showed venous flow. Contrast-enhanced computed tomography showed aneurysmal venous dilatation. We diagnosed left ovarian and renal venous aneurysms. We also review the clinical presentation and implications of visceral venous aneurysms. PMID:27317200

  17. Uterus didelphys with unilateral obstructed hemivagina and haematocolpos with ipsilateral renal agenesis - a case report.

    PubMed

    Chowdhury, S; Ara, R; Begum, S A; Chowdhury, S B; Hussain, M A; Mirza, T T

    2015-01-01

    Mullerian anomalies are a relatively uncommon occurrence with implication for adolescents and adults as they may result in specific gynaecologic, fertility and obstetrical issues. Uterus didelphys with blind hemivagina and ipsilateral renal agenesis is a rare congenital anomaly. Patient may be asymptomatic and unaware of having double uterus or may present with severe dysmenorrhoea or dyspareunia or a palpable mass due to unilateral haematocolpos. We report a case of 12 year old girl with this condition who was diagnosed as uterus didelphys with unilateral haematocolpos with ipsilateral renal agenesis on the basis of clinical association, physical examination and sonography and intravenous urogram. PMID:25725693

  18. Case Report: Successful Staged Ureteroscopic Treatment of a 5 cm Staghorn Renal Calculus

    PubMed Central

    Ciccone, Joseph M.; McCabe, J. Clinton; Eyre, Robert C.

    2012-01-01

    It is widely accepted that percutaneous nephrostolithotorny (PCNL) is the standard of choice for the removal of large staghorn renal calculi. Although data exists supporting a stagad ureteroscopic as an alternate treatment for stones up to 3 cm in select patients, little data exists to support a ureteroscopic approach for stones as large as 5 cm. We present a case of a 68 year old female with a 5 cm staghorn renal calculus managed successfully with a staged ureteroscopic approach. A staged ureteroscopic approach can be effective in treating stones as large as 5 cm. PMID:22606638

  19. Renal flow studies after abdominal aortic aneurysmectomy and axillo-bifemoral bypass graft: case report

    SciTech Connect

    LaManna, M.M.; Yussen, P.S.

    1988-03-01

    Vascular disorders affecting the kidneys are either acquired or congenital. Included in this category are common multiplicity of renal arteries, the rare arteriovenous malformation, stresses due to fibromuscular disease or atherosclerosis including abdominal aortic aneurysms, arterial thrombosis, venous thrombosis, and infarction. In contrast to the group of cystic and neoplastic kidneys where scintigraphic or pathologic are not diagnostic, scintigraphic or pathologic anatomy in vascular disease is often diagnostic by nuclear medicine techniques. The authors present an interesting case of evaluation of acute renal failure in a patient abdominal aortic aneurysmectomy and axillo-bifemoral bypass graft.

  20. Renal granuloma and immunoglobulin M-complex glomerulonephritis: a case of common variable immunodeficiency?

    PubMed

    Benoit, Geneviève; Lapeyraque, Anne-Laure; Sartelet, Hervé; Saint-Cyr, Claire; Le Deist, Françoise; Haddad, Elie

    2009-03-01

    Common variable immunodeficiency (CVID) is characterized by reduced serum immunoglobulin levels and recurrent bacterial infections. Granulomatous infiltrations are occasionally found in the lymphoid or solid organs of affected patients, but renal involvement is rare. We present a case of possible CVID with interstitial noncaseating granuloma and immunoglobulin (IgM)-complex glomerulonephritis with a membranoproliferative pattern and with a favorable response to corticosteroids, intravenously administered immunoglobulins (IVIGs) and rituximab. CVID must be included in the differential diagnosis of renal granuloma and should be differentiated from sarcoidosis to ensure appropriate therapy. PMID:18696117

  1. African American female with renal failure presenting with skin lesions: a case report

    PubMed Central

    Israel, Nejla; Markova, Tsveti

    2009-01-01

    Calciphylaxis is a lethal disorder seen in patients with end-stage renal disease and is characterized by painful necrotic skin lesions. The pathophysiology is still unknown. Elevated calcium, phosphorous and parathormone appear to play a role in causing small and medium sized vasculopathy. Diagnosis is delayed, prognosis is poor and mortality remains high. In this article we describe the case of calciphylaxis in a patient with chronic renal failure and multiple medical comorbidities, and discuss diagnostic management, prognosis and treatment options. PMID:19830094

  2. Localized Pleural Metastases of Renal Cell Carcinoma After Nephrectomy: A Case Report and Literature Review.

    PubMed

    Yasuda, Yuichiro; Tobino, Kazunori; Ko, Yuki; Asaji, Mina; Yamaji, Yoshikazu; Tsuruno, Kosuke; Mukasa, Yosuke; Ebi, Noriyuki

    2016-01-01

    We herein report the case of a 61-year-old Japanese male with localized pleural metastases of renal cell carcinoma. The patient was admitted to our hospital because of dyspnea on exertion and left-sided pleural effusion. He had undergone right radical nephrectomy 10 years previously. Contrast-enhanced whole-body computed tomography revealed scattered nodular thickening of the left pleura with contrast enhancement and left-sided pleural effusion. Thoracoscopy performed under local anesthesia was applied to obtain a biopsy of the pleural nodules, and the specimen was consequently diagnosed as exhibiting pleural metastasis of renal cell carcinoma, clear cell type. PMID:26705014

  3. Hemorrhagic Renal Angiomyolipoma in Pregnancy Effectively Managed by Immediate Cesarean Section and Elective Transcatheter Arterial Embolization: A Case Report

    PubMed Central

    Sawada, Norifumi; Miyamoto, Tatsuya; Mitsui, Takahiko; Zakoji, Hidenori; Takeda, Masayuki

    2016-01-01

    Abstract Renal angiomyolipoma (AML) is a benign renal tumor with a risk of rupture in intratumoral aneurysms. Although renal AML in pregnancy is rare, risk of rupture is greater. Management for AML and childbirth is important during pregnancy; however, it is undefined yet. We present a case of hemorrhagic angiomyolipoma in pregnancy that is effectively managed by immediate cesarean section and elective transcatheter arterial embolization.

  4. Hemorrhagic Renal Angiomyolipoma in Pregnancy Effectively Managed by Immediate Cesarean Section and Elective Transcatheter Arterial Embolization: A Case Report.

    PubMed

    Kira, Satoru; Sawada, Norifumi; Miyamoto, Tatsuya; Mitsui, Takahiko; Zakoji, Hidenori; Takeda, Masayuki

    2016-01-01

    Renal angiomyolipoma (AML) is a benign renal tumor with a risk of rupture in intratumoral aneurysms. Although renal AML in pregnancy is rare, risk of rupture is greater. Management for AML and childbirth is important during pregnancy; however, it is undefined yet. We present a case of hemorrhagic angiomyolipoma in pregnancy that is effectively managed by immediate cesarean section and elective transcatheter arterial embolization. PMID:27579420

  5. Bilateral multicystic renal dysplasia with potter sequence. A case with penile agenesis.

    PubMed

    Dursun, Ahmet; Ermis, Bahri; Numanoglu, Varim; Bahadir, Burak; Seckiner, Ilker

    2006-11-01

    Hereditary renal adysplasia (HRA) is a rare autosomal dominant condition. Patients have several other anomalies including Potter facies, thoracic, cardiac, and extremity deformities. The case present dysmorphic facial features such as hypertelorism, prominent epicanthic folds, a flat and broad nose, choanal stenosis, low-set ears, and a receding chin. He had femoral bowing, hypoplastic right tibia and agenesis of the right foot. He had rich and thick skin. He had also a dysplastic empty scrotum, penile agenesis, and anal atresia. The autopsy revealed pulmonary hypoplasia, ventricular septal defect, bilateral multicystic renal dysplasia, agenesis of both ureter and bladder, intraabdominal testicles, and a single umbilical artery. The penile agenesis was first reported, and including the consanguinity in the parents might further delineate the bilateral multicystic HRA. Vater/caudal regression anomalies, Mullerian duct/aplasia, unilateral renal agenesis, and cervicothoracic somite anomalies association, and Coloboma, heart anomaly, choanal atresia, retardation, genital and ear anomalies syndrome has been considered in differential diagnosis. PMID:17106555

  6. Successful endovascular treatment of transplant intrarenal artery stenosis in renal transplant recipients: Two case reports.

    PubMed

    Koukoulaki, Maria; Brountzos, Elias; Loukopoulos, Ioannis; Pomoni, Maria; Antypa, Eleni; Vougas, Vasileios; Drakopoulos, Spiros

    2015-06-24

    Transplant renal artery stenosis (TRAS) is a relatively rare complication after renal transplantation. The site of the surgical anastomosis is most commonly involved, but sites both proximal and distal to the anastomosis may occur, as well. Angioplasty is the gold standard for the treatment of the stenosis, especially for intrarenal lesions. We report two cases of intrarenal TRAS and successful management with angioplasty without stent placement. Both patients were male, 44 and 55 years old respectively, and they presented with elevated blood pressure or serum creatinine within three months after transplantation. Subsequently, they have undergone angioplasty balloon dilatation with normalization of blood pressure and serum creatinine returning to baseline level. Percutaneous transluminal balloon renal angioplasty is a safe and effective method for the treatment of the intrarenal TRAS. PMID:26131408

  7. Acute renal failure after cardiac transplantation: a case report and review of the literature.

    PubMed Central

    Cruz, D. N.; Perazella, M. A.

    1996-01-01

    Acute renal failure (ARF) is a relatively frequent complication associated with heart transplantation. It develops in the first few days postoperatively and is characterized by oliguria with laboratory and urinary indices typical of pre-renal azotemia. Cyclosporine, especially with higher doses, is one of the many factors which play an integral part in the nephrotoxicity following cardiac transplant. Poor preoperative renal function and perioperative hemodynamic compromise may also contribute to ARF. The actual incidence of ARF now encountered by transplant centers may be lower than previously reported, the result of lower cyclosporine doses. Currently, management is entirely supportive, but novel therapeutic approaches with atrial natriuretic peptide-like substances are being explored. A case illustrating the typical clinical presentation of ARF after heart transplant will be presented and the clinical features will be reviewed. PMID:9381741

  8. Application of Onyx for Renal Arteriovenous Malformation With First Case Report of a Renal Hyperdense Striation Sign: A CARE-Compliant Article.

    PubMed

    Juan, Yu-Hsiang; Lin, Yu-Ching; Sheng, Ting-Wen; Cheung, Yun-Chung; Ng, Shu-Hang; Yu, Chin-Wei; Wong, Ho-Fai

    2015-09-01

    Onyx is an emerging treatment modality for visceral vascular malformations, especially in cases in which delicate nidal penetration of the arteriovenous malformation (AVM) is desired. A computed tomography (CT) image presentation of hyperdense striations along the renal medulla secondary to the tantalum powder has not been previously reported. A 65-year-old woman presented to our institution with intermittent gross hematuria and left flank pain for 10 days. Both CT and conventional angiographies confirmed cirsoid-type renal AVM, which was successfully treated with Onyx. Follow-up CT after treatment revealed presence of hyperdense striations along the renal medulla, which resolved during later image follow-up. Despite its frequent usage in neural intervention, the application of Onyx in visceral AVM is gradually gaining interest, especially in cases in which delicate nidal penetration of the AVM is desired. Renal hyperdense striation sign should be recognized to avoid confusion with embolizer migration, and further studies in patients with renal function impairment may be helpful in understanding its influence of renal function. PMID:26426661

  9. A patient with Mullerian abnormalities, renal dysplasia, cervical spine fusion, cataracts and intellectual disability: MURCS-plus?

    PubMed

    Tan, Tiong Yang; Whitelaw, Charlotte; Savarirayan, Ravi

    2007-10-01

    We report a 15-year-old girl with features of the MURCS (Mullerian abnormalities, renal agenesis/ectopy and cervicothoracic somite dysplasia) association and birth defects not typically associated with MURCS. In addition to seizures and intellectual disability, she has cortical brain heterotopia, bilateral subclinical cataracts, submucous cleft palate and patent ductus arteriosus. We propose that this patient represents a more severe form of MURCS, or 'MURCS-plus', which may represent a defect of or insult to mesodermal morphogenesis. PMID:17786121

  10. A complex case of congenital cystic renal disease

    PubMed Central

    Cordiner, David S; Evans, Clair A; Brundler, Marie-Anne; McPhillips, Maeve; Murio, Enric; Darling, Mark; Taheri, Sepideh

    2012-01-01

    This case outlines the potential complexity of autosomal recessive polycystic kidney disease (ARPKD). It highlights the challenges involved in managing this condition, some of the complications faced and areas of uncertainty in the decision making process. With a paucity of published paediatric cases on this subject, this should add to the pool of information currently available. PMID:22605879

  11. A case of anorexia nervosa with acute renal failure induced by rhabdomyolysis; possible involvement of hypophosphatemia or phosphate depletion.

    PubMed

    Wada, S; Nagase, T; Koike, Y; Kugai, N; Nagata, N

    1992-04-01

    A 16-year-old girl with anorexia nervosa first presented with malnutrition, liver dysfunction, and rhabdomyolysis. Administration of fluid and nutrition saved her from the initial critical state, but acute renal failure followed. Laboratory examination revealed intrinsic renal failure induced by rhabdomyolysis. Latent phosphate depletion and refeeding-induced hypophosphatemia was implicated as the cause of rhabdomyolysis; however coexisting hypotension, dehydration, and liver dysfunction may have contributed to the renal failure. The patient recovered from azotemia by hemodialysis. This is the first reported case of anorexia nervosa with acute renal failure resulting from rhabdomyolysis induced by hypophosphatemia or phosphate depletion. PMID:1633352

  12. Systemic conditions, oral findings and dental management of chronic renal failure patients: general considerations and case report.

    PubMed

    Hamid, Mahmud Juma Abdalla Abdel; Dummer, Claus Dieter; Pinto, Lourenço Schmidt

    2006-01-01

    Chronic renal failure is a relatively common systemic disease. Systemic abnormalities such as anemia, platelet disorders and hypertension as well as oral manifestations including xerostomia, uremic stomatitis, periodontal disease and maxillary and mandibular radiographic alterations can be observed in individuals with chronic renal disease. In view of its frequent occurrence and the need of knowledge by dentists dealing with this condition, this paper discusses the most important issues regarding chronic renal failure, addressing its systemic and oral manifestations and the dental management of chronic renal patients. A case report is presented. PMID:16924347

  13. [Renal staghorn calculi in small children - presentation of two cases].

    PubMed

    Krzemień, Grażyna; Szmigielska, Agnieszka; Jankowska-Dziadak, Katarzyna; Pańczyk-Tomaszewska, Małgorzata

    2016-01-01

    Urolithiasis in children occurs with the incidence of 0.1-5%. Risk factors such as metabolic disorders, recurrent urinary tract infections and/or congenital abnormalities of urinary tract are detected in 75-85% of children with urolithiasis. Staghorn calculi is associated with delayed diagnosis and treatment of urinary tract infection caused by specific organisms, which produce the enzyme urease, promoting generation of ammonia and hydroxide from urea. We present two boys with staghorn calculi recognized in 8th and 31st month of age. The reason for performing ultrasonography was urinary tract infection in both boys. The younger child was previously healthy, with no symptoms of urolithiasis, the older one had recurrent urinary tract infections caused by Proteus mirabilis, episodes of anxiety and abdominal pain. Laboratory test and imaging studies excluded congenital abnormalities in the urinary tract and typical metabolic causes of urolithiasis in both boys. Treatment of infection-related stones in the younger child included two extracorporeal shock-wave lithotripsy (ESWL). In the older child, both ESWL and operation were performed. Staghorn calculi were composed of mixtures of magnesium ammonium phosphate (struvite) and calcium carbonate (apatite) and confirmed to be identified as infection-related stones. During follow-up in a nephrology outpatient clinic, values of blood pressure, renal ultrasonography, kidney function test were normal and no symptoms of urinary tract infections were clinically present. In patients with recurrent urinary tract infections, urolithiasis should be taken into consideration. The majority of staghorn calculi is often asymptomatic and can be diagnosed with an ultrasonography study performed routine or during urinary tract infection. PMID:27416622

  14. [Late presentation of an extrarenal pseudoaneurysm in a renal transplant patient: CT and color Doppler US findings (case report)].

    PubMed

    Düşünceli, Ebru; Atasoy, Cetin; Fitoz, Suat; Yağci, Cemil

    2004-12-01

    Vascular complications associated with renal transplants are a significant cause of graft dysfunction or failure. The most common complications are arterial and venous stenoses/thromboses, intrarenal and extrarenal arteriovenous fistulas, and pseudoaneurysms. In this case report, an extremely rare complication following renal transplantation, an extrarenal pseudoaneurysm, is presented with CT, gray scale, and color Doppler US findings. PMID:15611918

  15. Renal metastasis from papillary carcinoma thyroid detected by whole body iodine scan: A case report and review of the literature

    PubMed Central

    Nair, Lekha M.; Anila, K. R.; Sreekumar, A.; Pradeep, V. M.

    2016-01-01

    Papillary carcinoma is the most common thyroid malignancy. Usual sites of metastasis include lungs and bone, but renal metastasis is very rare. Here we present a case of a follicular variant of papillary carcinoma with renal and lung metastasis at presentation. PMID:27385900

  16. Renal cavernous hemangioma: robot-assisted partial nephrectomy with selective warm ischemia. Case report and review of the literature

    PubMed Central

    CECCARELLI, G.; CODACCI-PISANELLI, M.; PATRITI, A.; BIANCAFARINA, A.

    2015-01-01

    Renal hemangioma is a relatively rare benign tumor with a wide range of clinical and radiological presentation, not easy to differentiate preoperatively from a renal cancer. Due to its benign nature complete surgical resection is the recommended therapy and is considered curative. A 73-year old male patient followed-up for a lung carcinoma and a chronic renal failure underwent a CT scan showing a 35-mm mass of the inferior pole of the left kidney. The patient underwent robot-assisted partial nephrectomy with left inferior pole selective warm ischemia. The outcome was favorable and no repercussions on the renal reserve were observed postoperatively. Histopathological characteristics of the surgical specimen were consistent with renal cavernous hemangioma. A robot-assisted operation allows the fine dissection required to carry out a bloodless nephron-sparing surgery without a complete warm ischemia. The use of robot could be noteworthy for nephron-sparing surgery in cases of concomitant chronic renal failure. PMID:26712254

  17. Leptospirosis Presenting with Rapidly Progressing Acute Renal Failure and Conjugated Hyperbilirubinemia: A Case Report.

    PubMed

    Pothuri, Pallavi; Ahuja, Keerat; Kumar, Viki; Lal, Sham; Tumarinson, Taisiya; Mahmood, Khalid

    2016-01-01

    BACKGROUND Unexplained renal insufficiency combined with hepatic failure is a common problem encountered by clinicians. As with many disease processes involving multi-organ systems, reversible causes are usually not readily identifiable, and for many patients their health deteriorates rapidly. We present a rare cause of acute renal failure and hyperbilirubinemia occurring simultaneously, with leptospirosis presenting as Weil's disease. CASE REPORT A 53-year-old male presented to our clinic with complaints of anuria over the past two days. His symptoms started with dark urine, severe cramps in the thighs, and chills. The patient was a visitor to the United States from Guyana. Positive physical examination findings included mild tachycardia and hypotension, scleral icterus, and tenderness over abdomen, costovertebral angles, and thighs. The patient had a high white blood cell count, thrombocytopenia, renal/hepatic insufficiency, and an urinary tract infection (UTI). The patient was initially treated under the suspicion of acute kidney injury secondary to rhabdomyolysis and pyelonephritis. The patient continued to deteriorate with decreasing platelet counts, worsening renal function, hyperbilirubinemia, and respiratory distress, with no improvement with hemodialysis. Broad-spectrum antibiotics were administered, including doxycycline, due to a high suspicion of leptospirosis. The patient's condition drastically improved after initiation of doxycycline. On subsequent days, the patient's Leptospira antibody results were available, showing titers of more than 1:3200. Hemodialysis was discontinued as the patient started producing urine with improved kidney function. CONCLUSIONS As world travel becomes more economically feasible, we will continue to encounter foreign endemic diseases. Leptospirosis presenting as Weil's disease is a common cause of renal and hyperbilirubinemia in endemic areas. Often, as was the case for our patient where the time from presentation to acute

  18. Pathologic findings of renal biopsy were a helpful diagnostic clue of stenosis of the iliac segment proximal to the transplant renal artery: a case report.

    PubMed

    Aoyama, H; Saigo, K; Hasegawa, M; Akutsu, N; Maruyama, M; Otsuki, K; Matsumoto, I; Kawaguchi, T; Kitamura, H; Asano, T; Kenmochi, T; Itou, T; Matsubara, H

    2014-01-01

    Common iliac artery stenosis after renal transplantation is a rare complication; it can occur in the course of hypertension and renal dysfunction. We report a case of suspected renal allograft rejection with iliac artery stenosis proximal to a transplanted kidney. A 52-year-old man with a history of cadaveric kidney transplantation 26 years previously underwent a second cadaveric kidney transplantation in the left iliac fossa because of graft failure 3 years before. In June 2012, the patient had progressive renal dysfunction. In July, a percutaneous needle biopsy was taken, and it showed no rejection; however, his renal function continued to get worse through September. A percutaneous allograft renal biopsy was performed under ultrasound guidance and showed hyperplasia of the juxtaglomerular apparatus and renin granules. Magnetic resonance angiography was used to evaluate the arteries in the pelvis and showed left common iliac artery stenosis, and a stent was placed. After percutaneous intervention, the patient's ankle brachial pressure index was within the normal range and the allograft function had improved. PMID:24656037

  19. Renal cell carcinoma metastatic to the ovary or fallopian tube: a clinicopathological study of 9 cases.

    PubMed

    Liang, Li; Huang, He; Dadhania, Vipulkumar; Zhang, Jing; Zhang, Miao; Liu, Jinsong

    2016-05-01

    Renal cell carcinoma (RCC), the most common type of kidney cancer in adult, rarely metastasizes to the ovary or fallopian tube, and most cases published in the literature were case reports. Herein, we describe the clinicopathological features of 9 cases of RCC metastatic to the ovary (n = 8) or the fallopian tube (n = 1). The patients' age at the onset of primary renal tumor was available in 8 patients, ranging from 37 to 73 years (mean, 51 years; median, 50 years). Ovarian metastasis was detected prior to or concurrently with the primary renal tumors in 3 patients, and after the diagnosis of renal tumors in 6 patients. The histotypes of the RCCs were clear cell (n = 7), chromophobe (n = 1), and unclassified (n = 1). Immunohistochemical stainings were performed on the sections containing metastatic tumors in 4 cases. Interestingly, pagetoid intraepithelial spread in the tubal mucosa was observed in the case of RCC metastatic to the fallopian tube. Among the 8 patients with follow-up data, 5 died of disease and 3 were alive with disease, with a follow-up period ranging from 3.7 months to 17 years (mean, 77 months; median, 53 months) after the diagnosis of primary kidney tumors. Diagnostically, metastatic RCC may mimic primary ovarian tumors clinically, morphologically, or immunophenotypically. Pathologists should also keep in mind that both ovarian and kidney tumors express PAX8 and PAX2, the markers commonly used to diagnose metastatic RCC. In addition, chromophobe RCC only rarely metastasizes, but it can be a diagnostic challenge when it metastasizes to the ovary. PMID:27067787

  20. Spontaneous Subcapsular Renal Hematoma: Strange Case in an Anticoagulated Patient with HWMH after Aortic and Iliac Endovascular Stenting Procedure

    PubMed Central

    Greco, Michele; Benedetto, Filippo; Spinelli, Francesco; Traxer, Olivier; Tefik, Tzevat; Pappalardo, Rosa

    2016-01-01

    Spontaneous subcapsular renal hematoma is a rare condition in clinical practice. It is caused by renal cysts, benign and malignant renal tumors, vascular lesions, and antiplatelet or anticoagulant therapy. In this paper we report an unusual case of rupture of a renal cyst of a 66-year-old male patient during an aortic and iliac endovascular procedure for a massive calcified atheroma above the iliac bifurcation. We suspected that the bolus of high weight molecular heparin given during the procedure caused the rupture of the cyst. According to the literature, this is the first case of renal cyst rupture during an endovascular aortic procedure after administering a high weight molecular heparin bolus. PMID:27579210

  1. Spontaneous Subcapsular Renal Hematoma: Strange Case in an Anticoagulated Patient with HWMH after Aortic and Iliac Endovascular Stenting Procedure.

    PubMed

    Greco, Michele; Butticè, Salvatore; Benedetto, Filippo; Spinelli, Francesco; Traxer, Olivier; Tefik, Tzevat; Pappalardo, Rosa; Magno, Carlo

    2016-01-01

    Spontaneous subcapsular renal hematoma is a rare condition in clinical practice. It is caused by renal cysts, benign and malignant renal tumors, vascular lesions, and antiplatelet or anticoagulant therapy. In this paper we report an unusual case of rupture of a renal cyst of a 66-year-old male patient during an aortic and iliac endovascular procedure for a massive calcified atheroma above the iliac bifurcation. We suspected that the bolus of high weight molecular heparin given during the procedure caused the rupture of the cyst. According to the literature, this is the first case of renal cyst rupture during an endovascular aortic procedure after administering a high weight molecular heparin bolus. PMID:27579210

  2. Acute Renal Failure and Jaundice without Methemoglobinemia in a Patient with Phenazopyridine Overdose: Case Report and Review of the Literature.

    PubMed

    Holmes, Ian; Berman, Nathaniel; Domingues, Vinicius

    2014-01-01

    Phenazopyridine is a commonly used urinary analgesic available throughout the United States. Ingestion of large quantities can lead to methemoglobinemia, hemolytic anemia, jaundice, and acute renal failure. We report a case of a 78-year-old male with previously normal renal function who developed acute renal failure and jaundice without methemoglobinemia or hyperbilirubinemia after taking nearly 8 g of phenazopyridine over the course of 4 days. Initially presenting with oliguria, the urine output began to increase by day 2 of his admission, and the creatinine peaked 11 days after he began taking phenazopyridine, and he was discharged safely soon after. To our knowledge, this is the first such case of renal failure and jaundice without methemoglobinemia or hemolytic anemia in an adult patient with normal renal function. PMID:24711939

  3. Acute Renal Failure and Jaundice without Methemoglobinemia in a Patient with Phenazopyridine Overdose: Case Report and Review of the Literature

    PubMed Central

    Berman, Nathaniel; Domingues, Vinicius

    2014-01-01

    Phenazopyridine is a commonly used urinary analgesic available throughout the United States. Ingestion of large quantities can lead to methemoglobinemia, hemolytic anemia, jaundice, and acute renal failure. We report a case of a 78-year-old male with previously normal renal function who developed acute renal failure and jaundice without methemoglobinemia or hyperbilirubinemia after taking nearly 8 g of phenazopyridine over the course of 4 days. Initially presenting with oliguria, the urine output began to increase by day 2 of his admission, and the creatinine peaked 11 days after he began taking phenazopyridine, and he was discharged safely soon after. To our knowledge, this is the first such case of renal failure and jaundice without methemoglobinemia or hemolytic anemia in an adult patient with normal renal function. PMID:24711939

  4. A Case of Leser-Trélat Syndrome Associated with a Renal Cell Carcinoma

    PubMed Central

    Barth, Dietrich; Puhlmann, Silvio; Barth, Joachim

    2015-01-01

    Seborrheic keratoses can often be found in elderly people. In general, they appear gradually. In cases of a sudden eruption with itching it might be paraneoplastic. Although some authors doubt the existence of the paraneoplastic Leser-Trélat syndrome, we present a case of sudden eruption of seborrheic keratoses connected with a newly diagnosed renal cell carcinoma. As far as we know, this is the first case report of a Leser-Trélat syndrome with a malignancy of the kidney. PMID:26500537

  5. A Case of Leser-Trélat Syndrome Associated with a Renal Cell Carcinoma.

    PubMed

    Barth, Dietrich; Puhlmann, Silvio; Barth, Joachim

    2015-01-01

    Seborrheic keratoses can often be found in elderly people. In general, they appear gradually. In cases of a sudden eruption with itching it might be paraneoplastic. Although some authors doubt the existence of the paraneoplastic Leser-Trélat syndrome, we present a case of sudden eruption of seborrheic keratoses connected with a newly diagnosed renal cell carcinoma. As far as we know, this is the first case report of a Leser-Trélat syndrome with a malignancy of the kidney. PMID:26500537

  6. Extramedullary hematopoiesis within cystic renal cell carcinoma with oncocytic and chromophobe cell types: A case report

    PubMed Central

    CELIK, BETUL; BULUT, TANGUL; SEDELE, MURAT; SEZER, CEM; KARAKUS, VOLKAN

    2014-01-01

    Extramedullary hematopoiesis (EMH) is a phenomenon in which hematopoietic cells are found in sites other than the bone marrow. It is usually observed in the liver and spleen but may occasionally be found within solid tumors. The current case report presents a 69-year-old female patient who presented with a renal cyst. Histopathological examination following surgical removal of the cyst revealed a lining of oncocytic- and chromophobe-type cells with capsular invasion and a mass forming EMH with evident bone trabeculae within the cyst wall. Circulating hematopoietic stem cells in the blood and their colonization within tissues is discussed in the present case report, emphasizing certain types of renal cell carcinoma. PMID:24520308

  7. A case of fulminant type 1 diabetes associated with acute renal failure.

    PubMed

    Deng, Datong; Xia, Li; Chen, Mingwei; Xu, Min; Wang, Youmin; Wang, Changjiang

    2015-01-01

    A 56-year-old man suffered from severe diabetic ketoacidosis which was complicated by acute renal failure and rhabdomyolysis. Before admission the patient had had flu-like symptoms for 5 days and had developed polyuria and polydipsia. The clinical examination on admission showed his plasma glucose level was 80.65 mmol/L while the HbA1c was 7.4%. His amylase concentration was high without any signs of pancreatitis. The islet-associated autoantibodies (GAD antibody, islet cell antibody) were absent. These data were compatible with the diagnosis of fulminant type 1 diabetes. A continuous intravenous insulin infusion therapy was given during the acute phase to control hyperglycemia and ketoacidosis. This patient remained dependent on continuous veno-venous hemofiltration (CVVHF) for 5 days, followed by regular kidney dialysis for three times, before his renal function was finally recovered. To conclude, this is a rare case of abrupt onset fulminant type 1 diabetes with the onset of acute renal failure. Hence, early detection, quick diagnosis and immediate treatment are very important. In particular, prompt CVVHF and kidney dialysis are required and useful for rescuing the renal function. PMID:26071577

  8. Absence of Inferior Vena Cava in a Renal Transplant Recipient: A Case Report.

    PubMed

    Eroğlu, A; Turunç, V; Tabandeh, B; Oruğ, T; Sener, T; Değer, E; Dheir, H

    2015-06-01

    A 27-year-old woman was admitted to our department with end-stage renal failure due to reflux nephropathy. She had no history of deep venous thrombosis. After pretransplantation evaluation, her father was accepted for kidney donation. We observed intraoperatively that the patient's iliac veins and inferior vena cava (IVC) were absent. There were many venous collaterals, but none of them was dilated enough for renal vein anastomosis. Since we could not find a suitable vein for venous drainage of the allograft, we decided to stop donor surgery and postpone renal transplantation (RT) for detailed radiologic examination. Contrast-enhanced computed tomography revealed the absence of an infrahepatic segment of IVC. Superior mesenteric vein was thin. Portal and splenic veins were normal, but we decided not to use them for venous drainage because of increased risk of torsion. We informed the patient and her family about the situation and cancelled RT. Iliac vein and IVC anomalies are not absolute contraindications for RT, but when a dilated collateral vein is not present or when there is no option for safe renal vein anastomosis as in our case, RT may not be possible. PMID:26093758

  9. Klebsiella pneumoniae Renal Abscess Syndrome: A Rare Case with Metastatic Involvement of Lungs, Eye, and Brain

    PubMed Central

    Raza, Fayez S.; Pandey, Ambarish

    2013-01-01

    We describe a rare case of Klebsiella pneumoniae renal abscess with metastatic spread leading to endopthalmitis, pulmonary cavitary lesions, and cerebral emboli in a 41-year-old Hispanic female with diabetes mellitus who presented with a four-to-five-day history of fevers, headache, eye pain, and vomiting. She was treated with IV antibiotics and made a gradual but full recovery. PMID:23984128

  10. Arthrogryposis, renal tubular acidosis and cholestasis (ARC) syndrome: two new cases and review.

    PubMed

    Abu-Sa'da, Omar; Barbar, Maha; Al-Harbi, Naffaa; Taha, Doris

    2005-10-01

    ARC syndrome, the association of arthrogryposis, renal tubular dysfunction and cholestasis, is a rare genetic disorder. We report two Saudi infants from two different families with ARC syndrome. Magnetic resonance imaging of the brain of one of the infants showed lissencephaly, a previously unreported finding in this syndrome. We also review 39 ARC cases reported in the literature using the Medline database from January 1966 to September 2004. PMID:16155421

  11. Amlodipine-induced gingival hyperplasia in chronic renal failure: a case report.

    PubMed

    Aldemir, N M; Begenik, H; Emre, H; Erdur, F M; Soyoral, Y

    2012-12-01

    Amlodipine is a dihydropyridine calcium channel blocker that is used in the management of both hypertension and angina. Amlodipine induced side effects are headache, dizziness, edema, flushing, palpitations, and rarely gingival hyperplasia. The exact reason of amlodipine-induced gingival hyperplasia is not known. We presented a case with chronic renal failure (CRF) that developed gingival hyperplasia due to amlodipine use, which improved after ceasing the drug. PMID:23516009

  12. Embolization of a Bleeding Renal Angiomyolipoma in Pregnancy: Case Report and Review

    SciTech Connect

    Morales, Jose P.; Georganas, Marios; Khan, Mohammad S.; Dasgupta, Prokar; Reidy, John F.

    2005-04-15

    A case is described of a woman 10 weeks pregnant who had severe bleeding, secondary to a renal angiomyolipoma (AML), that was treated with embolization. Subsequent pregnancy was uneventful and she delivered a normal female infant 28 weeks after the procedure. One month after delivery, liquefaction of the AML occurred, which eventually required surgical drainage. We review and discuss AML during pregnancy, its management and post-embolization complication000.

  13. Morphologic features of uterine leiomyomas associated with hereditary leiomyomatosis and renal cell carcinoma syndrome: a case report.

    PubMed

    Garg, Karuna; Tickoo, Satish K; Soslow, Robert A; Reuter, Victor E

    2011-08-01

    Patients with hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome are prone to develop smooth muscle tumors of the uterus and skin and also renal carcinomas. The morphologic features of renal tumors that arise in the setting of HLRCC are well described, the hallmark feature being the presence of prominent eosinophilic nucleoli surrounded by a clear halo. Renal tumors associated with HLRCC are aggressive and often present late with high-stage disease. Early detection of patients with HLRCC could lead to surveillance for renal carcinomas. Women with HLRCC often present at a young age with uterine leiomyomas and frequently undergo hysterectomy as a result. HLRCC associated uterine leiomyomas show nuclear features similar to those described in HLRCC associated renal tumors. Therefore, presence of these nuclear features in uterine smooth muscle tumors may aid in early detection of HLRCC, resulting in surveillance for renal carcinoma. We present a case of a 32-year-old woman who underwent hysterectomy for uterine fibroids and subsequently presented 5 years later with high-stage renal carcinoma. Histologic evaluation of uterine leiomyomas and renal carcinoma revealed identical nuclear features, that is, prominent nucleoli with perinucleolar halos, raising the possibility of HLRCC. Subsequent testing confirmed a fumarate hydratase mutation. The presence of above-described nuclear features in uterine leiomyomas should raise the possibility of HLRCC. PMID:21753700

  14. The pathogenesis of renal dysplasia. III. Complete and incomplete urinary obstruction.

    PubMed

    Schwarz, R D; Stephens, F D; Cussen, L J

    1981-09-01

    We graded obstructed kidneys of infants on the hypodysplasia scale to assess the influence of complete and partial obstruction on the pathogenesis of hypodysplasia. Kidneys with complete obstruction exhibited severe grades; those with partial ureteral obstruction had near normal grades. Those kidneys subjected to partial urethral obstruction ranged from mild to severe grades which correlated with degrees of lateral ectopy of the urethral office. Renal parenchymal development was impaired by complete obstruction but was tolerant to incomplete obstruction. Abnormal orifice positions associated with urethral obstructions were considered to be manifestations of ectopic ureteric buds and the hypodysplasia to be evidence of abnormal induction of abnormal renal blastema. PMID:7196894

  15. Tuberous Sclerosis and Bilateral Renal Angiomyolipomas: A Case Report and Literature Review of Emerging Treatment Strategies

    PubMed Central

    James, Leighton R.

    2016-01-01

    Tuberous sclerosis complex is a rare multisystemic genetic disorder associated with the development of benign hamartomas. Angiomyolipomas are one such characteristic finding that may be seen in 55–80% of tuberous sclerosis complex patients. While being normally asymptomatic, they can also cause significant morbidity and mortality. We present the case of a patient with tuberous sclerosis complex and recently discovered bilateral renal angiomyolipomas, admitted for hematuria who underwent left renal artery embolization; however, worsening renal function necessitated subsequent nephrectomy. Despite still being mainstays of treatment, invasive interventions are now being recommended for specific patient populations as demonstrated in our case. Emerging strategies targeting the PI3K/AKT/mTOR pathway have been shown to reduce the size of angiomyolipomas and are now used to treat asymptomatic cases >3 cm. Our review discusses these treatment options with the intention of increasing awareness of current recommendations and hopefully leading to increased application of these novel therapies that will reduce the need for invasive interventions. PMID:27525138

  16. Renal clear cell carcinoma with thyroid and parotid metastases: A case report

    PubMed Central

    SHI, JIA-LI; ZHOU, JIA-QING; LI, JI-PING

    2015-01-01

    The present study reports a rare case of a renal clear cell carcinoma with thyroid and parotid metastases. A 56-year-old female, with a painless, right preauricular mass present for 6 months was referred to Renji Hospital (Shanghai, China). Physical examination revealed a mass of 3×3 cm, which was smooth, firm, immobile and non-tender. There was no accompanying facial weakness. Parotid ultrasonography revealed a hypoechoic mass within the right parotid gland, which was potentially a parotid mixed tumor. In July 2011, the patient underwent a superficial parotidectomy with preservation of the facial nerve. Pathology confirmed as right parotid clear cell carcinoma (metastasis). The patient's relevant medical history included a right radical nephrectomy for renal clear cell carcinoma (clinical stage III) in 2004. Additionally, in 2009, the patient underwent a resection of thyroid metastatic renal cell carcinoma. To the best of our knowledge, no similar case has previously been reported in English-language literature. The present study discusses a case report, and investigates the clinical features and treatment strategy. PMID:26622899

  17. A rare anomaly of left renal vein drainage into the left common iliac vein: A case report

    PubMed Central

    Kawai, Kazushige; Tanaka, Toshiaki; Watanabe, Toshiaki

    2016-01-01

    Introduction Herein, we describe a case of sigmoid colon cancer with a rare anomaly of the left renal vein located between the inferior mesenteric artery (IMA) and the left common iliac artery. Case presentation A 57-year-old woman with sigmoid colon cancer underwent three-dimensional computed tomography angiography for a preoperative assessment; the results revealed a rare variant of the left renal vein. There were two left renal veins: one retroaortically drained into the inferior vena cava, and the other was located between the IMA and the left common iliac artery and drained into the left common iliac vein. Laparoscopic sigmoid colectomy was performed safely while carefully avoiding any injury to the left renal vein located posterior to the IMA. Discussion Several variations of the left renal vein have been reported, such as retroaortic or circumaortic left renal veins. The variants of renal vessels, which are frequently overlooked in the preoperative assessment, is rarely affected in colorectal surgery. However, if the surgeon is unaware of such renal vessel anomalies, an injury can occur, resulting in severe bleeding. Conclusion It is important that surgeons identify retroperitoneal vessel variants before performing colorectal surgery. PMID:26773205

  18. Mini percutaneous nephrolithotomy for renal calculi in paediatric patients: A review of twenty cases

    PubMed Central

    D'Souza, Nischith; Paul, Saptarshi

    2016-01-01

    Objective: The objective was to report our initial experience of mini percutaneous nephrolithotomy (mPCNL) performed on patients in the pediatric age group (<18 years) using a miniature nephroscope (12F). Subjects and Methods: A total of 20 children underwent mPCNL for renal stone extraction in the Department of Urology, Yenepoya Medical College, Mangalore, India, from February 2013 to January 2014. The patients were evaluated on the basis of parameters viz. age at the time of surgery, size and number of stones, duration of surgery, stone clearance, and postoperative complications. Results: A total of 20 mPCNLs were performed on children, with age ranging from 8 to 16 years. Three children had three stones each, six children had two stones each, eight children had one stone each, and three had multiple. The median stone burden was 1.36 cm. The procedure was via single puncture in 15 cases, and two punctures in five cases. Punctures were upper calyceal in seven cases, lower calyceal in seven cases, and combined upper and lower calyceal in six cases. The calculi were accessed by a 12F mini nephroscope, laser lithotripsy was used in 12 cases and pneumatic lithotripsy used for the rest. Total clearance was achieved in 18 out of 20 cases (90%). Postoperative complications developed in one child, in the form of sepsis. Conclusion: Our initial experience concludes that mPCNL is a safe and efficacious tool for the management of renal calculi in the pediatric population. PMID:26834395

  19. The second short-term warm ischemia after vascular anastomosis did not affect early renal function recovery in renal transplantation: a case report.

    PubMed

    Qiu, Tao; Zhou, Jiangqiao; Liu, Xiuheng; Ge, Minghuan; Chen, Zhiyuan

    2012-09-01

    Ischemic postconditioning was defined as rapid intermittent interruptions of blood flow in the early phase of reperfusion, which has been found to be protective against renal ischemia-reperfusion injury (IRI) in animal models but not in clinical trials.We describe a case that the allograft renal vein was twisted because of the surgeon's mistake, which caused the warm ischemia of allograft after reperfusion. The allograft restored blood flow without second reperfusion and cold preservation after 9 min of warm ischemia. The patient was followed up for 3 months and the allograft worked well without complications. PMID:22865119

  20. Erythropoietin production in renal cell carcinoma and renal cysts in autosomal dominant polycystic kidney disease in a chronic dialysis patient with polycythemia: A case report.

    PubMed

    Ito, Keiichi; Asano, Takako; Tominaga, Susumu; Yoshii, Hidehiko; Sawazaki, Harutake; Asano, Tomohiko

    2014-11-01

    In patients undergoing chronic hemodialysis (HD), erythropoietin (EPO) production from the kidney generally decreases and renal anemia develops. Patients without anemia, but with high serum EPO (sEPO) levels are rare among HD patients. The current study presents the case of a 67-year-old female HD patient with autosomal dominant polycystic kidney disease (ADPKD) and renal cell carcinoma (RCC), manifesting polycythemia with elevated sEPO levels. A radical nephrectomy was performed, which diminished the polycythemia, but the sEPO levels remained high. To determine the origin of the EPO production, immunohistochemistry was performed to detect EPO in the RCC and the renal cysts of the surgically resected kidney. In addition, the sEPO and EPO levels in a renal cyst were determined by enzyme immunoassay. EPO expression was demonstrated in RCC and cyst epithelial cells using immunohistochemistry, revealing extremely high EPO levels in the cyst fluid. Due to the remission of polycythemia following the nephrectomy, EPO production from the resected kidney appeared to have been the cause of the polycythemia. Positive EPO staining of the renal cysts in the resected polycystic kidney and sustained sEPO elevation following nephrectomy led to the hypothesis of EPO production in the renal cysts of the contralateral polycystic kidney. Although the postoperative EPO level was higher than the normal range, the hematocrit (Hct) level gradually decreased and recombinant human EPO was required again three months following the nephrectomy. Eight months after the nephrectomy, the Hct level was 30.2% with the use of rHuEPO. In conclusion, EPO production from RCC and renal cysts in ADPKD appeared to cause polycythemia in the HD patient. PMID:25295086

  1. Beethoven's renal disease based on his autopsy: a case of papillary necrosis.

    PubMed

    Schwarz, A

    1993-06-01

    The autopsy report of Ludwig van Beethoven written by Dr Johann Wagner in 1827 reveals that he had renal calculi that had not been diagnosed during his lifetime, together with perirenal fibrosis. The most comprehensive interpretation of this autopsy finding is that the regular calcareous deposits in every one of his renal calices represented calcified necrotic papillae. Severe urinary obstruction or diabetes as possible causes of papillary necrosis were not present. Analgesic abuse because of headaches, back pain, and attacks of rheumatism or gout may be presumed on the basis of Beethoven's uncontrolled way of taking medication. Salicin, a commonly used analgesic substance of that time (dried and powdered willow bark), is able to cause papillary necrosis. Perirenal fibrosis may be due to chronic infection or drug intake. Beethoven's other well-known diseases are deafness caused by otosclerosis of the inner ear, relapsing attacks of diarrhea as the symptoms of irritable bowel syndrome, and liver cirrhosis following viral hepatitis and chronic alcohol consumption. Liver cirrhosis also may cause papillary necrosis. In Beethoven's case, renal papillary necrosis was most probably the consequence of analgesic abuse together with decompensated liver cirrhosis. The autopsy report of Beethoven is the first case of papillary necrosis recorded in the literature. PMID:8503419

  2. A CASE OF CALCIPHYLAXIS IN A PATIENT WITH HYPOPARATHYROIDISM AND NORMAL RENAL FUNCTION

    PubMed Central

    Erdel, Blake L.; Juneja, Rattan; Evans-Molina, Carmella

    2014-01-01

    Objective To present the case of a patient with a history of thyroid cancer, post-surgical hypoparathyroidism, chronic calcitriol use, and normal renal function who presented with painful skin lesions secondary to calciphylaxis. Methods We describe the history, biochemistry, histopathology, evaluation, and management of this patient. Results A 47 year-old female with hypoparathyroidism, chronically treated with calcitriol and calcium, presented with exquisitely painful skin ulcerations. Four months prior to the onset of symptoms, she had initiated warfarin therapy for atrial fibrillation. Review of laboratory data from the past year revealed elevated calcium and phosphorus levels. A diagnosis of calciphylaxis was made based upon pathologic evaluation of a skin biopsy. Management included titration of calcitriol and calcium to maintain serum calcium and phosphate levels in the low normal range. Sodium thiosulfate was administered at a dose of 25 mg IV three times a week with some resolution in the patient's pain. Unfortunately, the patient battled recurrent bacteremia and sepsis, presumably related to her calciphylaxis wounds, and ultimately succumbed to complications from sepsis. Conclusion While calciphylaxis is typically associated with renal insufficiency and secondary hyperparathyroidism, we highlight the case of a patient with normal renal function and hypoparathyroidism. Patients treated with chronic calcitriol should have serum calcium and phosphorus monitored closely and may benefit from non-calcium based phosphate binders if hyperphosphatemia becomes unavoidable. This is especially important in the presence of other risk factors for calciphylaxis including warfarin use. PMID:24518186

  3. Renal transplantation in a patient with chronic granulomatous disease: case report.

    PubMed

    Caliskan, B; Yazici, H; Gulluoglu, M; Caliskan, Y; Turkmen, A; Sever, M S

    2015-01-01

    Chronic granulomatous disease (CGD) is a genetic disease caused by structural mutations in the enzyme NADPH oxidase that results in severe immunodeficiency. End-stage renal disease occurs in this patient population and is attributed to various factors, including infections, amyloidosis, and nephrotoxic anti-infective agents. In this report, we present our experience in transplantation for a patient with CGD complicated by isolated hepatic tuberculosis abscess. The course of the case demonstrates the absolute requirements for a multidisciplinary and compulsive approach before, during, and after transplantation. This case report also highlights the unexpectedly benign effects of immunosuppressive therapy in this patient population. PMID:25480525

  4. Fatal Case of Trichoderma harzianum Infection in a Renal Transplant Recipient

    PubMed Central

    Guarro, Josep; Antolín-Ayala, María Isabel; Gené, Josepa; Gutiérrez-Calzada, Jesús; Nieves-Díez, Carlos; Ortoneda, Montserrat

    1999-01-01

    We describe the second known case of human infection by Trichoderma harzianum. A disseminated fungal infection was detected in the postmortem examination of a renal transplant recipient and confirmed in culture. The only other reported infection by this fungus caused peritonitis in a diabetic patient. The in vitro antifungal susceptibilities of the clinical strain and three other strains of Trichoderma species to six antifungal drugs are provided. This case illustrates the widening spectrum of opportunistic Trichoderma spp. in immunocompromised patients and emphasizes the problems in diagnosing invasive fungal diseases. PMID:10523593

  5. A rare case of renal metastasis from squamous cell carcinoma of the cervix.

    PubMed

    Kulkarni, Maithili Mandar; Khandeparkar, Siddhi Gaurish Sinai; Joshi, Avinash R; Kothikar, Vishakha

    2016-01-01

    Cervical cancer is the most frequent type of cancer in women in many developing countries. Squamous cell carcinoma of the cervix spreads principally by lymphatics and less commonly through blood vessels. The most frequent sites for those who develop distant metastasis include lungs (21%), lumbar and thoracic spine (16%), and para-aortic lymph nodes (7%). Metastasis to the kidney is extremely rare with <10 previously reported cases. We report a case of renal metastasis from squamous cell carcinoma of the cervix detected in end-stage kidney due to hydronephrosis. PMID:27499599

  6. Incidence of Clear Cell Papillary Renal Cell Carcinoma in Low-Grade Renal Cell Carcinoma Cases: A 12-Year Retrospective Clinicopathologic Study From a Single Cancer Center.

    PubMed

    Gill, Simpal; Kauffman, Eric C; Kandel, Sirisa; George, Saby; Schwaab, Thomas; Xu, Bo

    2016-05-01

    Clear cell papillary renal cell carcinoma (CCPRCC) is a recently recognized subtype of renal cell carcinoma entity after 2004 World Health Organization classification of renal tumors. CCPRCC has unique histomorphological and immunohistochemical characteristics. The distinction of CCPRCC from renal cell carcinoma (RCC) with clear cell morphology is crucial because the former is considered to have a favorable clinical outcome. CCPRCC may be interpreted in the past as other renal cell carcinomas, particularly low-grade clear cell RCC. In this study, the frequency of CCPRCC in previously diagnosed low-grade RCC and its clinicopathologic features were examined. A total of 126 cases of stage T1a with low nuclear grade RCC were identified from 625 consecutive RCCs removed by radical/partial nephrectomy over 12-year period (2000-2011). Archival tissue sections were retrospectively reviewed along with patient medical charts. Eight cases (1.3% of all RCC, 6.3% of pT1a low grade RCC) with characteristic histologic features of CCPRCC were confirmed by immunohistochemical studies. Seven cases were previously diagnosed as clear cell RCC and one as multilocular cystic RCC. Radiographically, CCPRCC favored a mid-pole location in the kidneys. At a median follow-up period of 52 months (range 20-114.5 months), there were no cases of local or distant recurrence. In conclusion, CCPRCC is not uncommon among small low-grade RCC tumors. CCPRCC can be correctly recognized by its unique histomorphological features and confirmed by immunohistochemistry studies, which is important due to the excellent clinical outcome following resection. PMID:26510859

  7. A case of γ-butyrolactone associated with severe withdrawal delirium and acute renal failure.

    PubMed

    Bhattacharya, Indrani S; Watson, Fiona; Bruce, Malcolm

    2011-01-01

    γ-Butyrolactone (GBL) is a popular drug of abuse which is easily available over the internet. Following a UK classification change to a class C drug in January 2010, internet supply has become difficult. Some of the effects have resulted in sourcing GBL from industrial solvents. We report a case of a 24-year-old man who was admitted for detoxification from GBL. He reported having sourced the GBL by diluting the contents of nail varnish remover pads with water. During his admission he developed a severe withdrawal delirium and acute renal failure. He required admission to the intensive care unit. Physicians and psychiatrists should be aware of toxic sources of GBL leading to renal failure and consider GBL in those presenting with agitation, psychosis or coma. PMID:21454980

  8. Intrarenal mature cystic teratoma associated with renal dysplasia: case report and literature review.

    PubMed

    Otani, M; Tsujimoto, S; Miura, M; Nagashima, Y

    2001-07-01

    We report a case of intrarenal teratoma in a 6-year-old boy. Two years before his operation, multicystic masses had been found in the left side of his abdomen. In the operation, three main cystic masses were located in the upper and lower poles of the left kidney, which were removed in pieces. Histologically, the cyst wall was lined mainly with keratinizing squamous epithelium with hair follicles, shafts and sebaceous glands. The adjacent renal parenchyma showed atrophy, with partially dysplastic and angiomyolipoma-like lesions. Based on these findings, the lesion was diagnosed as mature cystic teratoma of dermoid cyst type. Extragonadal teratoma occurs predominantly along the median line of the body. Intrarenal teratoma is extremely rare; however, it should be distinguished from teratoid Wilms' tumor and other renal cystic lesions. PMID:11472570

  9. Uterus didelphys with obstructed right hemivagina, ipsilateral renal agenesis and right pyocolpos: a case report.

    PubMed

    Dhar, Hansa; Razek, Yasser A; Hamdi, Ilham

    2011-11-01

    Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis (OHVIRA Syndrome) is a rare congenital anomaly of the female genital tract. Uterus didelphys occurs when the midline fusion of the mullerian ducts is arrested, either completely or incompletely. Women with didelphic uterus may be asymptomatic and unaware of having a double uterus. They may present with complaints of dysmenorrhoea and dyspareunia. A 25 year old woman attending the infertility clinic at Nizwa regional referral hospital presented with history of dysmenorrhoea and foul vaginal discharge with right cystic pelvic mass. She was diagnosed as a case of double uterus with obstructed right hemivagina and right pyocolpos with ipsilateral renal agenesis after routine ultrasonography in the clinic followed by MRI. Excision of the right vaginal septum with drainage of 200 ml of purulent discharge was performed. She was relieved of her symptoms and conceived promptly after the surgical excision of the partial vaginal septum. PMID:22253958

  10. Uterus Didelphys with Obstructed Right Hemivagina, Ipsilateral Renal Agenesis and Right Pyocolpos: A Case Report

    PubMed Central

    Dhar, Hansa; Razek, Yasser A.; Hamdi, Ilham

    2011-01-01

    Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis (OHVIRA Syndrome) is a rare congenital anomaly of the female genital tract. Uterus didelphys occurs when the midline fusion of the mullerian ducts is arrested, either completely or incompletely. Women with didelphic uterus may be asymptomatic and unaware of having a double uterus. They may present with complaints of dysmenorrhoea and dyspareunia. A 25 year old woman attending the infertility clinic at Nizwa regional referral hospital presented with history of dysmenorrhoea and foul vaginal discharge with right cystic pelvic mass. She was diagnosed as a case of double uterus with obstructed right hemivagina and right pyocolpos with ipsilateral renal agenesis after routine ultrasonography in the clinic followed by MRI. Excision of the right vaginal septum with drainage of 200 ml of purulent discharge was performed. She was relieved of her symptoms and conceived promptly after the surgical excision of the partial vaginal septum. PMID:22253958

  11. Grandma's TUM-my Trouble: A Case Study in Renal Physiology and Acid-Base Balance

    ERIC Educational Resources Information Center

    Massey, Ann T.

    2015-01-01

    This case study involves the role of the kidneys in regulating blood pH and electrolytes. The case was used near the end of a two-semester Human Anatomy and Physiology course sequence, during the time when renal physiology was under study. Groups of two to three students were given the case and associated information (lab values, etc.). Students…

  12. Leptospirosis Presenting with Rapidly Progressing Acute Renal Failure and Conjugated Hyperbilirubinemia: A Case Report

    PubMed Central

    Pothuri, Pallavi; Ahuja, Keerat; Kumar, Viki; Lal, Sham; Tumarinson, Taisiya; Mahmood, Khalid

    2016-01-01

    Patient: Male, 53 Final Diagnosis: Leptospirosis Symptoms: — Medication: — Clinical Procedure: None Specialty: Infectious Diseases Objective: Rare disease Background: Unexplained renal insufficiency combined with hepatic failure is a common problem encountered by clinicians. As with many disease processes involving multi-organ systems, reversible causes are usually not readily identifiable, and for many patients their health deteriorates rapidly. We present a rare cause of acute renal failure and hyperbilirubinemia occurring simultaneously, with leptospirosis presenting as Weil’s disease. Case Report: A 53-year-old male presented to our clinic with complaints of anuria over the past two days. His symptoms started with dark urine, severe cramps in the thighs, and chills. The patient was a visitor to the United States from Guyana. Positive physical examination findings included mild tachycardia and hypotension, scleral icterus, and tenderness over abdomen, costovertebral angles, and thighs. The patient had a high white blood cell count, thrombocytopenia, renal/hepatic insufficiency, and an urinary tract infection (UTI). The patient was initially treated under the suspicion of acute kidney injury secondary to rhabdomyolysis and pyelonephritis. The patient continued to deteriorate with decreasing platelet counts, worsening renal function, hyperbilirubinemia, and respiratory distress, with no improvement with hemodialysis. Broad-spectrum antibiotics were administered, including doxycycline, due to a high suspicion of leptospirosis. The patient’s condition drastically improved after initiation of doxycycline. On subsequent days, the patient’s Leptospira antibody results were available, showing titers of more than 1:3200. Hemodialysis was discontinued as the patient started producing urine with improved kidney function. Conclusions: As world travel becomes more economically feasible, we will continue to encounter foreign endemic diseases. Leptospirosis

  13. Mediastinal mass and pericardial tamponade in a renal transplant recipient: A rare case of nocardia infection

    PubMed Central

    Salazar, Maria Nieva; Wray, Dannah; Denlinger, Chadrick; Srinivas, Titte; Thomas, Beje; Posadas, Aurora

    2013-01-01

    Patient: Female, 30 Final Diagnosis: Nocardiosis Symptoms: Cardiac tamponade • cough • dyspnea • hoarseness • mediastinal mass • pericardial effusion • short of breath Medication: — Clinical Procedure: — Specialty: Transplantology Objective: Rare disease Background: Nocardia infections can complicate solid organ transplantation. The usual clinical presentations include pulmonary infiltrates with or without cavitation and subcutaneous and brain abscesses. We report an unusual case of nocardia infection in a kidney transplant recipient that presented as mediastinal mass and was associated with pericardial tamponade. Case Report: A 30 year old African American renal transplant recipient presented with cough, hoarseness and shortness of breath nine months after kidney transplantation. She received basiliximab perioperatively and her maintenance immunosuppression included tacrolimus, mycophenolate mofetil and prednisone. Computed tomography (CT) showed a large mediastinal mass with a large pericardial effusion. An echocardiogram revealed collapse of the right ventricle consistent with tamponade. We performed emergent pericardiocentesis to treat the tamponade. A mediastinoscopic biopsy of the mediastinal mass was done to establish a diagnosis. The mediastinal biopsy confirmed the growth of Nocardia. After 2 weeks of imipenem and 6 weeks of linezolid, there was marked radiographic improvement in the size of the mediastinal mass. Conclusions: We report a rare case of a large mediastinal mass associated with pericardial tamponade from nocardia infection in a renal transplant recipient. An invasive approach may be necessary to obtain tissue diagnosis to direct treatment in these cases. Prompt and appropriate medical therapy leads to marked radiographic improvement. PMID:23940824

  14. Asymptomatic renal cell carcinoma with metastasis to the skin and duodenum: a case report and review of the literature

    PubMed Central

    Mandal, Adhip; Littler, Yvonne; Libertiny, Gabor

    2012-01-01

    Renal cell carcinoma is known to have blood-borne metastasis. This is usually to the bone, lungs and brain. Other unusual metastatic presentations such as skin and bowel metastasis have also been described. In most cases, the metastasis occurs as a late manifestation in a patient with known primary renal cell carcinoma. A rare synchronous presentation of skin and duodenal metastasis in an otherwise asymptomatic patient is reported here. This patient presented with a skin lesion that, on excision, brought up the diagnosis of metastatic renal cell carcinoma. While the patient was waiting for surgery, she also developed melena that, on gastroscopy, confirmed a duodenal metastasis. This case highlights the importance of early recognition of otherwise unrelated lesions as presentations for an advanced renal malignancy. PMID:22684828

  15. Laparoscopic sigmoid colectomy for a patient with sigmoid colon cancer and crossed-fused renal ectopia: a case report.

    PubMed

    Nakai, Nozomu; Yamaguchi, Tomohiro; Kinugasa, Yusuke; Shiomi, Akio; Tomioka, Hiroyuki; Kagawa, Hiroyasu; Yamakawa, Yushi; Sato, Sumito

    2015-03-01

    Crossed-fused renal ectopia (CFRE) is a very rare congenital renal malformation. This condition comprises several anatomic anomalies, including unilateral ureteral intersection of the midline, anteriorly-placed renal pelvises, and aberrant renal blood vessels, all of which increase the difficulty of colectomy. This report describes a case of laparoscopic sigmoidectomy with sufficient lymphadenectomy for a patient with sigmoid colon cancer and left-sided L-shaped CFRE. Preoperative computed tomography demonstrated that the origin of the inferior mesenteric artery (IMA) was free from anomalies and that the tumor did not invade surrounding organs. Therefore, we planned conventional laparoscopic sigmoid colectomy with D3 lymphadenectomy. Division of IMA at its origin and anterior colon resection was successfully performed by careful mobilization of the mesocolon to avoid exposing the retroperitoneal organs. To our knowledge, this is the first case report of laparoscopic colectomy for a patient with CFRE. Sufficient preoperative assessment of anatomic anomalies enabled successful surgery. PMID:25785321

  16. Laparoscopic Sigmoid Colectomy for a Patient With Sigmoid Colon Cancer and Crossed-Fused Renal Ectopia: A Case Report

    PubMed Central

    Nakai, Nozomu; Yamaguchi, Tomohiro; Kinugasa, Yusuke; Shiomi, Akio; Tomioka, Hiroyuki; Kagawa, Hiroyasu; Yamakawa, Yushi; Sato, Sumito

    2015-01-01

    Crossed-fused renal ectopia (CFRE) is a very rare congenital renal malformation. This condition comprises several anatomic anomalies, including unilateral ureteral intersection of the midline, anteriorly-placed renal pelvises, and aberrant renal blood vessels, all of which increase the difficulty of colectomy. This report describes a case of laparoscopic sigmoidectomy with sufficient lymphadenectomy for a patient with sigmoid colon cancer and left-sided L-shaped CFRE. Preoperative computed tomography demonstrated that the origin of the inferior mesenteric artery (IMA) was free from anomalies and that the tumor did not invade surrounding organs. Therefore, we planned conventional laparoscopic sigmoid colectomy with D3 lymphadenectomy. Division of IMA at its origin and anterior colon resection was successfully performed by careful mobilization of the mesocolon to avoid exposing the retroperitoneal organs. To our knowledge, this is the first case report of laparoscopic colectomy for a patient with CFRE. Sufficient preoperative assessment of anatomic anomalies enabled successful surgery. PMID:25785321

  17. Dental Aspect of Distal Tubular Renal Acidosis with Genu Valgum Secondary to Rickets: A Case Report

    PubMed Central

    Bahadure, Rakesh N.; Thosar, Nilima; Kriplani, Ritika; Baliga, Sudhindra; Fulzele, Punit

    2012-01-01

    Distal renal tubular acidosis is a disease that occurs when the kidneys do not remove acid properly into the urine, leaving the blood too acidic (called acidosis). Distal renal tubular acidosis (type I RTA) is caused by a defect in the kidney tubes that causes acid to build up in the bloodstream. It ultimately results rickets which include chronic skeletal pain, in skeletal deformities, skeletal fractures. Rickets is among the most frequent childhood diseases in many developing countries. Dental problems in rickets include delayed eruption of permanent teeth, premature fall of deciduous teeth, defects in structure of teeth, enamel defects in permanent teeth (hypoplastic), pulp defects, intraglobular dentine, and caries tooth. Herewith, reported a case of distal tubular renal acidosis with genu valgum secondary to rickets, with pain and extraoral swelling associated with right and left mandibular 1st permanent molars. Teeth were infected with pulp without being involved with caries. Radiographically cracks in enamel and dentin were observed. Pulp revascularization with 46 and root canal treatment was done for 36 with followup of 1 year. PMID:22567455

  18. Multicentric Castleman’s disease with renal amyloidosis and mesangial proliferative glomerulonephritis: a case report

    PubMed Central

    Tan, Zhicheng; Wang, Lihua; Wang, Chen; Gao, Lifang; Yang, Yanrong

    2015-01-01

    Renal involvement is a significant complication of multicentric Castleman’s disease (MCD) and various glomerular involvements have been reported. A 56-year-old Chinese woman presented with proteinuria and skin rash, with lymphadenopathy and hypergammaglobulinemia. Lymph nodes and skin biopsy proven the case was multicentric CD with plasma cell pathological pattern. The renal biopsy was performed and six glomeruli were observed and two of these showed global sclerosis. Moderate increasing of mesangial matrix with mesangial cell proliferation were seen in every glomerulus. In addition, one-segmental sclerosis accompanied by adhesion of the Bowman’s capsule was revealed. Two of the glomeruli had crescents formation. Under immunofluorescence microscopy, immunofluorescence for anti-IgA, IgM, C3, C1q and FRA showed coarse and fine granular depositions along capillary walls and sparsely in the mesangium. Staining for anti-IgG was negative. Under electron microscopy revealed indiscriminate amyloidal deposits in glomerular basement membrane. The foot process of glomerular podocytes was fusion. Moderate increasing of mesangial matrix and mesangial cell proliferation were found. Subsequently, she was successfully treated with prednisone combined with cyclophosphamide therapy not only for proteinuria but also for renal function. PMID:25932265

  19. Two Cases of Renal Cell Carcinoma Harboring a Novel STRN-ALK Fusion Gene.

    PubMed

    Kusano, Hironori; Togashi, Yuki; Akiba, Jun; Moriya, Fukuko; Baba, Katsuyoshi; Matsuzaki, Naomi; Yuba, Yoshiaki; Shiraishi, Yusuke; Kanamaru, Hiroshi; Kuroda, Naoto; Sakata, Seiji; Takeuchi, Kengo; Yano, Hirohisa

    2016-06-01

    Anaplastic lymphoma kinase (ALK) translocation renal cell carcinomas (RCCs) have been reported by several independent groups in recent times. The clinical behavior and histopathologic characteristics of these carcinomas are not fully understood because of the paucity of cases reported. Here, we describe 2 cases of RCC harboring a novel striatin (STRN)-ALK fusion. The first case was a 33-year-old woman with no sickle cell trait who underwent nephrectomy for right renal mass and had late recurrence in para-aortic lymph nodes twice 10 and 12 years after initial surgery. After the second recurrence, she was carefully observed without any treatment. Twenty-six years after the initial nephrectomy, the second para-aortic lymphadenectomy was performed, and gastrectomy was performed for newly developed primary gastric cancer. The resected para-aortic lymph nodes were largely replaced by metastatic carcinoma. The second case was a 38-year-old man with no sickle cell trait who underwent cytoreductive nephrectomy followed by sunitinib therapy for metastatic RCC. In both cases, the tumor showed solid, papillary, tubular, and mucinous cribriform structures. Psammoma bodies were occasionally seen in the stroma. Tumor cells had a large nucleus and prominent nucleoli with predominantly eosinophilic cytoplasm. Rhabdoid cells and signet-ring cells were also observed. Intracytoplasmic mucin deposition and background mucinous stroma were confirmed. In the second case, tumor necrosis was seen in some areas. Tumor cells exhibited diffuse positive staining for ALK in both cases. ALK translocation was confirmed by fluorescent in situ hybridization, and further gene analysis revealed a STRN-ALK fusion. These cases provide great insights into ALK translocation RCCs. PMID:26848800

  20. Ambient particulate air pollution and ectopy - The Environmental Epidemiology of Arrhythmogenesis in Women’s Health Initiative Study, 1999-2004

    PubMed Central

    Liao, Duanping; Whitsel, Eric A.; Duan, Yinkang; Lin, Hung-Mo; Quibrera, P. Miguel; Smith, Richard; Peuquet, Donna J.; Prineas, Ronald J.; Zhang, Zhu-Ming; Anderson, Garnet

    2008-01-01

    The relationships between ambient PM2.5 and PM10 and arrhythmia and the effect modification by cigarette smoking were investigated. Data from EPA air quality monitors and an established national-scale, log-normal kriging method were used to spatially estimate daily mean concentrations of PM at addresses of 57,422 individuals from 59 examination sites in 24 US states in 1999-2004. The acute and subacute exposures were estimated as mean, geocoded address-specific PM concentrations on the day of, 0-2 days before, and averaged over 30 days before the ECG (Lag0; Lag1; Lag2; Lag1-30). At the time of standard 12-lead resting ECG, the mean age (SD) of participants was 67.5 (6.9) years (84% non-Hispanic White; 6% current smoker; 15% with coronary heart disease; 5% with ectopy). After the identification of significant effect modifiers, two-stage random-effects models were used to calculate center-pooled odds ratios and 95% confidence intervals (OR, 95% CI) of arrhythmia per 10 μg/m3 increase in PM concentrations. Among current smokers, Lag0 and Lag1 PM concentrations were significantly associated ventricular ectopy (VE) - the OR (95% CI) for VE among current smokers was 2 (1.32-3.3) and 1.32 (1.07-1.65) at Lag1 PM2.5 and PM10, respectively. The interactions between current smoking and acute exposures (Lag0; Lag1; Lag2) were significant in relationship to VE. Acute exposures were not significantly associated with supraventricular ectopy (SVE), or with VE among non-smokers. Subacute (Lag1-30) exposures were not significantly associated with arrhythmia. Acute PM2.5 and PM10 exposure is directly associated with the odds of VE among smokers, suggesting that they are more vulnerable to the arrhythmogenic effects of PM. PMID:18979352

  1. Gallbladder’s clear cell renal carcinoma metastasis: A case report

    PubMed Central

    Castro Ruiz, Carolina; Pedrazzoli, Claudio; Bonacini, Stefano

    2015-01-01

    Introduction Clear cell renal cell carcinoma (ccRCC) is well known for its propensity to metastasize to unusual sites, even after 10 years. Gallbladder metastases are extremely rare, being found in approximately 0.6% of cases, at autopsy. Case presentation A 51-year-old man with a history of right ccRCC underwent total nephrectomy with extended lymphadenectomy, in another Hospital. Three years later, he was hospitalized at our Hospital, with gallbladder metastasis detected during a follow-up CT scan. At clinical examination, the patient did not present any symptoms or signs of gallbladder disease. Several imaging tests were performed to better characterize the lesion. A successful cholecystectomy and hepatic resection of 4b segment were performed, obtaining a R0 resection. The clinical course was uneventful, without any complications. After a 7-month follow-up, the patient is free from disease. Discussion A typical metastases are those located in a site other than thoracic, skeletal, hepatic, adrenal or encephalic tissue. Cholecystectomy with R0 resection has demonstrated to be the only factor increasing survival, mainly in isolated cases of metastasis, providing an overall 35–60% survival rate at 5 years. Conclusion In the follow-up of patients with a positive history of renal cell carcinoma specially clear cell subtype, all new finding should be taken into account as possible metastases. We ought to consider US and CT-scan behavior of gallbladder metastatic disease in order to orientate our diagnosis. Surgery for metastatic gallbladder disease of renal origin seems to be a feasible therapy which is capable of increasing patients’ overall survival. PMID:26688513

  2. Curious Case of Photo-distributed Verrucae in a Renal Transplant Patient: Report of Three Cases

    PubMed Central

    Deb, Samujjala; Bhat, P Ishwara; Thomas, Naveen

    2016-01-01

    Viral warts are a common lesion found in patients who have undergone a renal transplant. The occurrence of verrucae also depends on the choice of immunosuppressant and posttransplant time interval. The presence of viral warts only on sun-exposed parts of the body is extremely uncommon and rarely reported. It might also influence the choice of treatment since these warts are often resistant to treatment. PMID:27512193

  3. A Case of von Hippel–Lindau Disease with Colorectal Adenocarcinoma, Renal Cell Carcinoma and Hemangioblastomas

    PubMed Central

    Heo, Su Jin; Lee, Choong-kun; Hahn, Kyu Yeon; Kim, Gyuri; Hur, Hyuk; Choi, Sung Hoon; Han, Kyung Seok; Cho, Arthur; Jung, Minkyu

    2016-01-01

    von Hippel–Lindau (VHL) disease is an autosomal dominant inherited tumor syndrome associated with mutations of the VHL tumor suppressor gene located on chromosome 3p25. The loss of functional VHL protein contributes to tumorigenesis. This condition is characterized by development of benign and malignant tumors in the central nervous system (CNS) and the internal organs, including kidney, adrenal gland, and pancreas. We herein describe the case of a 74-year-old man carrying the VHL gene mutation who was affected by simultaneous colorectal adenocarcinoma, renal clear cell carcinoma, and hemangioblastomas of CNS. PMID:25715769

  4. Lymphoblastic lymphoma presenting as bilateral renal enlargement diagnosed by percutaneous kidney biopsy: Report of three cases

    PubMed Central

    Rajakumar, V.; Balaraman, V.; Balasubramaniam, R.; Shankar, S.; Ganesan, T. S.; Kurien, A. A.

    2016-01-01

    Renal involvement by lymphoma can be a diagnostic challenge. Acute kidney injury (AKI) is an unusual manifestation of lymphomatous infiltration in the kidneys. We report three cases of lymphoblastic lymphoma, a very rare form of lymphoma, presenting with AKI and bilateral enlargement of kidneys, diagnosed by percutaneous kidney biopsy. Lymphomatous infiltration should be suspected with such clinical presentation. Kidney biopsy is a valuable diagnostic tool, to establish the correct diagnosis and subtype of lymphoma for timely initiation of therapy for these aggressive hematological malignancies. PMID:27512306

  5. Extensive intestinal metaplasia of renal pelvis: Report of a case and literature review.

    PubMed

    Shukla, Prakriti; Gulwani, Hanni V

    2015-01-01

    Transformation of the urothelium to the intestinal type of epithelium is rare in the pelvis with very few cases reported in the literature. The present study reports extensive intestinal metaplasia of the pelvi-calyceal system without residual urothelium in a 35-years-old woman with a 2 years history of renal calculi. Right - sided Nephrectomy was undertaken. Immunohistochemistry of the metaplastic epithelium revealed positive expression of CK20, low Ki-67 index and negative expression of p53. In this patient long standing metaplastic changes did not progress to adenocarcinoma which indicates that extensive intestinal metaplasia is not always associated with malignancy. PMID:26549072

  6. The effect of chronic renal failure on the benzoylecgonine blood level: a case report.

    PubMed

    Guillaud, Daniel A; Jones, Prentiss; Prahlow, Joseph A

    2015-06-01

    Chronic renal failure results in reduced elimination of a variety of substances within the blood, including numerous drugs and their metabolites. This report describes a case of a man who died in jail, after less than 48 hours of being incarcerated, wherein postmortem toxicology testing revealed a blood benzoylecgonine level of 0.25 mg/L with no cocaine detected, suggesting possible recent cocaine use in jail. Autopsy and investigation revealed severe underlying cardiovascular disease and dialysis-dependent CRF, thus accounting for the elevated benzoylecgonine levels and allaying concerns that the man obtained and used cocaine in jail. PMID:25881815

  7. Rhodococcus equi Sepsis in a Renal Transplant Recipient: A Case Study

    PubMed Central

    Macken, Eline; de Jonge, Hylke; Van Caesbroeck, Daniël; Verhaegen, Jan; Van Kerkhoven, Dana; Van Wijngaerden, Eric; Kuypers, Dirk

    2015-01-01

    Abstract Rhodococcus equi is an unusual cause of infection in humans, but has emerged as an opportunistic pathogen among immunocompromised patients. Primary pulmonary involvement is the most common clinical presentation, although the spectrum of disease is broad. Diagnosing R. equi infections remains challenging, both from clinical and microbiological view, and no standard treatment has been established. In this report, we present a detailed case of a 57-year-old male renal transplant recipient who developed R. equi bacteremia with a concomitant Pneumocystis jirovecii pneumonia. We describe the clinical features of R. equi infections, highlight the importance of an early diagnosis, and briefly review treatment options for this rare infection. PMID:27500216

  8. A 44 year-old lady with chronic renal disease and intractable ulcers: a case report

    PubMed Central

    Pujar, Thejeswi; Spinello, Irene M

    2009-01-01

    Calciphylaxis is a rare but potentially fatal condition occurring in patients with end stage renal disease on dialysis. Due to interplay of various factors, disturbances occur in the metabolism of calcium and phosphate leading to calcification within the vessel walls. The net result is tissue ischemia and necrosis. Clinically this presents as painful non-healing skin ulcers, which contribute to significant morbidity and mortality due to septic progression of the lesion. In this case report, we highlight the rapidly progressive nature of this disease, its etiopathogenesis and the role of early diagnosis in preventing life-threatening complications. PMID:19646226

  9. Prevalence of Intestinal Protozoa among Saudi Patients with Chronic Renal Failure: A Case-Control Study

    PubMed Central

    Hawash, Yousry A.; Dorgham, Laila Sh.; Amir, El-Amir M.; Sharaf, Osama F.

    2015-01-01

    It has been hypothesized that chronic renal failure (CRF) predisposes patients to infection with intestinal protozoa. We tested this hypothesis with a matched case-control study to determine the prevalence of these protozoa and their diarrhea associated symptoms among 50 patients with CRF (cases) from Taif, western Saudi Arabia. Fifty diarrheal patients without CRF were recruited in the study as controls. Participants were interviewed by a structured questionnaire and stool samples were collected. Samples were thoroughly examined with microscopy and three coproantigens detection kits. Enteric protozoa were detected in 21 cases and 14 controls. Blastocystis spp. were the most predominant parasite (16% in cases versus 8% in controls), followed by Giardia duodenalis (10% in cases versus 12% in controls) and Cryptosporidium spp. (10% in cases versus 6% in controls). Cyclospora cayetanensis was identified in two cases, while Entamoeba histolytica was described in one case and one control. Intestinal parasitism was positively associated with the male gender, urban residence, and travel history. Clinical symptoms of nausea/vomiting and abdominal pain were significantly varied between the parasitized cases and controls (P value ≤ 0.05). Given the results, we recommend screening all diarrheal feces for intestinal protozoa in the study's population, particularly those with CRF. PMID:26491455

  10. A rare case of cytomegalovirus, scedosporium apiospermum and mycobacterium tuberculosis in a renal transplant recipient

    PubMed Central

    2014-01-01

    Background Renal transplant recipients are at high risk of developing multiple infections, often concomitantly because of their immunocompromised status. Post renal transplant infections are often elusive and require extensive evaluation for proper diagnosis and treatment. A high index of suspicion is required and an attempt should be made to confirm the microbiological diagnosis from each site involved to rule out multiple infections. Case presentation We report a 50-year-old female, a renal allograft recipient who presented with left hemiplegia, esophageal ulcers and fever 3 months after her transplant. Esophageal biopsy revealed Cytomegalovirus (CMV) inclusions and the whole blood quantitative CMV polymerase chain reaction (PCR) was positive. Neuroimaging showed a brain abscess, stereotactic biopsy from which revealed Scedosporium apiospermum on fungal culture. Her tacrolimus and mycophenolate were stopped and she was managed with intravenous ganciclovir and voriconazole. With these measures, she showed marked improvement in her general and neurological condition. Two months later, she developed recurrence of fever with dry cough. Radiological investigation revealed a cavitating lung lesion, a needle aspiration from which demonstrated acid-fast bacilli. She was started on antituberculous treatment. With these measures, she recovered completely and maintained good graft function despite being on only prednisolone 10 mg once a day. Conclusion Although CMV disease is not uncommon in the first three months post transplant, Scedosporium is a rare cause of brain abscess. On the other hand, tuberculosis is common in transplant recipients, especially in developing countries, like India. However, this is the first case report of occurrence of these three infections in the same patient, demonstrating the importance of a good microbiological work-up from each site involved in immunosuppressed subjects. PMID:24885965

  11. Simultaneous Bilateral Femur Neck Fracture in A Young Adult with Chronic Renal Failure- A Case Report and Review of Literature

    PubMed Central

    V, Sathyanarayana; Patel, Maulik Tulsibhai; S, Raghavan; D, Naresh

    2015-01-01

    Introduction: Pathological bilateral femoral neck fracture due to renal osteodystrophy is rare. This is a report of a chronic renal failure patient who had sustained bilateral intra-capsular displaced fracture neck of femur following an episode of convulsion and the difficulties encountered in early diagnosis and treatment. The pathophysiology of renal osteodystrophy and the treatment of hip fractures in patients with renal failure are also discussed. Case Report: A 23 years old male patient admitted with h/o dysuria, pyuria and loss of appetite since 3 months. He was a known case of chronic renal failure and reflux nephropathy. On investigating, patient’s renal parameters were high and he was started with haemodialysis. The next day patient had c/o bilateral hip pain and inability to move bilateral lower limbs following an episode of seizure. Radiograph of pelvis showed vertical sub capital fractures of bilateral neck of femur. In this patient, considering his age, general condition & prognosis, an elective surgery in the form of bilateral uncemented modular bipolar hemiarthroplasty was done. Conclusion: Overall risk of hip fracture among patients with chronic renal failure is considerably higher than in the general population, independent of age and gender. Simultaneous spontaneous bilateral fractures of the femoral neck are rare and a delayed diagnosis is usual. The study of etiological factors of these fractures is essential to guide us in choosing the treatment of choice. Obviously patient’s age, life expectancy as well as renal co morbidity has an influence over deciding treatment and outcome. PMID:27299091

  12. Membranous nephropathy in the cat and dog: a renal biopsy and follow-up study of sixteen cases.

    PubMed

    Wright, N G; Nash, A S; Thompson, H; Fisher, E W

    1981-09-01

    A morphologic study of biopsy specimens from 16 cases of membranous nephropathy in the cat (11 cases) and dog (five cases) was carried out using conventional light microscopy, immunofluorescence, transmission electron microscopy, and scanning electron microscopy. Depending on the degree of membranous change of the capillary loops and glomerular scarring, each case was graded "mild," "moderately severe," or "advanced." Clinically, most cases were presented showing the nephrotic syndrome, although two cases were presented in chronic renal failure. Most cases were followed through to necropsy after an interval ranging between 2 days and 3 years. In some cases, repeated biopsies were taken during this period. PMID:7024632

  13. "Mucin"-secreting papillary renal cell carcinoma: clinicopathological, immunohistochemical, and molecular genetic analysis of seven cases.

    PubMed

    Pivovarcikova, Kristyna; Peckova, Kvetoslava; Martinek, Petr; Montiel, Delia Perez; Kalusova, Kristyna; Pitra, Tomas; Hora, Milan; Skenderi, Faruk; Ulamec, Monika; Daum, Ondrej; Rotterova, Pavla; Ondic, Ondrej; Dubova, Magdalena; Curik, Romuald; Dunatov, Ana; Svoboda, Tomas; Michal, Michal; Hes, Ondrej

    2016-07-01

    Mucin and mucin-like material are features of mucinous tubular and spindle renal cell carcinoma (MTS RCC) but are rarely seen in papillary renal cell carcinoma (PRCC). We reviewed 1311 PRCC and identified 7 tumors containing extracellular and/or intracellular mucinous/mucin-like material (labeled as PRCCM). We analyzed these using morphological, histochemical, immunohistochemical, and molecular genetic methods (arrayCGH, FISH). Clinical data were available for six of the seven patients (five males and one female, age range 61-78 years). Follow-up was available for four patients (2-4 years); one patient died of widespread metastases. Tumor size ranged from 3 to 5 cm (mean 3.8). Of all cases, histological architecture showed a predominantly papillary pattern. Mucin or mucin-like was extracellular in one, intracellular in three, and both intra/extracellular in three cases. All tumors were positive for AMACR, vimentin, and OSCAR, while CK7 was positive in four. Mucicarmine stain was positive in all cases, PAS in six and Alcian blue in three cases. Five tumors were positive for MUC 1, but none were positive for MUC 2, MUC 4, or MUC 6. In only four cases, genetic analysis could be performed. Gain of chromosomes 7 and 17 was found in two cases; gain of 17 only was found in one case. Loss of heterozygosity of 3p was found in one case together with polysomy of chromosomes 7 and 17. No abnormalities of VHL, fumarate dehydrogenase, and TFE3 genes were detected. We conclude that PRCCM is a rare but challenging subtype of RCC that deserves to be further studied. In all the tumors, the mucin-like material was found in those stained with mucicarmin, but other conventional and immunohistochemical stains did not reveal consistent features of a single mucin. The molecular-genetic profile of these tumors was most consistent with that of typical papillary RCC, although one case had mixed genetic features of papillary and clear RCC. PRCCM has metastatic potential, as evidenced by

  14. Impact on creatinine renal clearance by the interplay of multiple renal transporters: a case study with INCB039110.

    PubMed

    Zhang, Yan; Warren, Mark S; Zhang, Xuexiang; Diamond, Sharon; Williams, Bill; Punwani, Naresh; Huang, Jane; Huang, Yong; Yeleswaram, Swamy

    2015-04-01

    Serum creatinine is commonly used as a marker of renal function, but increases in serum creatinine might not represent changes in glomerular filtration rate (GFR). INCB039110 (2-(3-(4-(7H-pyrrolo[2,3-day]pyrimidin-4-yl)-1H-pyrazol-1-yl)-1-(1-(3-fluoro-2-(trifluoromethyl)isonicotinoyl)piperidin-4-yl)azetidin-3-yl)acetonitrile) is an inhibitor of the Janus kinases (JAKs) with selectivity for JAK1. In a phase 1 study, a modest and reversible increase in serum creatinine was observed after treatment with INCB039110. However, a dedicated renal function study with INCB039110, assessed by iohexol plasma clearance, conducted in healthy volunteers indicated no change in GFR. In vitro studies were therefore conducted to investigate the interaction of INCB039110 with five transporters that are likely involved in the renal clearance of creatinine. Cell systems expressing individual or multiple transporters were used, including a novel quintuple-transporter model OAT2/OCT2/OCT3/MATE1/MATE2-K. INCB039110 potently inhibited OCT2-mediated uptake of creatinine as well as MATE1-/MATE2-K-mediated efflux of creatinine. Given the interactions of INCB039110 with multiple transporters affecting creatinine uptake and efflux, an integrated system expressing all five transporters was sought; in that system, INCB039110 caused a dose-dependent decrease in transcellular transport of creatinine with weaker net inhibition compared with the effects on individual transporters. In summary, a molecular mechanism for the increase in serum creatinine by INCB039110 has been established. These studies also underline the limitations of using serum creatinine as a marker of renal function. PMID:25605813

  15. A Challenging Case of Rapid Progressive Kaposi Sarcoma After Renal Transplantation

    PubMed Central

    Reuter, Stefan; Vrachimis, Alexis; Huss, Sebastian; Wardelmann, Eva; Weckesser, Mathias; Pavenstädt, Hermann

    2014-01-01

    Abstract De-novo malignancy is a serious posttransplant complication. While the incidence of Kaposi sarcoma (KS) is low, the time for its diagnosis is early after renal transplantation. Typically, it can be identified because of the classical skin lesion. We herein report an unusual case of rapid progressive KS without skin lesions in a 52-year-old patient leading to death within 8 months after kidney transplantation. This striking case illustrates the usefulness of [18F]2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography for demonstrating the cause of unexplained deterioration of patient’s condition. Early identification of KS is critical because early (modification of) therapy can substantially improve patient’s prognosis. PMID:25192485

  16. Mediastinal lymph node metastasis of renal cell carcinoma: A case report

    PubMed Central

    MIYAZAKI, KUNIHIKO; SATO, SHINYA; KODAMA, TAKAHIDE; KURISHIMA, KOICHI; SATOH, HIROAKI; HIZAWA, NOBUYUKI

    2016-01-01

    Renal cell carcinoma (RCC) may metastasize to mediastinal lymph nodes without any abdominal lymph node involvement. The present study describes an autopsy-proven case of RCC presenting with a large mediastinal mass; the case had been previously misdiagnosed as small cell lung carcinoma due to imaging analysis results, an elevated serum level of neuron-specific enolase and the presence of small atypical cells with a high nuclear/cytoplasmic ratio. Despite RCC occurrence being rare, it should be considered in the differential diagnosis, particularly when a mass located in the kidneys presents with metastases to the mediastinal lymph nodes, even if there is no involvement of the abdominal lymph nodes and the primary lesion is of a small size. PMID:26893788

  17. Differential uptake of Tc-99m DMSA and Tc-99m EC in renal tubular disorders: Report of two cases and review of the literature

    PubMed Central

    Reddy Gorla, Arun Kumar; Agrawal, Kanhaiyalal; Sood, Ashwani; Bhattacharya, Anish; Mittal, Bhagwant Rai

    2014-01-01

    Tc-99m DMSA and Tc-99m EC studies are invaluable functional imaging modalities for renal structural and functional assessment. Normally, the relative renal function estimated by the two methods correlates well with each other. We here present two patients with renal tubular acidosis who showed impaired/altered DMSA uptake with normal EC renal dynamic study depicting the pitfall of DMSA imaging in tubular disorders. The two presented cases also depict distinct pattern of Tc-99m DMSA scintigraphic findings in patients with proximal and distal renal tubular acidosis, thus highlighting the factors affecting DMSA kinetics. PMID:25210282

  18. An Isolated Metastasis From Clear Cell Renal Cell Carcinoma to the Uterus: A Case Report and Review of Literature.

    PubMed

    Singh, Kamaljeet; DiSilvestro, Paul A; Lawrence, W Dwayne; Quddus, M Ruhul

    2016-09-01

    Ovaries are a favored site for metastatic tumors arising in the female genital tract. Other organs of the mullerian system, that is, the uterine corpus as well as the fallopian tubes, cervix, and the vagina are less commonly involved by metastases. If there is no clinical history of a known extramullerian primary tumor, suspicion that a uterine mass represents metastatic disease is low. We report the case of a renal clear cell carcinoma presenting as an isolated uterine mass and morphologically mimicking a primary endometrial clear cell adenocarcinoma. A review of the English literature yielded only a recent abstract describing 3 cases of renal clear cell carcinoma metastasizing to the endometrium. PMID:26630224

  19. Unilateral Congenital Lacrimal Fistula with Renal Agenesis and Pelvic Kidney: A Case Report and Review of the Literature

    PubMed Central

    Altun, A.; Kurna, S. A.; Sengor, T.; Altun, G.; Oflaz, A.; Sonmez, H. S.

    2015-01-01

    A 12-year-old boy presented to the clinic of ophthalmology because of watering and discharge from his left lower eyelid. The inspection examination revealed an orifice that was associated with congenital lacrimal fistula (CLF). He underwent a complete ophthalmologic and systemic evaluation to explore possible associated findings. Systemic evaluation revealed multiple renal anomalies: right renal agenesis and left ectopic pelvic kidney. This case is unique because this is the first reported case of CLF accompanied with ectopic pelvic kidney in the literature. PMID:26090250

  20. Delusional Infestation in a Patient with Renal Failure, Metabolic Syndrome, and Chronic Cerebrovascular Disease Treated with Aripiprazole: A Case Report

    PubMed Central

    Carpiniello, Bernardo; Pinna, Federica; Tuveri, Raffaella

    2011-01-01

    Delusional infestation is an aspecific psychiatric condition manifested either as a primary psychotic disorder or a secondary disorder induced by a wide range of very different medical conditions. Both primary and secondary delusional infestations seem to respond to typical and atypical antipsychotics. The latter are considered the first-line treatment although the use of second-generation antipsychotics featuring a higher metabolic, cardiovascular, and renal tolerability is preferable in secondary cases, which often occur in patients with multiple, severe medical conditions. We report a case of a 72-year-old patient affected by delusional infestation associated with severe renal failure, metabolic syndrome, hypertensive cardiopathy, and chronic cerebrovascular disease. PMID:22174718

  1. Cross ectopic multicystic dysplastic kidney with ureterocele in nonectopic site.

    PubMed

    Narcı, Adnan; Korkmaz, Mevlit; Karakuş, Muhittin; Sen, Tolga Altuğ; Surer, Ilhamı; Cetinkurşun, Salih

    2010-06-01

    Crossed renal ectopy (CRE) is the second most common fusion anomaly of the kidney, with an incidence of 1 in 7000 autopsies; it comes in second after horseshoe kidney. Crossed renal ectopy is associated with an ectopic ureter and generally an ectopic kidney fused with a normal kidney. A 7-month-old boy who had left-to-right crossed non-fused renal ectopy and multicystic renal dysplasia with ureterocele in nonectopic kidney was reported in English language literature. In this article, we present the first case of CRE where surgical intervention has been performed. PMID:23293688

  2. Some Renal Masses Did Not “Read the Book”: A Case of a High Grade Hybrid Renal Tumor Masquerading as a Renal Cyst on Non-contrast Imaging

    PubMed Central

    Kominsky, Hal D.; Parker, Daniel C.; Gohil, Dharam; Musial, Rachel; Edwards, Kristin; Kutikov, Alexander

    2015-01-01

    Hybrid renal tumors (HRT) are rare neoplasms that contain both benign and malignant components. Sporadic solitary HRT that contain high-grade malignant pathology appear to be extremely rare [1]. We describe a case at our institution of a tumor that was characterized as a type-2 papillary RCC and atypical oncocytoma hybrid that mimicked a simple cyst on non-contrast computed tomography. PMID:26793558

  3. Cutaneous alternariosis in a renal transplant recipient: a case report and literature review.

    PubMed

    Hsu, Chia-Chi; Chang, Shen-Shin; Lee, Po-Chang; Chao, Sheau-Chiou

    2015-01-01

    Organ transplant recipients under immunosuppressive therapy have a highly increased risk of acquiring unusual opportunistic infections. Diagnosis of the etiology of infection may be difficult in clinical manifestations, which need further histological and biological investigations. We recently treated a male renal transplant recipient with a cutaneous phaeohyphomycosis due to Alternaria species. The diagnosis was based on microscopy and culture of the skin lesions. Treatment with oral itraconazole for 5 weeks was ineffective, then clinical improvement was achieved by combination of amphotericin B wet-packing and systemic antifungal therapy with oral voriconazole. Alternaria species are ubiquitous plant-inhabiting saprobes, which are increasingly associated with opportunistic phaeohyphomycosis in immunocompromised individuals. To the best of our knowledge, this is the second case report noting sporotrichoid pattern as the manifestation of cutaneous alternariosis. In this context, we reviewed recent renal-transplant-related cutaneous alternariosis reported in the English-language literature during 1995 to 2011 to summarize its clinical features and outcomes, and to guide clinicians in the care of kidney transplant patients with cutaneous alternariosis. PMID:25554667

  4. Independent Tumor Origin in Two Cases of Synchronous Bilateral Clear Cell Renal Cell Carcinoma.

    PubMed

    Ji, Zhengguo; Zhao, Jialu; Zhao, Tian; Han, Yuying; Zhang, Yujun; Ye, Haihong

    2016-01-01

    Bilateral renal cell carcinomas (RCCs) pose a challenge for clinical treatment and management. Most bilateral RCCs are sporadic, and do not show a hereditary pattern indicative of VHL syndrome or other inherited cancers. The origin and evolution of these sporadic bilateral RCCs remains elusive. We obtained normal and tumor samples from two male patients suffering from early stage synchronous bilateral clear cell RCC (ccRCC), and analyzed genomic DNA using whole exome sequencing and bisulfite pyrosequencing. We detected distinct 3p loss of heterozygosity (LOH) in both tumors in each patient. Two tumors within the same patient harbored distinct driver mutations and different CpG hypermethylation sites in the VHL promoter. Moreover, tumors exhibit independent evolutionary trajectories. Therefore, distinct 3p LOH, combined with contingent driver gene mutations and independent VHL hypermethylation, led to independent tumor origin and parallel evolution of bilateral ccRCC in these two patients. Our results indicate that tumors in these two cases were not due to common germline oncogenic mutations. They were results of multiple de novo mutations in each kidney, rather than primary ccRCC with contralateral renal metastasis. Therefore, histopathologic and genetic profiling from single tumor specimen may underestimate the mutational burden and somatic heterogeneity of bilateral ccRCCs. PMID:27383411

  5. Independent Tumor Origin in Two Cases of Synchronous Bilateral Clear Cell Renal Cell Carcinoma

    PubMed Central

    Ji, Zhengguo; Zhao, Jialu; Zhao, Tian; Han, Yuying; Zhang, Yujun; Ye, Haihong

    2016-01-01

    Bilateral renal cell carcinomas (RCCs) pose a challenge for clinical treatment and management. Most bilateral RCCs are sporadic, and do not show a hereditary pattern indicative of VHL syndrome or other inherited cancers. The origin and evolution of these sporadic bilateral RCCs remains elusive. We obtained normal and tumor samples from two male patients suffering from early stage synchronous bilateral clear cell RCC (ccRCC), and analyzed genomic DNA using whole exome sequencing and bisulfite pyrosequencing. We detected distinct 3p loss of heterozygosity (LOH) in both tumors in each patient. Two tumors within the same patient harbored distinct driver mutations and different CpG hypermethylation sites in the VHL promoter. Moreover, tumors exhibit independent evolutionary trajectories. Therefore, distinct 3p LOH, combined with contingent driver gene mutations and independent VHL hypermethylation, led to independent tumor origin and parallel evolution of bilateral ccRCC in these two patients. Our results indicate that tumors in these two cases were not due to common germline oncogenic mutations. They were results of multiple de novo mutations in each kidney, rather than primary ccRCC with contralateral renal metastasis. Therefore, histopathologic and genetic profiling from single tumor specimen may underestimate the mutational burden and somatic heterogeneity of bilateral ccRCCs. PMID:27383411

  6. Silicosis and renal disease: insights from a case of IgA nephropathy

    PubMed Central

    RICCÒ, Matteo; THAI, Elena; CELLA, Simone

    2015-01-01

    A 68-yr-old male, smoker, is admitted for proteinuria (2,800 mg/24 h) and reduced renal function (serum creatinine 2 mg/dl, GFR 35 ml/min). Renter, he started working 20-yr-old as a sandstone cave miner. Despite the high levels of silica dusts, he reported no mandatory use of airways protection devices during the first 25 yr of activity. No clinical or radiological signs of silicosis or pneumoconiosis where reported until the year of retirement (1997). Erythrocyte sedimentation rate (91 mm/h) and C reactive protein (35 mg/l) suggested a pro-inflammatory status. High serum IgA was found (465 mg/dl). A renal biopsy identified glomerular sclerosis with IgA deposition, signs of diffuse vasculitis and tubular atrophia suggesting a diagnosis of IgA nephropathy. Chest X-Rays showed emphysema and diffuse nodularity suggesting diagnosis of silicosis. Chest tomography was also positive for mild signs of silicosis with silicotic nodules and without honeycombing. IgA nephropathy is the most common type of glomerulonephritis worldwide. Several clues suggest a genetic or acquired abnormality of immune system as a trigger of the increased production of IgA. In our case report, simultaneous kidney and pulmonary disease could suggest same triggers (e.g. exposure to virus, bacteria or environmental agents) inducing IgA synthesis and pulmonary immune system activation. PMID:26423329

  7. Silicosis and renal disease: insights from a case of IgA nephropathy.

    PubMed

    Riccò, Matteo; Thai, Elena; Cella, Simone

    2016-01-01

    A 68-yr-old male, smoker, is admitted for proteinuria (2,800 mg/24 h) and reduced renal function (serum creatinine 2 mg/dl, GFR 35 ml/min). Renter, he started working 20-yr-old as a sandstone cave miner. Despite the high levels of silica dusts, he reported no mandatory use of airways protection devices during the first 25 yr of activity. No clinical or radiological signs of silicosis or pneumoconiosis where reported until the year of retirement (1997). Erythrocyte sedimentation rate (91 mm/h) and C reactive protein (35 mg/l) suggested a pro-inflammatory status. High serum IgA was found (465 mg/dl). A renal biopsy identified glomerular sclerosis with IgA deposition, signs of diffuse vasculitis and tubular atrophia suggesting a diagnosis of IgA nephropathy. Chest X-Rays showed emphysema and diffuse nodularity suggesting diagnosis of silicosis. Chest tomography was also positive for mild signs of silicosis with silicotic nodules and without honeycombing. IgA nephropathy is the most common type of glomerulonephritis worldwide. Several clues suggest a genetic or acquired abnormality of immune system as a trigger of the increased production of IgA. In our case report, simultaneous kidney and pulmonary disease could suggest same triggers (e.g. exposure to virus, bacteria or environmental agents) inducing IgA synthesis and pulmonary immune system activation. PMID:26423329

  8. Bardet-Biedl syndrome with vulva carcinoma presented with acute renal failure: a case report

    PubMed Central

    Sari, F; Sarikaya, A M; Suren, D; Eren, M; Yilmaz, B

    2015-01-01

    Background Bardet-Biedl syndrome is a rare disorder characterized by retinal dystrophy, obesity, kidney dysfunction, polydactyly, hypogonadism and cognitive impairment. It can be accompanied by systemic findings such as malignancy, hypertension, diabetes mellitus, constitutional and functional disorders of urogenital system and liver fibrosis. Case report A 35-year-old woman with Bardet-Biedl syndrome was referred to our outpatient nephrology clinic with dysuria, acute renal failure, and urinary tract infection. A sized 2 x 1 cm mass between labia major and minor was noted, while CT scan showed a lesion that encompassed uterus and extended to the posterior side of the bladder in the left adnexal region and a 3 cm lesion in the liver. Excisional biopsy of the mass revealed a well-differentiated, squamous cell carcinoma. Dysuria resolved with insertion of urinary catheter after bougie dilatation and the patient was referred for radiotherapy. Conclusion It should be kept in the mind that renal failure may develop due to constitutional urogenital anomalies such as vulva carcinoma. This can be an important cause of morbidity and mortality in patients with Bardet-Biedl syndrome.Hippokratia 2015; 19 (2):176-178.

  9. Xp11.2 translocation renal cell carcinoma with multiple bone metastases: A case report

    PubMed Central

    LIU, JIAJU; SU, ZHENGMING; LI, YIFAN; CHEN, DUQUN; NI, LIANGCHAO; MAO, XIANGMING; YANG, SHANGQI; LAI, YONGQING

    2016-01-01

    Xp11.2 translocation/transcription factor enhancer 3 (TFE3) fusion gene associated with renal cell carcinoma (Xp11.2 translocation RCC) is rare and occurs predominantly in children and adolescents. The current study reports the case of a 14-year-old male with Xp11.2 translocation RCC, who presented with chest pain that had persisted for 1 month. A solid neoplasm was located in the left kidney of the patient. Contrast-enhanced computed tomography revealed the presence of a solid mass in the kidney, with uneven enhancement. Destruction of multiple bones was also observed. The patient was treated with a radical nephrectomy. The pathological examination of the tumor revealed that the tumor cells contained an eosinophilic cytoplasm in the renal interstitial tissue. Immunohistochemistry revealed that the tumor cells expressed P504S, cluster of differentiation 10, pan-cytokeratin, vimentin and TFE3. In conclusion, Xp11.2 translocation RCC is a rare type of kidney cancer. Diagnosing this disease prior to surgery is challenging, and providing a definite diagnosis requires histopathological and immunohistochemical examination, while genetic analysis may also be required. PMID:26998154

  10. Microsporidiosis in pediatric renal transplant patients in Cape Town, South Africa: two case reports.

    PubMed

    Ladapo, Taiwo A; Nourse, Peter; Pillay, Komala; Frean, John; Birkhead, Monica; Poonsamy, Bhavani; Gajjar, Priya

    2014-11-01

    Microsporidia are an emerging group of pathogens associated with life-threatening opportunistic infections in immunocompromised hosts, particularly human immunodeficiency virus (HIV)-infected individuals. There have, however, been recent reports of infection in adult solid organ transplant recipients. We report two cases in children, to our knowledge the first in the paediatric literature. Two 13-yr-old, HIV-seronegative females received deceased donor renal transplants from the same donor. Both patients suffered acute cell-mediated rejection and CMV infection reactivation, managed with intensified immunosuppression and ganciclovir. Pyrexia of unknown origin and intermittent diarrhea in both prompted extensive investigations. In both patients, numerous spores of a microsporidial species were demonstrated in renal tissue on biopsy and in the urine, using modified trichrome and quick-hot Gram-chromotrope staining. Electron microscopy and PCR confirmed Encephalitozoon cuniculi infections. Both patients were successfully treated with 400 mg twice daily of albendazole, with sustained clinical improvement. We recommend that microsporidiosis be considered in the differential diagnosis of pyrexia of unknown origin in severely immunocompromised pediatric solid organ transplant recipients, particularly when associated with diarrhea. PMID:25132634

  11. Pancreatic metastases from renal cell carcinoma: a case report and literature review of the clinical and radiological characteristics

    PubMed Central

    2013-01-01

    Metastatic pancreatic cancer is rare, accounting for approximately 2% of all pancreatic malignancies, and most cases arise from renal cell carcinoma. We report the case of a 63-year-old woman, who presented with a pancreatic tumor detected during her annual health examination. She had undergone left nephrectomy 13 years previously for renal cell carcinoma. Computed tomography (CT) revealed two tumors in the head and body of the pancreas, a hypervascular tumor and a hypovascular tumor with an enhanced rim, respectively. She underwent pylorus-preserving pancreaticoduodenectomy, and metastatic pancreatic tumors arising from the kidney with clustered clear cell carcinoma immunohistochemically positive for CD10 were diagnosed. This report presents the different enhancement features of different lesions on CT scans. Because the enhancement features of lesions have been reported to vary according to the size of the metastatic tumor, a knowledge of the history of renal cell carcinoma is crucial for diagnosis. PMID:24209713

  12. [Three Patients with Acute Myocardial Infarction Associated with Targeted Therapy of Sorafenib for Metastatic Renal Cell Carcinoma : Case Report].

    PubMed

    Takagi, Kimiaki; Takai, Manabu; Kawata, Kei; Horie, Kengo; Kikuchi, Mina; Kato, Taku; Mizutani, Kosuke; Seike, Kensaku; Tsuchiya, Tomohiro; Yasuda, Mitsuru; Yokoi, Shigeaki; Nakano, Masahiro; Ushikoshi, Hiroaki; Miyazaki, Tatsuhiko; Deguchi, Takashi

    2015-09-01

    Sorafenib is a tyrosine kinase inhibitor (TKI) of the vascular endothelial growth factor receptor (VEGFR) used for advanced renal cell carcinoma. Treatment with sorafenib prolongs progression-free survival in patients with advanced clear-cell renal cell carcinoma. However, in spite of its therapeutic efficacy, sorafenib causes a wide range of adverse events. Cardiovascular adverse events have been observed when sorafenib was used with targeted agents. Although these adverse events like hypertension, reduced left ventricular ejection fraction, cardiac ischemia or infarction were manageable with standard medical therapies in most cases, some had a poor clinical outcome. We report three cases of acute myocardial infarction associated with sorafenib in patients with metastatic renal cell carcinoma. PMID:26497860

  13. Pancreatic metastases from renal cell carcinoma: a case report and literature review of the clinical and radiological characteristics.

    PubMed

    Hoshino, Yoshinori; Shinozaki, Hiroharu; Kimura, Yuki; Masugi, Yohei; Ito, Homare; Terauchi, Toshiaki; Kimata, Masaru; Furukawa, Junji; Kobayashi, Kenji; Ogata, Yoshiro

    2013-01-01

    Metastatic pancreatic cancer is rare, accounting for approximately 2% of all pancreatic malignancies, and most cases arise from renal cell carcinoma. We report the case of a 63-year-old woman, who presented with a pancreatic tumor detected during her annual health examination. She had undergone left nephrectomy 13 years previously for renal cell carcinoma. Computed tomography (CT) revealed two tumors in the head and body of the pancreas, a hypervascular tumor and a hypovascular tumor with an enhanced rim, respectively. She underwent pylorus-preserving pancreaticoduodenectomy, and metastatic pancreatic tumors arising from the kidney with clustered clear cell carcinoma immunohistochemically positive for CD10 were diagnosed. This report presents the different enhancement features of different lesions on CT scans. Because the enhancement features of lesions have been reported to vary according to the size of the metastatic tumor, a knowledge of the history of renal cell carcinoma is crucial for diagnosis. PMID:24209713

  14. A Case of Cryptorchidism with Ipsilateral Congenital Unilateral Absence of the Vas Deferens and Contralateral Renal Agenesis.

    PubMed

    Yu, Young Dong; Hong, Young Kwon

    2016-01-01

    Introduction and Aims. Congenital absence of the vas deferens is an uncommon anomaly and this clinical condition is responsible for up to 1-2% of male infertility. It can be either unilateral or bilateral and the associated anomalies include cryptorchidism, seminal vesicles and ejaculatory ducts anomalies, and renal anomalies such as renal agenesis. We hereby present a case of congenital unilateral absence of vas deferens, which was found incidentally during an evaluation of undescended testis in a patient with ipsilateral renal agenesis. Case Presentation. A 10-month-old boy was referred to the urology clinic with an undescended right testis. Preoperative abdominal ultrasonography showed agenesis of the right kidney and the absence of right vas deferens and epididymis was confirmed during laparoscopic orchiectomy performed due to short right spermatic cord. There were no other concomitant anomalies of the genitourinary system observed in evaluation. Conclusion. Congenital unilateral absence of the vas deferens with cryptorchidism and renal agenesis is a rare diagnostic entity. Cryptorchidism or absent vas deferens found incidentally should lead the physician to evaluate the status of the contralateral vas deferens and conduct a renal tract ultrasound study. PMID:27597925

  15. A Case of Cryptorchidism with Ipsilateral Congenital Unilateral Absence of the Vas Deferens and Contralateral Renal Agenesis

    PubMed Central

    Yu, Young Dong

    2016-01-01

    Introduction and Aims. Congenital absence of the vas deferens is an uncommon anomaly and this clinical condition is responsible for up to 1-2% of male infertility. It can be either unilateral or bilateral and the associated anomalies include cryptorchidism, seminal vesicles and ejaculatory ducts anomalies, and renal anomalies such as renal agenesis. We hereby present a case of congenital unilateral absence of vas deferens, which was found incidentally during an evaluation of undescended testis in a patient with ipsilateral renal agenesis. Case Presentation. A 10-month-old boy was referred to the urology clinic with an undescended right testis. Preoperative abdominal ultrasonography showed agenesis of the right kidney and the absence of right vas deferens and epididymis was confirmed during laparoscopic orchiectomy performed due to short right spermatic cord. There were no other concomitant anomalies of the genitourinary system observed in evaluation. Conclusion. Congenital unilateral absence of the vas deferens with cryptorchidism and renal agenesis is a rare diagnostic entity. Cryptorchidism or absent vas deferens found incidentally should lead the physician to evaluate the status of the contralateral vas deferens and conduct a renal tract ultrasound study. PMID:27597925

  16. Diagnosis of rare association of orthotopic multicystic dysplasia with crossed fused renal ectopia.

    PubMed

    Tang, Linnan; Koshy, June; Spevak, Melissa R; Benson, Jane E; Bosemani, Thangamadhan

    2014-01-01

    Orthotopic multicystic dysplastic kidney with crossed fused ectopia is a rare congenital anomaly. This congenital anomaly may give an appearance of a solitary kidney morphology during the initial imaging evaluation. A solitary kidney should be carefully evaluated for the presence of duplication, horseshoe configuration, or crossed renal ectopy. Vesicoureteral reflux is a common finding associated with a multicystic dysplastic kidney. We present an infant with an orthotopic multicystic dysplastic kidney and an inferiorly placed crossed fused ectopic kidney. The presence of a complex congenital anomaly may warrant further evaluation with cross-sectional imaging to depict the anatomy and structure. PMID:24839577

  17. Diagnosis of Rare Association of Orthotopic Multicystic Dysplasia with Crossed Fused Renal Ectopia

    PubMed Central

    Tang, Linnan; Koshy, June; Spevak, Melissa R.; Benson, Jane E.; Bosemani, Thangamadhan

    2014-01-01

    Orthotopic multicystic dysplastic kidney with crossed fused ectopia is a rare congenital anomaly. This congenital anomaly may give an appearance of a solitary kidney morphology during the initial imaging evaluation. A solitary kidney should be carefully evaluated for the presence of duplication, horseshoe configuration, or crossed renal ectopy. Vesicoureteral reflux is a common finding associated with a multicystic dysplastic kidney. We present an infant with an orthotopic multicystic dysplastic kidney and an inferiorly placed crossed fused ectopic kidney. The presence of a complex congenital anomaly may warrant further evaluation with cross-sectional imaging to depict the anatomy and structure. PMID:24839577

  18. Renal myelolipoma: a rare extra-adrenal tumor in a rare site: a case report and review of the literature

    PubMed Central

    2013-01-01

    Introduction Myelolipomas are uncommon, benign tumors composed of mature adipose tissue and hematopoietic elements. They mostly occur in the adrenal glands, but extra-adrenal myelolipomas have also been reported in other locations such as the presacral region, retroperitoneum, pelvis and mediastinum. Here, we present a case of an extra-adrenal myelolipoma in a rare site: the renal parenchyma. To the best of our knowledge, it is only the third case reported in this unusual location. Case presentation We report a case of primary myelolipoma occurring in the kidney of a 55-year-old Moroccan man. We describe the radiological and clinicopathologic features of this unusual tumor with a review of the literature, and we discuss differential diagnosis of retroperitoneal myelolipomas. Conclusion This case is noteworthy because the tumor site was unusual. Although renal myelolipoma is rare, it should be considered in the differential diagnosis of lesions in this site. PMID:23556993

  19. Unusual case of tacrolimus vascular toxicity after deceased donor renal transplantation.

    PubMed

    Sugitani, Atsushi; Takahashi, Chihiro; Naka, Takuji; Hisamitsu, Kazunori; Yamamoto, Osamu; Taniguchi, Kenjiro; Kobayashi, Naoto; Kimura, Mari; Yoshida, Haruhiko; Hamazoe, Ryuichi

    2016-07-01

    We report a case of tacrolimus vascular toxicity found on a protocol biopsy shortly after a deceased donor renal transplantation. The patient was immunologically high-risk and acute antibody-mediated rejection during post-transplant dialysis phase was suspected on the protocol biopsy. Although the patient was stable after treatment of rejection, a further examination showed a very rare but specific side-effect of tacrolimus. It is sometimes difficult to make a differential diagnosis during postoperative dialysis period among AMR, primary non-functioning, drug toxicity, infection or just prolonged recovery from the damage of a long agonal phase on the non-heart beating donor. Although the possibilities of coexistence of rejection or other causes such as infection have not been completely excluded, it is important to be aware of this unusual side effect of tacrolimus. PMID:27004749

  20. An Unusual Combination of Biliary Cystadenoma and Renal Angiomyolipoma- A Case Report

    PubMed Central

    Thambi, Renu; Syriac, Sylvia; Kumar, Anil

    2016-01-01

    Hepatobiliary cystadenomas are mucinous cystic neoplasms arising in the liver, extrahepatic bile ducts or gall bladder. Extrahepatic cystadenomas are rare neoplasms requiring complete excision as there is a chance for recurrence and malignant transformation. Angiomyolipoma (AML) belongs to the perivascular epithelioid cell group of neoplasms, and kidney is the commonest site involved. We report a case of an unusual combination of extrahepatic biliary cystadenoma with angiomyolipoma in an adult female without evidence of tuberous sclerosis. The patient presented with abdominal discomfort and on ultrasonological examination showed a cyst close to liver suggestive of hydatid disease and an incidental mass in kidney which was diagnosed as angiomyolipoma. Histopathological examination revealed biliary cystadenoma of liver and renal angiomyolipoma. Clinical and radiological evaluation did not show any manifestations of tuberous sclerosis. Such an unusual incidence of two separate neoplasms in a patient without syndromic association was not obtained even after extensive literature search.

  1. Histological and immunohistochemical characterization of feline renal cell carcinoma: a case series

    PubMed Central

    BONSEMBIANTE, Federico; BENALI, Silvia Lucia; TREZ, Davide; ARESU, Luca; GELAIN, Maria Elena

    2016-01-01

    Four feline renal cell carcinomas (RCCs) were examined using histopathological and immunohistochemical procedures. Specimens were classified by predominant histological pattern according to WHO criteria. A panel of antibodies including β-catenin, C-KIT, VEGF and VEGF-R2 and double immunostaining for vimentin/cytokeratin and for E-cadherin/CD10 was selected to characterize the tumors. Neoplasms were classified as tubular (3/4) and papillary (1/4). Neoplastic epithelial cells were cytokeratin, vimentin, E-cadherin, VEGF-R2 positive and C-KIT negative; 3 cases were β-catenin positive, whereas only 2 tumors were CD10 and VEGF positive. No correlation with histotype was evident. Our results confirm the low frequency of RCCs in cats and suggest a histological pattern similar to canine RCCs. In contrast, a peculiar immunohistochemical profile different from both canine and human RCCs is identified. PMID:26888581

  2. Rhabdomyolysis and acute renal failure following use of succinylcholine and enflurane: report of a case.

    PubMed

    Lee, S C; Abe, T; Sato, T

    1987-09-01

    A case of succinylcholine and enflurane induced rhabdomyolysis and myoglobinuric acute renal failure in a mentally retarded patient is presented. The report illustrates some principles of management and the correlation of laboratory findings with the syndrome. When using general anesthesia in mentally retarded patients it is recommended that: 1) a careful personal and family past anesthetic history be taken; 2) drugs and apparatus for treatment of the crisis be available before anesthesia is induced; 3) the use of succinylcholine and potent inhalation anesthetic agents be avoided; 4) there is early diagnosis by prompt recognition of the clinical signs; and 5) that body temperature monitoring and frequent observation of vital signs during and after an operation be carried out. PMID:3476700

  3. Laparoscopic Renal Denervation for Uncontrolled Hypertension Due to Medication Intolerance: A Case Report.

    PubMed

    Gerber, Rebecca C; Bahler, Clint D; Kraus, Michael A; Sundaram, Chandru P

    2016-07-01

    Resistant hypertension is challenging to treat, and most patients with the condition fail to achieve blood pressure control, putting them at increased risk for adverse long-term outcomes. We present the case of a 59-year-old woman with resistant hypertension due to intolerance to nearly all antihypertensive medications. After failure to achieve blood pressure control over a 5-year period, with blood pressures as high as 220/110mmHg, the patient underwent surgical treatment with bilateral laparoscopic renal denervation. Immediately after the procedure, as well as at the 1-, 3-, 9-, and 12-month follow-ups, the patient's blood pressure was reduced to the range of 120-140/80-90mmHg. PMID:26994687

  4. Metastatic clear cell variant of renal cell carcinoma of the mandible: Review and case report

    PubMed Central

    Shah, Ajaz; Jahan, Shahi; Najar, Latief; Hassan, Shahid; Mohammad, Manzoor

    2016-01-01

    A case of metastatic renal cell carcinoma (RCC) to the mandible is reported. A 22-year-old man consulted us for hypoesthesia of the right lower lip. Panorama X-ray film showed a radiolucent lesion in the right mandibular body. A diagnosis of a metastatic tumor to the mandible from the right kidney was made after evaluation by computed tomography and bone scan with Tc99 methyl diphosphonate which also revealed multiple bone metastases. Histologically diagnosis was clear cell variant of RCC. Patient has been put on radiotherapy for symptomatic treatment and a molecularly targeted drug. The therapy effectively stopped the progressive growth of oral and other metastatic lesions. The quality of life is relatively well maintained with tolerable adverse effects. The patient is still on our follow-up with an improved quality of life.

  5. Metastatic clear cell variant of renal cell carcinoma of the mandible: Review and case report.

    PubMed

    Shah, Ajaz; Jahan, Shahi; Najar, Latief; Hassan, Shahid; Mohammad, Manzoor

    2016-01-01

    A case of metastatic renal cell carcinoma (RCC) to the mandible is reported. A 22-year-old man consulted us for hypoesthesia of the right lower lip. Panorama X-ray film showed a radiolucent lesion in the right mandibular body. A diagnosis of a metastatic tumor to the mandible from the right kidney was made after evaluation by computed tomography and bone scan with Tc99 methyl diphosphonate which also revealed multiple bone metastases. Histologically diagnosis was clear cell variant of RCC. Patient has been put on radiotherapy for symptomatic treatment and a molecularly targeted drug. The therapy effectively stopped the progressive growth of oral and other metastatic lesions. The quality of life is relatively well maintained with tolerable adverse effects. The patient is still on our follow-up with an improved quality of life. PMID:27563625

  6. Case of early-disseminated Rhizopus microsporus var. microsporus mucormycosis in a renal transplant patient

    PubMed Central

    Sharma, Dikshya; Dahal, Kumud; Pathak, Bandana; Dahal, Udip

    2016-01-01

    Mucormycosis is a rare infection caused by the ubiquitous filamentous fungi of the order Mucorales and class Zygomycetes. These species are vasotropic, causing rapid onset of tissue infarctions and necrosis and subsequent thrombosis by invading vascular bed. The disease spectrum ranges from involvement of skin, sinuses, lung, and brain to disseminated and mostly fatal infections, especially in immunocompromised hosts. Here, we present a case of a fatal disseminated mucormycosis in a 56-year-old female who had deceased donor renal allograft transplantation ~2 weeks prior to presentation. She presented with shortness of breath and dry cough. Despite being on broad-spectrum antibiotics/antifungals and proper management by transplant, infectious disease, and primary team, she died within 3 weeks of admission. Autopsy showed disseminated mucormycosis of lungs and thyroid. Disseminated infection within 2 weeks of solid organ transplantation in this patient was one of the rare features of mucormycosis. PMID:27354831

  7. Histological and immunohistochemical characterization of feline renal cell carcinoma: a case series.

    PubMed

    Bonsembiante, Federico; Benali, Silvia Lucia; Trez, Davide; Aresu, Luca; Gelain, Maria Elena

    2016-07-01

    Four feline renal cell carcinomas (RCCs) were examined using histopathological and immunohistochemical procedures. Specimens were classified by predominant histological pattern according to WHO criteria. A panel of antibodies including β-catenin, C-KIT, VEGF and VEGF-R2 and double immunostaining for vimentin/cytokeratin and for E-cadherin/CD10 was selected to characterize the tumors. Neoplasms were classified as tubular (3/4) and papillary (1/4). Neoplastic epithelial cells were cytokeratin, vimentin, E-cadherin, VEGF-R2 positive and C-KIT negative; 3 cases were β-catenin positive, whereas only 2 tumors were CD10 and VEGF positive. No correlation with histotype was evident. Our results confirm the low frequency of RCCs in cats and suggest a histological pattern similar to canine RCCs. In contrast, a peculiar immunohistochemical profile different from both canine and human RCCs is identified. PMID:26888581

  8. Escherichia Coli-Related Necrotizing Fasciitis After Renal Transplantation: A Case Report.

    PubMed

    Turunç, V; Eroğlu, A; Cihandide, E; Tabandeh, B; Oruğ, T; Güven, B

    2015-06-01

    A 39-year-old man who had received cadaveric renal transplantation (RT) 1 month previously presented with rash and pain on his left lower extremity. Initially, bacterial cellulitis was suspected, and ampicillin/sulbactam was initiated; however, 3 days later, skin necrosis occurred and pain increased. Ampicillin/sulbactam was replaced with imipenem+ciprofloxacin, and surgical debridement was performed. Escherichia coli was identified in the wound culture, urine culture, and blood culture. After repeated debridement, wound care, and appropriate antimicrobial treatment, wounds began to heal and skin grafting was planned at the 4th month of therapy. However, the patient died of viral pneumonia. To date, 20 cases of necrotizing fasciitis (NF) after RT have been reported (including our case), and, as far as we know, this is the second E coli-related NF case. An analysis of all 20 cases showed that the most common infection site was the extremities (90%) and that 45% of pathogens were fungus. The mortality rate was 30%. NF is a rare but rapidly developing and life-threatening soft-tissue infection in RT patients. To reduce mortality rates, early diagnosis, recurrent surgical debridement, and aggressive therapy are mandatory. PMID:26093756

  9. [Solitary Bladder Metastasis of Chromophobe Renal Cell Carcinoma: Report of a Case].

    PubMed

    Nitta, Satoshi; Suetomi, Takahiro; Kojou, Kousuke; Tanaka, Ken; Kurobe, Masahiro; Yoshino, Takayuki; Yamazaki, Kazumitu; Kimura, Tomokazu; Kandori, Shuya; Kawahara, Takashi; Kawai, Kouji; Miyazaki, Jun; Yano, Youko; Yamada, Kenji; Noguchi, Masayuki; Nishiyama, Hiroyuki

    2016-02-01

    Bladder metastasis of renal cell carcinoma (RCC) is relatively rare, and only 43 cases have been reported in the Japanese literature. In most cases, the histology of the primary site was clear cell type. Here, we report a case of bladder metastasis of chromophobe RCC. A 74-year-old man presented with asymptomatic gross hematuria. He had a history of chromophobe RCC treated with radical nephrectomy 11 years previously. Since cystoscopy revealed a papillary pedunculated tumor, he underwent transurethral resection of the bladder tumor (TUR-Bt). The pathological diagnosis was chromophobe RCC because the histological findings were similar to those of nephrectomized specimens. Four years after TUR-Bt, the patient received bacillus Calmette-Guérin (BCG) therapy under the diagnosis of carcinoma in situ of urothelial cancer of the bladder but not chromophobe RCC. There was no recurrence of chromophobe RCC within 5 years follow-up after TUR-Bt. To the best of our knowledge, there has been only one other case report of bladder metastasis of chromophobe RCC in the Japanese literature. PMID:27018407

  10. Recurrent renal cell carcinoma manifesting as a large intrathoracic fibrotic mass: A case report

    PubMed Central

    KIM, JI HYUN; JEONG, JAE HOON; PARK, SUNG-HYUN; JEONG, JIN SEON; RYU, YOUNG-JOON; SONG, SEO-YOUNG

    2016-01-01

    Renal cell carcinomas (RCCs) have a strong tendency to metastasize, and the most common sites are the lungs, bones and liver. Late recurrence is another feature of the RCC, with lesions appearing ≥10 years after surgical treatment. However, fibrosis has rarely been associated with the disease. The present study reports a case of recurrent RCC that manifested as a fibrotic mass within the thorax. A 48-year-old man presented with dyspnea that had persisted for 3 days. The patient had undergone a right radical nephrectomy for stage II clear cell carcinoma of the kidney 6 years previously. The patient was a current smoker, with a smoking history of 20 pack-years. Chest radiography showed pleural effusion in the right thorax with an egg-sized mass shadow within the right upper lung (RUL) field. Computed tomography (CT) showed a main mass, 7 cm in diameter, within the RUL, with heterogeneous enhancement and multiple nodules of various sizes in the lungs, suggestive of primary lung cancer or metastatic RCC. A CT-guided percutaneous needle aspiration biopsy was obtained from the main mass, but histology revealed dense fibrous tissue without any malignant cells. Positron emission tomography-CT demonstrated an irregular hypermetabolic RUL mass, with a standardized uptake value (SUV) of 5.0, along the right pleura, and small pulmonary nodules (SUV, 2.0). Ultrasound-guided biopsy was attempted for a smaller hypermetabolic pleural nodule and the result was clear cell adenocarcinoma, consistent with the previous renal histology. The present study describes the case, along with a review of the relevant literature. PMID:27313703

  11. Renal sparing treatment of upper tract malignant urothelial tumours using photodynamic therapy (PDT)-three case reports.

    PubMed

    Coombs, L M; Dixon, Kate

    2004-05-01

    Urothelial cancers of the upper urinary tract are usually treated by excision of the kidney, ureter and cuff of the bladder on the affected side. These three cases demonstrate the feasibility, safety and efficacy of photodynamic therapy as a renal sparing procedure for urothelial tumours. PMID:25048071

  12. A novel germline mutation in SDHA identified in a rare case of gastrointestinal stromal tumor complicated with renal cell carcinoma.

    PubMed

    Jiang, Quan; Zhang, Yong; Zhou, Yu-Hong; Hou, Ying-Yong; Wang, Jiong-Yuan; Li, Jing-Lei; Li, Ming; Tong, Han-Xing; Lu, Wei-Qi

    2015-01-01

    Succinate dehydrogenase (SDH), which is located on the mitochondrial inner membrane, is essential to the Krebs cycle. Mutations of the SDH gene are associated with many tumors, such as renal cell carcinoma, wild type gastrointestinal stromal tumors (WT GISTs) and hereditary paragangliomas/pheochromocytomas. Herein we present a rare case diagnosed as a WT GIST complicated with a renal chromophobe cell tumor and detected a novel germline heterozygous mutation (c.2T>C: p.M1T) in the initiation codon of the SDHA gene. We also conduct a preliminary exploration for the mechanism of reduced expression of SDHB without mutation of SDHB gene. Our case enriches the mutation spectrum of the SDH gene. After reviewing previous studies, we found it to be the first case diagnosed as a WT GIST complicated with a synchronous renal chromophobe cell tumor and identified a novel germline heterozygous mutation. It was also the second reported case of a renal cell carcinoma associated with an SDHA mutation. PMID:26722403

  13. Do Not Judge a Kidney by Its Pelvis: A Rare Case of an Unobstructed Dilated Renal Pelvis

    PubMed Central

    Martin, Aaron D.; Peters, Craig A.

    2014-01-01

    We present a rare case of an unobstructed dilated renal pelvis in a newborn female. Prenatal imaging documented a large abdominal cyst in a stable fetus. Postnatal imaging confirmed persistence of this large cyst but with an unclear etiology. The child was taken to surgery by the pediatric surgeons with concern for a possible harmful nonurologic diagnosis. Intraoperative findings were that of a severely dilated renal pelvis; however, in the absence of an expected ureteropelvic junction obstruction. Reduction pyeloplasty without interference of the ureteropelvic junction proved successful. PMID:26955549

  14. Do Not Judge a Kidney by Its Pelvis: A Rare Case of an Unobstructed Dilated Renal Pelvis.

    PubMed

    Martin, Aaron D; Peters, Craig A

    2014-03-01

    We present a rare case of an unobstructed dilated renal pelvis in a newborn female. Prenatal imaging documented a large abdominal cyst in a stable fetus. Postnatal imaging confirmed persistence of this large cyst but with an unclear etiology. The child was taken to surgery by the pediatric surgeons with concern for a possible harmful nonurologic diagnosis. Intraoperative findings were that of a severely dilated renal pelvis; however, in the absence of an expected ureteropelvic junction obstruction. Reduction pyeloplasty without interference of the ureteropelvic junction proved successful. PMID:26955549

  15. A Case Report of Familial Renal Hypouricemia Confirmed by Genotyping of SLC22A12, and a Literature Review.

    PubMed

    Kim, Hyung Oh; Ihm, Chun-Gyoo; Jeong, Kyung Hwan; Kang, Hyun Joon; Kim, Jae-Min; Lim, Hyung Suk; Kim, Jin Sug; Lee, Tae Won

    2015-12-01

    A 24-year-old male visited our hospital because of pain in both flanks. His biochemistry profile showed an elevated serum creatinine level and low serum uric acid level. History taking revealed that he had undertaken exercise prior to the acute kidney injury (AKI) event, and he stated that family members had a history of urolithiasis. His renal profile improved after hydration and supportive care during hospitalization. Although the patient was subsequently admitted again due to AKI, his status recovered with similar treatment. Since the diagnosis of the patient was familial renal hypouricemia with exercise-induced AKI, we performed genotyping of SLC22A12, which encodes human urate transporter 1. The diagnosis was confirmed by the detection of a homozygous mutation of W258X. We herein, report a case of familial renal hypouricemia confirmed by genotyping of SLC22A12, and review the relevant literature. PMID:26848304

  16. Minimal Change Disease as a Secondary and Reversible Event of a Renal Transplant Case with Systemic Lupus Erythematosus

    PubMed Central

    Gkrouzman, Elena; Kirou, Kyriakos A.; Seshan, Surya V.; Chevalier, James M.

    2015-01-01

    Secondary causes of minimal change disease (MCD) account for a minority of cases compared to its primary or idiopathic form and provide ground for consideration of common mechanisms of pathogenesis. In this paper we report a case of a 27-year-old Latina woman, a renal transplant recipient with systemic lupus erythematosus (SLE), who developed nephrotic range proteinuria 6 months after transplantation. The patient had recurrent acute renal failure and multiple biopsies were consistent with MCD. However, she lacked any other features of the typical nephrotic syndrome. An angiogram revealed a right external iliac vein stenosis in the region of renal vein anastomosis, which when restored resulted in normalization of creatinine and relief from proteinuria. We report a rare case of MCD developing secondary to iliac vein stenosis in a renal transplant recipient with SLE. Additionally we suggest that, in the event of biopsy-proven MCD presenting as an atypical nephrotic syndrome, alternative or secondary, potentially reversible, causes should be considered and explored. PMID:26351598

  17. A child presenting with acute renal failure secondary to a high dose of indomethacin: a case report

    PubMed Central

    2009-01-01

    Introduction Acute renal failure caused by nonsteroidal anti-inflammatory drugs administered at therapeutic doses is generally mild, non-anuric and transitory. There are no publications on indomethacin toxicity secondary to high doses in children. The aim of this article is to describe acute renal failure secondary to a high dose of indomethacin in a child and to review an error in a supervised drug prescription and administration system. Case presentation Due to a medication error, a 20-day-old infant in the postoperative period of surgery for Fallot's tetralogy received a dose of 10 mg/kg of indomethacin, 50 to 100 times higher than the therapeutic dose. The child presented with acute, oligo-anuric renal failure requiring treatment with continuous venovenous renal replacement therapy, achieving complete recovery of renal function with no sequelae. Conclusion In order to reduce medication errors in critically ill children, it is necessary to develop a supervised drug prescription and administration system, with controls at various levels. PMID:19192282

  18. Follow up of an immunocompromised contact group of a case of open pulmonary tuberculosis on a renal unit.

    PubMed Central

    Drobniewski, F. A.; Ferguson, J.; Barritt, K.; Higgins, R. M.; Higgon, M.; Neave, D.; Uttley, A. H.; O'Sullivan, D.; Hay, A.

    1995-01-01

    BACKGROUND--The organisation, management, outcome and cost of follow up of a large group of mainly immunocompromised patients and healthcare workers who were exposed to a staff member of a London renal unit with smear positive pulmonary tuberculosis are described. METHODS--Following British Thoracic Society (BTS) guidelines, 576 close contacts were identified and divided into three groups: (1) 303 renal patients including 61 with renal transplants; (2) 90 surgical patients; and (3) 183 staff members. Screened contacts were interviewed, completed a symptoms questionnaire, and were offered a chest radiograph and Heaf or Mantoux test if appropriate with referral to a chest physician if required. RESULTS--Overall, 524 (85%) living contacts have been screened: 243 (97%) renal (first screening), 63 (70%) surgical, and 135 (74%) staff contacts. Thirty one transplant patients were prescribed isoniazid chemoprophylaxis. Fifty two renal patients had died before screening and 11 deaths occurred after first interview. One case of tuberculosis epidemiologically related to the index case was diagnosed on clinical criteria. A review of the case records and/or death certificates and entries on to tuberculosis registers indicated no further cases. The cost of the investigation was estimated to be approximately franc25 000, or franc44 per contact screened, with staff costs comprising 79% of the total. CONCLUSIONS--Undiagnosed tuberculosis in healthcare workers working with immunosuppressed patients can lead to large and expensive follow up studies. The applicability of the 1990 and 1994 BTS guidelines to the investigation of tuberculosis in an immunocompromised nosocomial group, and the role of the infection control doctor and the consultant in Communicable Disease Control in overlapping nosocomial and community incidents, are discussed. PMID:7570438

  19. Renal cell carcinoma with vena caval involvement: a contemporary clinicopathologic analysis of 53 cases.

    PubMed

    Nwadei, Ifeoma U; Lorentz, Adam; Patil, Dattatraya; Dimarco, Michelle A; Master, Viraj A; Osunkoya, Adeboye O

    2016-03-01

    A clinicopathologic analysis of patients with renal cell carcinoma (RCC) and vena caval involvement diagnosed at our institution was performed. Multiple clinicopathologic parameters were examined. Fifty-three cases were identified. Mean patient age was 62 years (range, 40-82 years). The cohort comprised 36 of 53 (68%) men and 17 of 53 (32%) women. Mean primary tumor size was 10.4 cm (range, 3.1-21.0 cm). The breakdown of tumor stage was as follows: 37 of 53 (70%) were pT3b, 14 of 53 (26%) were pT3c, and 2 of 53 (4%) were pT4. Most of the tumors were clear cell RCC (45/53, 84.6%), although other variants were also represented. All cases were Fuhrman nuclear grade 3 (34/53, 64%) or 4 (19/53, 36%). Tumor necrosis was present in 41 of 53 (77%) cases. At the time of the initial tumor resection, 11 of 53 (21%) cases were staged pM1. Of the 42 patients staged as pMX at the time of primary tumor resection, 12 of 42 (29%) later developed metastasis, most commonly to the lungs. Of all 53 cases with these very advanced tumors, only 6 of 53 (11.3%) had positive surgical margins: 4 of 53 (7.5%) had positive vascular resection margins, and 2 of 53 (3.8%) had focally positive perinephric fat margins. The mean 5-year survival in our cohort was 50%. Our findings suggest that a select group of patients with RCC with vena caval involvement may benefit from radical nephrectomy, although some tumors may have positive vascular and/or nonvascular surgical resection margins even in the best surgical hands. Multi-institutional studies are needed to further characterize these advanced tumors from the molecular standpoint. PMID:26826414

  20. Clinicopathologic findings associated with chronic renal disease in cats: 74 cases (1973-1984).

    PubMed

    DiBartola, S P; Rutgers, H C; Zack, P M; Tarr, M J

    1987-05-01

    The historic, physical, laboratory, and histologic findings for 74 cats with chronic renal disease were reviewed. Most cats were older, and no breed or sex predilection was detected. This most common clinical signs detected by owners were lethargy, anorexia, and weight loss. Dehydration and emaciation were common physical examination findings. Common laboratory findings were nonregenerative anemia, lymphopenia, azotemia, hypercholesterolemia, metabolic acidosis, hyperphosphatemia, and isosthenuria. The most common morphologic diagnosis was chronic tubulointerstitial nephritis of unknown cause. The other pathologic diagnoses were renal lymphosarcoma, renal amyloidosis, chronic pyelonephritis, chronic glomerulonephritis, polycystic renal disease, and pyogranulomatous nephritis secondary to feline infectious peritonitis. PMID:3583899

  1. Benefits of a combined approach to sampling of renal neoplasms as demonstrated in a series of 351 cases.

    PubMed

    Parks, Graham E; Perkins, Louis Allen; Zagoria, Ronald J; Garvin, Abbott Julian; Sirintrapun, Sahussapont Joseph; Geisinger, Kim R

    2011-06-01

    Percutaneous radiofrequency ablation is increasingly used for curative treatment of primary cancers of the kidney. We reviewed our experience of percutaneous sampling performed under computed tomographic guidance with fine needle aspiration biopsy (FNAB) and core biopsy (CB), and we report on the complementary roles of these 2 techniques in a series of 351 consecutive patients undergoing radiofrequency ablation for renal neoplasms. Both FNAB and CB were obtained in 290 cases, of which 156 patients (54%) were positive for neoplasm in both specimens, and 27 (9%) were negative for tumor in both specimens. In 58 (20%) patients, the FNABs were positive, but the CBs were negative, and the reverse occurred in 11 patients (4%). When suspicious interpretations by FNAB and CB are included as positives in the calculations, both their complementary nature and the relative higher diagnostic yield of FNAB persisted. In 25 cases with FNABs positive for neoplasm, the CB allowed a more specific tumor classification. The 19 cases of FNAB which were read as negative/benign had corresponding CBs that were also negative/benign in 13 cases; yet, 6 were diagnostic of renal cell carcinoma not otherwise specified (1 case), renal cell carcinoma clear cell/conventional (4 cases), and non-Hodgkin lymphoma (1 case). These and additional findings illustrate the complementary value of the combination of the 2 biopsy methods for a reliable pretherapy morphologic confirmation of specific renal neoplasms. FNAB has relatively greater sensitivity and utility for on-site evaluation, whereas CB provides an additional sample for more specific subclassification and additional studies. PMID:21552112

  2. Inherited renal cystic diseases.

    PubMed

    Kim, Bohyun; King, Bernard F; Vrtiska, Terri J; Irazabal, Maria V; Torres, Vicente E; Harris, Peter C

    2016-06-01

    A number of inherited renal diseases present with renal cysts and often lead to end-stage renal disease. With recent advances in genetics, increasing number of genes and mutations have been associated with cystic renal diseases. Although genetic testing can provide a definite diagnosis, it is often reserved for equivocal cases or for ongoing investigational research. Therefore, imaging findings are essential in the routine diagnosis, follow-up, and detection of complications in patients with inherited cystic renal diseases. In this article, the most recent classification, genetic analysis, clinical presentations, and imaging findings of inherited cystic renal diseases will be discussed. PMID:27167233

  3. Left-sided renal colic as a symptom of advanced stomach cancer – a case report

    PubMed Central

    Kuciel-Lisieska, Grażyna; Licznerska, Grażyna; Tenderenda, Michał

    2012-01-01

    The typical symptoms of advanced cancer of the stomach are well known in clinical practice. The presented case concerns a patient with symptoms of left-sided renal colic, caused by a malignant tumour involving the ureter, which was diagnosed with a CT scan. The multifocal process, involving the stomach, two parts of the colon, the left ovary and the side of the pelvis, was confirmed only during surgery. The resection or partial resection of the above-mentioned organs involved by the malignant process and reconstruction of the alimentary tract as well as the ureter were performed at time of this operation. The patient's recovery was without any complications. The histopathological findings support the diagnosis of this malignant process as disseminated stomach cancer. In the available literature only two cases of stomach cancer metastasis to the ureter have been described. In both cited examples resection of the ureter with nephrectomy was performed. The review of the literature supports the value of stomach palliative resection in prolonging life and improving quality of life. PMID:23788876

  4. Fatal hyperammonemia after renal transplant due to late-onset urea cycle deficiency: a case report.

    PubMed

    Bezinover, D; Douthitt, L; McQuillan, P M; Khan, A; Dalal, P; Stene, J; Uemura, T; Kadry, Z; Janicki, P K

    2010-06-01

    We present a case of severe hyperammonemia with subsequent brain herniation in an adult man after renal transplantation. After successful surgery and an initially uneventful postoperative course, the patient developed significant mental status changes associated with seizure activity. His condition rapidly deteriorated, requiring mechanical ventilation and cardiovascular support. Laboratory studies at that time demonstrated an increased serum ammonia level without evidence of liver or kidney dysfunction. Further investigation revealed an increased orotic acid level in the urine, suggesting a urea cycle disorder (UCD). Despite aggressive therapy, the patient's condition continued to deteriorate. Magnetic resonance imaging demonstrated severe brain edema with no cerebral perfusion; after consultation with the family, care was withdrawn. The combination of hyperammonemia and elevated urine orotic acid with normal liver and kidney function suggested a UCD. It is important to note that patients with a UCD may be free of symptoms for many years. Several factors are able to trigger the disease in adulthood, leading to encephalopathy and death. In this case, the patient's seizures were initially assumed to be a side effect of immunosuppressive therapy. Further diagnostic measures were only performed late in the course of the disease, which delayed the diagnosis of UCD. PMID:20620562

  5. A case of renal cell carcinoma metastasizing to invasive ductal breast carcinoma.

    PubMed

    Chen, Tai-Di; Lee, Li-Yu

    2014-02-01

    Tumor-to-tumor metastasis is an uncommon but well-documented phenomenon. We present a case of a clear cell renal cell carcinoma (RCC) metastasizing to an invasive ductal carcinoma (IDC) of the breast. A 74-year-old woman with a past history of clear cell RCC status after radical nephrectomy underwent right modified radical mastectomy for an enlarging breast mass 3 years after nephrectomy. Histological examination revealed a small focus with distinct morphological features similar to clear cell RCC encased in the otherwise typical IDC. Immunohistochemical studies showed that this focus was positive for CD10 and vimentin, in contrast to the surrounding IDC, which was negative for both markers and positive for Her2/neu. Based on the histological and immunohistochemical features, the patient was diagnosed with metastasis of clear cell RCC to the breast IDC. To the best of our knowledge, this is the first reported case of a breast neoplasm as the recipient tumor in tumor-to-tumor metastasis. PMID:24530247

  6. Asynchronous Bilateral Renal Infarction and Thrombophilia With Associated Gene Mutations in a 43-Year-Old Man: A Case Report.

    PubMed

    Zhou, Xu-Jie; Liu, Li-Jun; Chen, Min; Zhou, Fu-De

    2016-04-01

    Renal infarction (RI) is frequently misdiagnosed or diagnosed late because of its rarity and nonspecific clinical presentation, which may result in irreversible damage to the renal parenchyma or increase the risk of other embolic events affecting additional organs. Multiple causal mechanisms and cases of idiopathic RI have been reported, but the causal factors are not clear in most cases.Here, we report the case of a patient with heterochronic bilateral RI caused by thrombophilia. Although he had several risk factors for hypercoagulation disorders, two gene mutations-MTHFR 677 C>T and PLG 1858G>A-were identified by genome sequencing of the entire exome. The findings suggest the possibility of a synergistic relationship between the two gene mutations.Thus, screening for gene mutations may provide additional clues for clarifying the cause of RI and thrombophilia. PMID:27057875

  7. An unusual case of hematuria in a young female: renal artery embolism, mitral stenosis, and sinus rhythm.

    PubMed

    Kumar, Ashok; Kapoor, Aditya; Kumar, Sudeep

    2016-03-01

    Renal artery embolism (RAE) is an uncommon entity that is most often secondary to a cardiac source. Most reported cases have been in patients with underlying atrial fibrillation (AF), and occurrence of RAE, especially in patients with valvular heart disease, and sinus rhythm is very rare. We describe an unusual case of a young female who presented with sudden onset right flank pain, vomiting, anorexia, and hematuria, and was found to have thrombotic occlusion of the distal right renal artery. Although she denied any previous cardiac history, detailed cardiovascular examination revealed the presence of severe rheumatic mitral stenosis without any evidence of AF or left atrial clot. She was initially managed conservatively using low molecular weight heparin followed by oral anticoagulation with resolution of symptoms. A successful balloon mitral valvotomy was performed six weeks later. The patient is asymptomatic at her last follow-up of six months with preserved renal function. In symptomatic patients, clinicians need to consider the possibility of RAE even in patients of valvular heart disease with underlying sinus rhythm. Appropriate management of the underlying cardiac condition is imperative since embolism may be recurrent leading to compromise of renal function, if left untreated. PMID:26997399

  8. Breast metastases from a Renal Cell Carcinoma. A case report and review of the literature☆

    PubMed Central

    Falco, G.; Buggi, F.; Sanna, P.A.; Dubini, A.; Folli, S.

    2014-01-01

    INTRODUCTION Metastases to the breast from extra-mammary tumors are uncommon and few sporadic cases are reported in the international literature. An accurate differential diagnosis of secondary cancer is mandatory because both prognosis and treatment differ with respect to primary breast tumors. PRESENTATION OF CASE We present the case of a 70-year-old woman with an isolated metastasis to the breast occuring 9 years after undergoing a nephrectomy for Renal Cell Carcinoma (RCC). Clinical examination revealed a palpable and mobile mass in the right breast with an enlarged ipsilateral axillary lymph node. Mammographic findings showed a dense, well circumscribed solid mass and the breast ultrasonography findings were those of a hypoechoic homogeneous solid nodule with no posterior attenuation but with prominent peripheral vascularity. A tru-cut biopsy was conclusive for a metastatic deposit by RCC. A whole-body CT scan showed no evidence of further recurrences. The patient underwent metastasectomy and exeresis of the papable lymphnode. DISCUSSION In patients with former surgery for RCC, a diagnosis based on a preoperative biopsy allows to indicate the proper surgical treatment: in facts, as compared to primary breast tumors treatment, the rationale to pursue wide surgical margins is pointless in cases of metastases and, similarly, the biopsy of the sentinel lymphnode is void of sense due to the lack of its physiopathological prerequisite. CONCLUSION We suggest to consider a micro-histological biopsy of any new breast lesion appearing in a patient with a history of treatment for RCC. Prompt diagnosis is necessary to choose the right treatment. PMID:24632302

  9. Association Between the Use of Proton Pump Inhibitors and the Risk of ESRD in Renal Diseases: A Population-Based, Case-Control Study

    PubMed Central

    Peng, Yen-Chun; Lin, Cheng-Li; Yeh, Hong-Zen; Chang, Chi-Sen; Wu, Yu-Lin; Kao, Chia-Hung

    2016-01-01

    Abstract Proton pump inhibitors (PPIs) use may be associated with nephritis and acute renal injury. The risk of PPIs and deterioration of renal function, in patients with renal diseases, needs to be investigated. A case-control study was conducted in a nation-wide data setting from the Taiwan National Health Insurance Research Database (NHIRD). This case-control study used data extracted from NHIRD between the years 2006 and 2011. We used propensity scores to match 3808 patients suffering from renal diseases (ICD-9-CM codes 580–589), with patients (aged ≥20 years) who had had a recent diagnosis of end-stage renal diseases (ESRDs) and had undertaken renal replacement therapy during the period of 2006 to 2011. The 3808 control subjects were selected from people who had a history of renal diseases, but no ESRD. The risk of ESRD in patients with renal diseases and PPIs use was estimated by using odds ratios (ORs) and 95% confidence intervals (CI). The use of a PPIs was associated with a significantly higher risk of ESRD (adjusted OR = 1.88, 95% CI = 1.71–2.06) in renal disease patients. Of all the types of PPI combined, the adjusted OR was 1.92 (95% CI = 1.74–2.13) for those on <100 cumulative DDD and was 1.74-fold (95% CI = 1.52–2.00) for those on ≥100 cumulative DDD. PPIs use is associated with the risk of ESRD in patients with renal diseases. It is necessary that appropriate prescription of PPIs coordinated with the close monitoring renal function of patients diagnosed with renal disease. PMID:27082596

  10. Renal carcinoma associated with a novel succinate dehydrogenase A mutation: a case report and review of literature of a rare subtype of renal carcinoma.

    PubMed

    Ozluk, Yasemin; Taheri, Diana; Matoso, Andres; Sanli, Oner; Berker, Neslihan Kayisoglu; Yakirevich, Evgeny; Balasubramanian, Sohail; Ross, Jeffrey S; Ali, Siraj M; Netto, George J

    2015-12-01

    Renal cell carcinoma (RCC) linked to germline mutation of succinate dehydrogenase subunits A, B, C, and D (SDHA, SDHB, SDHC, and SDHD, respectively) has been recently included as a provisional entity in the 2013 International Society of Urological Pathology Vancouver classification. Most SDH-deficient tumors show SDHB mutation, with only a small number of RCC with SDHC or SDHD having been reported to date. Only one case of SDH-deficient renal carcinoma known to be SDHA mutated has been previously reported. Here we report an additional RCC harboring an SDHA mutation occurring in a 62-year-old man with right flank pain and nodal metastasis. The tumor was characterized by an infiltrative pattern with solid, acinar, and papillary components. Loss of SDHA and SDHB protein by immunohistochemistry confirmed the diagnosis. Hybrid capture-based comprehensive genomic profiling identified 3 genomic alterations in tumor tissue: (i) a novel single-nucleotide splice site deletion in SDHA gene, (ii) single-nucleotide deletion in NF2 gene, and (iii) EGFR gene amplification of 19 copies. This is the second report of SDHA-mutated RCC. With increased awareness, this rare tumor can be recognized on the basis of distinctive morphology and confirmation by immunohistochemistry and genomic profiling. PMID:26476567

  11. A case-control study of occupational sunlight exposure and renal cancer risk.

    PubMed

    Karami, Sara; Colt, Joanne S; Stewart, Patricia A; Schwartz, Kendra; Davis, Faith G; Ruterbusch, Julie J; Chow, Wong-Ho; Wacholder, Sholom; Graubard, Barry I; Purdue, Mark P; Moore, Lee E

    2016-04-01

    Epidemiological evidence of a relationship between vitamin D and kidney cancer risk has been inconsistent despite experimental data indicating that vitamin D and its metabolites may inhibit carcinogenesis. Previously we reported an inverse association between renal cell carcinoma (RCC) risk and occupational ultraviolet (UV) exposure among European men. In this study, we examined the association between occupational UV exposure and RCC risk among US residents and investigated whether this association varied by race and sex. Lifetime occupational data for 1,217 RCC cases and 1,235 controls in a population-based case-control study, conducted from 2002 to 2007, were assessed for occupational UV exposure. We evaluated exposure metrics in quartiles based on control exposure levels and calculated associations between RCC risk and occupational UV exposure using unconditional logistic regression adjusted for sex, race, body mass index, smoking, hypertension, center, education, family history of cancer and dietary vitamin D intake. A general pattern of decreasing RCC risk with increasing UV exposure was observed. Cases had significantly lower cumulative occupational UV exposure than controls (fourth quartile vs. first: odds ratio = 0.74 [95% confidence interval = 0.56-0.99], p-trend = 0.03). Similar results were observed for other UV exposure metrics. The association with occupational UV exposure was stronger for women than for men, but did not differ by race. Our findings suggest an inverse association between occupational UV exposure and RCC, particularly among women. Given the sex finding discrepancies in this study versus our previous study, additional research is need to clarify whether the protective effects of occupational UV exposure and RCC risk are real. PMID:26505275

  12. Liver histology in the arthrogryposis multiplex congenita, renal dysfunction, and cholestasis (ARC) syndrome: report of three new cases and review.

    PubMed

    Horslen, S P; Quarrell, O W; Tanner, M S

    1994-01-01

    We report three cases from two unrelated families of infants with arthrogryposis multiplex congenita, cholestatic jaundice, and renal Fanconi's syndrome. In both families the parents were consanguineous. All three children died by 7 months of age. This association was first reported in 1973 by Lutz-Richner and Landolt and again in another family by Nezelof et al in 1979. However, because of differing liver histology the two sibships were considered to have two separate conditions. Based on the histological findings in one of our cases we propose that all cases described so far represent variation within a single syndrome. PMID:8151641

  13. Two Unexpected Tumors in a Laparoscopic Nephrectomy Specimen, Including a Rare Tubulocystic Renal-Cell Carcinoma: A Case Report

    PubMed Central

    Jipp, Jacob; Defrain, Chad; Schwartz, Bradley

    2015-01-01

    Abstract We present a case of a 52-year-old Caucasian male who underwent a laparoscopic nephrectomy for an atrophic kidney and was found to have two unexpected, synchronous kidney cancers. He had a remote history of testicular cancer complicated by lymphadenopathy and external ureteral compression. Over time, he developed an atrophic left kidney from obstructive uropathy. Years later, due to flank pain and renal scintigraphy showing minimal function, a laparoscopic nephrectomy was performed. Final pathology demonstrated papillary renal-cell carcinoma (RCC) and tubulocystic RCC. Tubulocystic RCC is a rare neoplasm thought to be an indolent subset of collecting duct carcinoma, but was identified as a unique entity in 2004. Currently, there are ∼100 cases of this neoplasm in the literature.

  14. Primary renal sclerosing epithelioid fibrosarcoma: report of 2 cases with EWSR1-CREB3L1 gene fusion.

    PubMed

    Argani, Pedram; Lewin, Jack R; Edmonds, Pamela; Netto, George J; Prieto-Granada, Carlos; Zhang, Lei; Jungbluth, Achim A; Antonescu, Cristina R

    2015-03-01

    We report the first 2 genetically confirmed cases of primary renal sclerosing epithelioid fibrosarcoma (SEF), occurring in a 17-year-old boy and a 61-year-old woman. In both cases, the tumors demonstrated the typical epithelioid clear cell morphology associated with extensive hyalinizing fibrosis, raising the differential diagnosis of solitary fibrous tumor, metanephric stromal tumor, and the sclerosing variant of clear cell sarcoma of the kidney. Both neoplasms demonstrated diffuse immunoreactivity for MUC4, a highly specific marker for SEF, and both demonstrated evidence of rearrangement of both the EWSR1 and CREB3L1 genes, which have recently been shown to be fused in this entity. Both neoplasms presented with metastatic disease. Primary renal SEF represents yet another translocation-associated sarcoma now shown to arise primarily in the kidney. PMID:25353281

  15. A case of kidney transplantation using donation after circulatory death with renal calculi

    PubMed Central

    Gao, Baoshan; Zhang, Kun; Guo, Chunjie; Wang, Weigang; Wang, Gang; Wang, Yuantao; Yao, Liyu; Fu, Yaowen; Zhou, Honglan

    2015-01-01

    Donation after circulatory death (DCD) supplies a big percentage of the organ source pool. Compared to living-related donations, donor kidneys from DCD are commonly with lower quality since they inevitably suffer from hypoxia, hypotension, and inadequate organ perfusion during the progression to circulatory arrest. The current case presents a 44-year-old male donor with wide range subarachnoid hemorrhage and multiple skull fracture from a car accident. Multiple stones were detected in his right kidney. We performed a modified ex vivo pyelolithotomy and ureteroscopy on the bench to render a stone-free allograft. We also improved the donor kidney with hypothermic/perfusion preservation machine before renal transplantation. The recipient showed no complications during the first two-month post-operational follow-up. Such a donor kidney with stones may probably be discarded by conventional perspective. Yet, the combination of the ex vivo bench-surgery technique and hypothermic oxygenation/perfusion makes it a qualified donor kidney. Thus we have demonstrated a promising way of saving borderline qualified DCD donor kidneys. PMID:26885172

  16. Renal mucinous tubular and spindle cell carcinoma: report of four cases and literature review.

    PubMed

    Wang, Hui; Xie, Jun; Lu, Changqing; Zhang, Dachuan; Jiang, Jingting

    2015-01-01

    Mucinous tubular and spindle cell carcinoma of the kidney (MTSCC-K) is an unusual renal tumor. It is important to increase the recognition of the clinicopathological features of MTSCC-K and improve its clinical and differential diagnosis. This report described four cases of MTSCC-K with clinical, imaging, and pathological examination and showed that the tumor boundaries of MTSCC-K were clear, and tumor cells arranged into tubules and cord-like beams, between which was lightly stained myxoid stroma. The tumor cells were smaller and cube- or oval-shaped, with single small eosinophilic nucleoli, low-grade nuclei, and little nuclear fission. The myxoid stroma was scattered around lymphocytes and plasma cells. Immunohistochemical markers including CK7, CD117, EMA (epithelial membrane antigen), vimentin, and CK8/18, showed positive expression in tumor cells, but the tumor cells were negative for CD10 and villin. The proliferation index of Ki-67 was 5-10%. Since MTSCC-K is a rare low-grade malignancy, with unique histological and immunohistochemical characteristics, it is important for clinicians and pathologists to have a defined awareness of this tumor type in order to decrease the rate of misdiagnosis. PMID:26045827

  17. Ovarian metastasis of clear cell renal cell carcinoma: A case report.

    PubMed

    Bauerová, Lenka; Dundr, Pavel; Fischerová, Daniela; Pešl, Michael; Zikán, Michal; Burgetová, Andrea

    2014-01-01

    We report on a 61-year-old woman with a history of right-sided nephrectomy for clear cell renal cell carcinoma (RCC) occurring 21 years ago; she currently presented with a bilateral ovarian tumour. Histologically, the tumour of both ovaries was clear cell carcinoma. Immunohistochemically, the tumour cells were positive for vimentin, RCC marker, epithelial membrane antigen, cytokeratin AE1/3 and CD10. Cytokeratin 7, CA125, HMWCK, estrogen and progesterone receptors were all negative. Based on the morphology and immunophenotype of the tumour, we established a diagnosis of late metastasis of RCC in the ovaries. A postoperative abdominal computed tomography scan, however, revealed a tumour mass solely in the left kidney, which had not been visible in the preoperative ultrasound. The patient underwent nephron-sparing surgery and a biopsy showed the tumour to be clear cell RCC. Metastasis of RCC to the ovaries is rare, and to the best of our knowledge, only 24 cases have been reported to date. However, due to the different treatments and prognosis, the distinction between a primary ovarian tumour and metastasis of RCC is important. PMID:24678363

  18. Primary carcinoma of the ureteral stump following radical nephrectomy for renal cell carcinoma: A case report and literature review

    PubMed Central

    JIN, SHIHUA; WANG, GANG; YU, CHENGFAN; LI, NINGCHEN

    2016-01-01

    The occurrence of primary carcinoma of the ureteral stump following radical nephrectomy for renal cell carcinoma is extremely rare; 7 patients with the disease have been reported previously. All these patients were males with transitional cell carcinoma. The current study reports the case of a 61-year-old woman, who presented with gross hematuria following a radical nephrectomy for local clear cell renal carcinoma. A computed tomography scan revealed the presence of a mass on the ureteral stump. The patient underwent a left ureteral stump and bladder cuff excision. The histological diagnosis was high-grade transitional cell carcinoma of the ureteral stump, with focal interstitial cancer cell infiltrates. There was no evidence of recurrence during a follow-up period of 35 months. In addition, the present study reviewed the literature for previous patients with ureteral stump carcinoma following a radical nephrectomy for renal cell carcinoma; 7 previous patients with the disease were identified. The present study suggests that, if patients who have previously undergone a radical nephrectomy for renal cell carcinoma present with hematuria, the possibility of ureteral stump carcinoma should be considered, particularly in East Asian countries. The existence or a history of bladder carcinoma should be considered as a high-risk factor for developing ureteral stump carcinoma. A ureteral stump and bladder cuff excision should be performed once ureteral stump carcinoma is diagnosed. PMID:27123110

  19. Pediatric Papillary Renal Cell Carcinoma in a Horseshoe Kidney: A Case Report with Review of the Literature.

    PubMed

    Loya-Solis, Abelardo; Alemán-Meza, Lucía; Canales-Martínez, Luis Carlos; Franco-Márquez, Rodolfo; Rincón-Bahena, Alim Adriana; Nuñez-Barragán, Karla María; Garza-Guajardo, Raquel; Ponce-Camacho, Marco Antonio

    2015-01-01

    Renal cell carcinoma is the most common malignancy of the kidney in adults. In children, however, it only accounts for an estimated 1.8 to 6.3% of all pediatric malignant renal tumors. Papillary renal cell carcinoma is the second most common type of renal cell carcinoma in children. We present the case of a 12-year-old boy with a 2-month history of abdominal pain, unexplained weight loss, and gross hematuria. Computed tomography revealed a horseshoe kidney and a well-defined mass of 4 cm arising from the lower pole of the right kidney. Microscopically the tumor was composed of papillae covered with cells with abundant eosinophilic cytoplasm and high-grade nuclei with prominent nucleoli. Immunohistochemistry was performed; EMA, Vimentin, and AMACR were strongly positive while CK7, CD10, RCC antigen, TFE3, HMB-45, and WT-1 were negative. Currently, 10 months after the surgical procedure, the patient remains clinically and radiologically disease-free. PMID:26301110

  20. An unusual case of non-small cell lung cancer presenting with renal angle pain and hematuria.

    PubMed

    Peedell, Clive; Dykes, Rachel

    2007-07-01

    A 53-year-old woman was referred urgently to the urology department with a history of worsening right renal angle pain and associated hematuria. Further investigations revealed the presence of a primary non-small cell lung cancer (NSCLC) invading the posterior chest wall with an associated vaginal metastasis. To our knowledge, this is only the second case report in the literature of a vaginal metastasis from NSCLC. PMID:17607127

  1. Association Between Graves’ Disease and Renal Coloboma Syndrome: A Case Report

    PubMed Central

    Sato, Takeshi; Muroya, Koji; Hanakawa, Junko; Asakura, Yumi; Takahashi, Eihiko; Shiroyanagi, Yoshiyuki; Yamazaki, Yuichiro; Tanaka, Yukichi; Hasegawa, Tomonobu; Adachi, Masanori

    2013-01-01

    Renal coloboma syndrome is an autosomal dominant condition characterized by renal lesions and optic nerve abnormalities. We report an 11-yr-old Japanese girl with familial renal coloboma syndrome, who also had Graves’ disease. Four affected family members had a previously reported heterozygous mutation (c.76dupG, p.Val26Glyfs*28) in the PAX2 gene. We hypothesized that PAX2 mutations may increase the risk of autoimmune diseases through alterations of human β-defensin 1 expression. PMID:23966757

  2. [Renal angiomyolipoma rupture as a cause of lumbar pain: report of one case].

    PubMed

    Cifuentes, Melissa; Calleja, Félix; Hola, José; Daviú, Antonio; Jara, Danilo; Vallejos, Humberto

    2008-08-01

    Renal angiomyolipoma is a benign tumor formed by smooth muscle, adipose tissue and blood vessels. It is commonly found incidentally and its clinical manifestations are pain and abdominal mass or spontaneous tumor rupture with retroperitoneal bleeding. The clinical presentation of a hemorrhagic shock secondary to a retroperitoneal hematoma is uncommon. We report a 40 year-old male who presented to the emergency room with lumbar pain and deterioration of hemodynamic parameters. The CT scan showed a left renal injury associated to an expansive retroperitoneal process. The abdominal exploration, vascular control of the renal pedicle and nephrectomy allowed a successful outcome. PMID:18949188

  3. Distal renal tubular acidosis, hypokalemic paralysis, nephrocalcinosis, primary hypothyroidism, growth retardation, osteomalacia and osteoporosis leading to pathological fracture: a case report.

    PubMed

    Basak, Ramen C; Sharkawi, Khairy Mostafa; Rahman, Mohammad Mizanur; Swar, Mayada Mohammad

    2011-07-01

    Renal tubular acidosis (RTA) is a constellation of syndromes arising from different derangements of tubular acid transport. Recent advances in the biology of urinary acidification have allowed us to discern various molecular mechanisms responsible for these syndromes. RTA often presents as renal stone disease with nephrocalcinosis, ricket/osteomalacia and growth retardation in children with ultimate short stature in adulthood. The case reported here has features of distal renal tubular acidosis (dRTA), hypokalemic paralysis, primary hypothyroidism, growth retardation, osteomalacia and osteopenia leading to stress fracture. All these features presenting in a single case (as in our case) is a rare occurrence, so far other cases of distal renal tubular acidosis (dRTA) have been reported. PMID:22043434

  4. Occult Congenital Ureteropelvic Junction Obstruction in Two Adults Presenting with Collecting System Rupture After Blunt Renal Trauma: A Case Report Series

    PubMed Central

    Hoffner, Haley E.; Dagrosa, Lawrence M.; Pais, Vernon M.

    2015-01-01

    Abstract We report two adult cases of congenital ureteropelvic junction obstruction detected incidentally in the setting of blunt abdominal trauma. CT images are provided to describe the presentation, while review of the literature and management of renal trauma are discussed.

  5. Isolated omental metastasis of renal cell carcinoma after extraperitoneal open partial nephrectomy: A case report

    PubMed Central

    Acar, Ömer; Mut, Tuna; Sağlıcan, Yeşim; Sag, Alan Alper; Falay, Okan; Selcukbiricik, Fatih; Tabak, Levent; Esen, Tarık

    2016-01-01

    Introduction Metachronous metastatic spread of clinically localized renal cell carcinoma (RCC) affects almost 1/3 of the patients. They occur most frequently in lung, liver, bone and brain. Isolated omental metastasis of RCC has not been reported so far. Case presentation A 62-year-old patient previously diagnosed and treated due to pulmonary sarcoidosis has developed an omental metastatic lesion 13 years after having undergone open extraperitoneal partial nephrectomy for T1 clear-cell RCC. Constitutional symptoms and imaging findings that were attributed to the presence of a sarcomatoid paraneoplastic syndrome triggered by the development this metastatic focus complicated the diagnostic work-up. Biopsy of the [18F]-fluorodeoxyglucose (+) lesions confirmed the diagnosis of metastatic RCC and the patient was managed by the resection of the omental mass via near-total omentectomy followed by targeted therapy with a tyrosine kinase inhibitor. Discussion Late recurrence of RCC has been reported to occur in 10–20% of the patients within 20 years. Therefore lifelong follow up of RCC has been advocated by some authors. Diffuse peritoneal metastases have been reported in certain RCC subtypes with adverse histopathological features. However, isolated omental metastasis without any sign of peritoneal involvement is an extremely rare condition. Conclusion To our knowledge, this is the first reported case of metachronously developed, isolated omental metastasis of an initially T1 clear-cell RCC. Constitutional symptoms, despite a long interval since nephrectomy, should raise the possibility of a paraneoplastic syndrome being associated with metastatic RCC. Morphological and molecular imaging studies together with histopathological documentation will be diagnostic. PMID:26874583

  6. [Living unrelated renal transplantation in an eldery couple: a case report].

    PubMed

    Saito, Jun; Namba, Yukiomi; Hatano, Koji; Imamura, Ryoichi; Ichimaru, Naotsugu; Miyagawa, Yasushi; Tsujihata, Masao; Tsujimura, Akira; Nishimura, Kazuo; Nonomura, Norio; Takahara, Shiro; Okuyama, Akihiko

    2006-07-01

    We present a 60-year-old female who underwent living unrelated renal transplantation from her 62-year-old husband. The primary immunosuppression consisted of tacrolimus, mycophenolate mofetil and steroid. We did not recognize any rejection in a histopathological study. The total ischemic time to carry out anastomosis of the two renal arteries was 121 minutes. After hemodialysis 5 times for acute tubular necrosis, her renal function improved. She was discharged on the 33rd postoperative day when her serum cretinine level was 1.0 mg/dl. The graft function was stable at 6 months after transplantation. We discussed living unrelated renal transplantation in the elderly population in Japan. PMID:16910589

  7. Acute renal failure due to phenazopyridine (Pyridium) overdose: case report and review of the literature.

    PubMed

    Onder, Ali Mirza; Espinoza, Veronica; Berho, Mariana E; Chandar, Jayanthi; Zilleruelo, Gaston; Abitbol, Carolyn

    2006-11-01

    Phenazopyridine (Pyridium) is a commonly used urinary tract analgesic. It has been associated with yellow skin discoloration, hemolytic anemia, methemoglobinemia, and acute renal failure, especially in patients with preexisting kidney disease. We report a 17-year-old female with vertically transmitted human immunodeficiency virus (HIV) infection, presenting with acute renal failure and methemoglobinemia following a suicidal attempt with a single 1,200 mg ingestion of Pyridium. She had no prior evidence of HIV nephropathy. The patient had a progressive nonoliguric renal failure on the 3rd day following the ingestion. She was treated with N-acetylcysteine, intravenous carnitine, and alkalinization of the urine. Her kidney biopsy revealed acute tubular necrosis with no glomerular changes. After 7 days of conservative management, she was discharged home with normal kidney function. To our knowledge, this is the second smallest amount of Pyridium overdose resulting in acute renal failure with no previous history of kidney disease. PMID:16897003

  8. A rare case of reversible acquired AA-type renal amyloidosis in a chronic filariasis patient receiving antifilarial therapy.

    PubMed

    Nayak, Hemanta Kumar; Daga, Mradul Kumar; Garg, Sandeep kumar; Sinha, Nitin kumar; Kumar, Rakshit; Mohanty, Pankaj Kumar; Pandey, Binay Kumar

    2011-08-01

    Lymphatic filariasis is a major health problem in India with a large number of patients tending to be asymptomatic. In the Southeast and South Asian regions, Wuchereria bancrofti is the most prevalent parasite, causing filariasis in 99.4% of cases. While kidney involvement is a rare event in chronic filariasis, this case is unique because AA-type renal amyloidosis occurs in chronic W. bancrofti infection. We present here a unique case of lymphatic filariasis. The patient, a 25-year-old male who was previously diagnosed with right lower limb filarial lymphedema and had undergone lymphovenous anastomosis, was admitted for evaluation of persistent nephrotic-range proteinuria. Autoimmune markers in the form of anti-nuclear antibodies, anti-double-stranded DNA and anti-neutrophil cytoplasmic antibody were negative; C3 was normal. Urine analysis revealed inactive sediment with moderate proteinuria. Both serum and urine electrophoresis were negative for paraproteins and bone marrow aspirate and biopsy were normal. Evidence of active filarial infection was established on the basis of microfilariae in the peripheral smear and a positive W. bancrofti antigen test. Kidney biopsy revealed renal amyloidosis when stained with Congo red and anti-AA immunostain. The patient's proteinuria improved on conservative management with angiotensin-converting enzyme inhibitors and a course of antifilarial drugs. His proteinuria returned to <1 g/24 h with normalization of renal function and no significant proteinuria on periodic follow-up at 6-month and 1-year intervals. Repeat kidney biopsy after 1.5 years showed regression of amyloidosis. Repeat demonstration of filarial antigen and microfilariae in the peripheral smear were negative on multiple occasions during the follow-up period. Although various chronic infections can lead to secondary renal amyloidosis, this is the first case reported in world literature where secondary amyloidosis developed as a complication of chronic filarial

  9. Occupational and other exposures associated with male end-stage renal disease: a case/control study.

    PubMed Central

    Steenland, N K; Thun, M J; Ferguson, C W; Port, F K

    1990-01-01

    We conducted a case-control study of 325 men ages 30-69 who were diagnosed with end-stage renal disease (ESRD) between 1976 and 1984, and resided in four urban areas of Michigan in 1984. Cases were selected from the Michigan Kidney Registry and excluded men with diabetic, congenital, and obstructive nephropathies. Controls were selected by random-digit dialing and were pair-matched to cases for age, race, and area of residence. Telephone interviews were conducted with 69 percent of eligible cases and 79 percent of eligible controls. Risk of ESRD was significantly related to phenacetin or acetaminophen consumption (odds ratio(OR) = 2.66), moonshine consumption (OR = 2.43), a family history of renal disease (OR = 9.30); and regular occupational exposures to solvents (OR = 1.51) or silica (OR = 1.67). Particular occupational exposures with elevated risk were solvents used as cleaning agents and degreasers (OR = 2.50) silica exposure in foundries or brick factories (OR = 1.92), and silica exposure during sandblasting (OR = 3.83). Little or no trend of increased risk with duration of exposure was found for these occupational exposures, with the exception of silica in sandblasting. Limitations of these data include representativeness of cases, possible overreporting by cases, and misclassification of exposures inherent in self-reports. PMID:2153349

  10. [Primary mucosa-associated lymphoid tissue (MALT) lymphoma of the urinary bladder associated with left renal pelvic carcinoma: a case report].

    PubMed

    Hatano, Koji; Sato, Mototaka; Tsujimoto, Yuichi; Takada, Tsuyoshi; Honda, Masato; Matsumiya, Kiyomi; Fujioka, Hideki; Oka, Kazuhisa; Tsujimoto, Masahiko

    2007-01-01

    We report a case of primary mucosa-associated lympoid tissue (MALT) lymphoma of the urinary bladder associated with left renal pelvic carcinoma. A 84-year-old woman showed microscopic hematuria during follow up for hypertention. Left renal pelvic tumor was found and she was referred to our hospital for further evaluation and managemant. She showed pyuria and Escherichia coli was detected by urine culture. Intravenous pyelography and computed tomography revealed the left renal pelvic tumor and solid bladder tumor. Transurethral resection of bladder tumor and left total nephroureterectomy were performed. Histologically, the left renal pelvic tumor was urothelial carcinoma > > adenocarcinoma, G2, pT2 and the bladder tumor was MALT lymphoma. Ga-scintigraphy showed no hot uptake suspicious of metastatic lesion. Then, external beam radiotherapy (36 Gy) was performed to the urinary bladder. She has been alive for 14 months with neither renal pelvic tumor nor MALT lymphoma showing any evidence of disease progression. PMID:17310771

  11. Tuberous sclerosis complex-associated renal angiomyolipomas: A single center study of 17 consecutive cases

    PubMed Central

    Wang, Hang; Long, Qilai; Wang, Yiwei; Liu, Li; Zhou, Lin; Guo, Jianming

    2016-01-01

    The aim of the present study was to investigate the treatment options for patients with tuberous sclerosis complex (TSC)-associated renal angiomyolipomas (AMLs). A total of 17 patients who were consecutively diagnosed with TSC-associated renal AMLs at the Department of Urology of Zhongshan Hospital between 1998 and 2012 were included in the study. The patient cohort included 7 males and 10 females with a mean age of 37.6 years (range, 18–62 years). A total of 12 patients were diagnosed with renal AML with TSC during physical examination (PE), while 5 patients were admitted to the Emergency Department of Zhongshan Hospital due to spontaneous rupture of renal AMLs. All renal lesions were examined by ultrasonography and abdominal computed tomography prior to treatment. The primary outcome measure was the kidney reservation rate (patients that had not received nephrectomies) in the rupture group and PE group. Both abdominal ultrasonography and CT revealed AMLs in all patients and the mean tumor size was 10.0±4.0 cm (range, 3.0–17.5 cm). Overall, 9 patients underwent surgery, which included unilateral nephrectomy in 4 patients and unilateral partial nephrectomy/tumor enucleation in 5 patients. The remaining 8 patients received medical treatment. All patients were followed-up for between 10 and 67 months. One patient succumbed as a result of multiple organ failure, which was caused by hypovolemic shock due to the spontaneous rupture of renal AML. The kidney reservation rate during surgery was 87.5% (7/8) in the PE group and 25% (1/4) in the spontaneous rupture group. The management of TSC-associated renal AMLs differs from that of solitary sporadic AMLs. Surgical therapy is recommended following careful risk-benefit analysis. PMID:27446460

  12. Treatment of renal uric acid stone by extracorporeal shock wave lithotripsy combined with sodium bicarbonate: 2 case reports

    PubMed Central

    Li, Hao-Yong; Lian, Pei-Yu; Zhou, Zhi-Yan; Song, Peng; Yan, Yi; Liu, Ji-Hong

    2015-01-01

    Uric acid stone is the most comment radiolucent renal stone with high recurrence rate, which would further cause acute upper urinary tract obstruction and kidney failure. Here we report two cases of renal uric acid stone from December 2012 to April 2013. One 43-year-old male patient suffered from chronic uric acid nephrolithiasis caused by the long-term indwelling of bilateral double-J stent. Another 69-year-old patient was also diagnosed with uric acid nephrolithiasis at the right kidney. Both patients were first treated with extracorporeal shock wave lithotripsy (ESWL), followed by 1.5% sodium bicarbonate dissolution therapy. After a week of the treatment, the uric acid stones in both patients were completely dissolved without retrograde infection. In summary, the use of ESWL and sodium bicarbonate dissolution therapy as a combined modality is a safe, effective, inexpensive treatment for uric acid nephrolithiasis. PMID:26550383

  13. [A Case of Small Intestinal Metastases from Renal Cell Carcinoma with Massive Bleeding].

    PubMed

    Shibutani, Masatsune; Maeda, Kiyoshi; Nagahara, Hisashi; Ohtani, Hiroshi; Sakurai, Katsunobu; Yamazoe, Sadaaki; Kimura, Kenjiro; Toyokawa, Takahiro; Amano, Ryosuke; Kubo, Naoshi; Tanaka, Hiroaki; Muguruma, Kazuya; Ohira, Masaichi; Ohsawa, Masahiko; Hirakawa, Kosei

    2015-11-01

    A 66-year-old man underwent laparoscopic right nephrectomy for renal cell carcinoma (T2b, N0, M1, clear cell, Grade 3). He was treated with targeted therapy for lung metastases after nephrectomy. Despite the targeted therapy, he was paralyzed in the lower half of the body due to the spinal metastases. Therefore, an osteoplastic laminectomy and domelaminectomy for the spinal metastases was performed. The FDG-PET examination, which was performed after the operation, revealed lung, liver, bone, and small intestinal metastases. After a while, he suffered from continuous massive melena. Double balloon enteroscopy revealed a hemorrhagic tumor in the small intestine, and an emergency operation was performed. A partial resection of the small intestine was performed for the 3 tumors. The histopathological diagnosis was small intestinal metastasis from renal cell carcinoma. It is well known that renal cell carcinoma often develops metastases to the lung, bone, and liver. However, small intestinal metastasis from renal cell carcinoma is rare. Although small intestinal metastasis from renal cell carcinoma often accompanies metastases to other organs, a palliative operation might improve the quality of life in patients with symptomatic tumors. PMID:26805327

  14. Clinicopathological features of renal amyloidosis: a single-center study on 47 cases.

    PubMed

    Luo, Chang-qing; Zhang, Yu-an; Li, Zhen-qiong; Wang, Yu-mei

    2015-02-01

    The correlations between the clinicopathological features and the long-term outcomes of renal amyloidosis (RA) were analyzed with a view to develop strategies for improving diagnosis and prognosis of RA. We retrospectively reviewed the clinicopathological characteristics of 47 patients diagnosed with RA between 2004 and 2014 at the Wuhan Union Hospital. The data on the renal histology, clinical manifestations, and prognosis of RA patients were retrieved from the hospital records and characteristic patterns were identified. The histological changes in the kidneys were correlated with the clinical manifestations of RA. Additionally, most RA patients in this study had decreased serum levels of κ light chain and increased urine levels of κ and λ light chains as well as presence of M-protein in the urine and serum. Patients with early RA showed no specific pathognomonic symptoms. Bleeding associated with diagnostic renal biopsy was rare. We recommend that the routine work-up of patients aged over 40 years and presenting with non-diabetic nephropathy includes the non-invasive tests for the measurement of serum and urine levels of κ and λ light chains as well as protein electrophoresis tests for the presence of urinary and serum M-protein. Additionally, such patients should undergo renal biopsy screening with Cong-red staining to ensure early diagnosis of RA and improve their survival, since the risk of hemorrhage related to renal biopsy screening is low at early stages of RA. PMID:25673192

  15. High phenobarbital clearance during continuous renal replacement therapy: a case report and pharmacokinetic analysis.

    PubMed

    Rosenborg, Staffan; Saraste, Lars; Wide, Katarina

    2014-08-01

    Phenobarbital is an old antiepileptic drug used in severe epilepsy. Despite this, little is written about the need for dose adjustments in renal replacement therapy. Most sources recommend a moderately increased dose guided by therapeutic drug monitoring.A 14 year old boy with nonketotic hyperglycinemia, a rare inborn error of metabolism, characterized by high levels of glycine, epilepsy, spasticity, and cognitive impairment, was admitted to the emergency department with respiratory failure after a few days of fever and cough. The boy was unconscious at admittance and had acute renal and hepatic failure.Due to the acute respiratory infection, hypoxic hepatic and renal failure occurred and the patient had a status epilepticus.The patient was intubated and mechanically ventilated. Continuous renal replacement therapy was initiated. Despite increased phenobarbital doses, therapeutic levels were not reached until the dose was increased to 500 mg twice daily. Therapeutic drug monitoring was performed in plasma and dialysate. Calculations revealed that phenobarbital was almost freely dialyzed.Correct dosing of drugs in patients on renal replacement therapy may need a multidisciplinary approach and guidance by therapeutic drug monitoring. PMID:25101986

  16. Rhabdomyolysis and acute renal failure following minimally invasive spine surgery: report of 5 cases.

    PubMed

    Dakwar, Elias; Rifkin, Stephen I; Volcan, Ildemaro J; Goodrich, J Allan; Uribe, Juan S

    2011-06-01

    Minimally invasive spine surgery is increasingly used to treat various spinal pathologies with the goal of minimizing destruction of the surrounding tissues. Rhabdomyolysis (RM) is a rare but known complication of spine surgery, and acute renal failure (ARF) is in turn a potential complication of severe RM. The authors report the first known case series of RM and ARF following minimally invasive lateral spine surgery. The authors retrospectively reviewed data in all consecutive patients who underwent a minimally invasive lateral transpsoas approach for interbody fusion with the subsequent development of RM and ARF at 2 institutions between 2006 and 2009. Demographic variables, patient home medications, preoperative laboratory values, and anesthetic used during the procedure were reviewed. All patient data were recorded including the operative procedure, patient positioning, postoperative hospital course, operative time, blood loss, creatine phosphokinase (CPK), creatinine, duration of hospital stay, and complications. Five of 315 consecutive patients were identified with RM and ARF after undergoing minimally invasive lateral transpsoas spine surgery. There were 4 men and 1 woman with a mean age of 66 years (range 60-71 years). The mean body mass index was 31 kg/m2 and ranged from 25 to 40 kg/m2. Nineteen interbody levels had been fused, with a range of 3-6 levels per patient. The mean operative time was 420 minutes and ranged from 315 to 600 minutes. The CPK ranged from 5000 to 56,000 U/L, with a mean of 25,861 U/L. Two of the 5 patients required temporary hemodialysis, while 3 required only aggressive fluid resuscitation. The mean duration of the hospital stay was 12 days, with a range of 3-25 days. Rhabdomyolysis is a rare but known potential complication of spine surgery. The authors describe the first case series associated with the minimally invasive lateral approach. Surgeons must be aware of the possibility of postoperative RM and ARF, particularly in

  17. Treatment of Focal Segmental Glomerulosclerosis Recurrence in the Renal Allograft: A Report of Two Cases

    PubMed Central

    Tran, Minh-Ha; Chan, Cynthia; Pasch, Whitney; Carpenter, Philip; Ichii, Hirohito; Foster, Clarence

    2016-01-01

    Focal segmental glomerulosclerosis (FSGS) causes glomerular lesions that can progress to end-stage renal disease. It is suspected to be caused by a circulating factor that is amenable to plasmapheresis removal and exhibits a risk for recurrence in the renal allograft. We present two patients with FSGS recurrence in their allograft kidneys diagnosed by biopsy after significant proteinuria developed in the posttransplant setting. Treatment with therapeutic plasma exchange induced long-term remission in both patients. Spot urine protein:creatinine ratios were monitored and treatment was continued until a target of <0.5 was achieved. In patient number two, a second peak in proteinuria and azotemia was ultimately attributable to ureteral stenosis and these values normalized following repair. In conclusion, therapeutic plasma exchange is an effective treatment for FSGS recurring following renal transplant. PMID:27099858

  18. Concurrent renal-cell carcinoma and cutaneous leiomyomas: A case of HLRCC.

    PubMed

    Fondriest, Sara A; Gowdy, John M; Goyal, Manish; Sheridan, Katherine C; Wasdahl, Daniel A

    2015-01-01

    A 51-year-old Caucasian female presenting with renal-cell cancer and cutaneous leiomyomas was later diagnosed with Hereditary Leiomyomatosis and Renal Cell Cancer (HLRCC) Syndrome. HLRCC is an autosomal dominant condition caused by a mutation in the fumarate hydratase gene, which encodes for an enzyme in the citric acid cycle. This syndrome has been reported in over 100 families throughout the world, the majority of whom are of Eastern European descent. Those with this syndrome have a significantly increased risk of developing renal-cell carcinoma, cutaneous leiomyomas, and uterine leiomyomas, and a smaller chance of developing uterine leiomyosarcomas. This syndrome has a relatively poor prognosis, with tumor metastasis occurring in approximately 50% of patients. However, more aggressive prophylactic measures and recent studies have shown potential to improve patient prognosis. PMID:27408652

  19. Bilateral Renal Agenesis/Hypoplasia/Dysplasia (BRAHD): Postmortem Analysis of 45 Cases with Breakpoint Mapping of Two De Novo Translocations

    PubMed Central

    Keeling, Jean; Howatson, Alan; Whiteford, Margo; Branney, Peter; Evans, Margaret; Fantes, Judy; FitzPatrick, David R.

    2010-01-01

    Background Bilateral renal agenesis/hypoplasia/dysplasia (BRAHD) is a relatively common, lethal malformation in humans. Established clinical risk factors include maternal insulin dependent diabetes mellitus and male sex of the fetus. In the majority of cases, no specific etiology can be established, although teratogenic, syndromal and single gene causes can be assigned to some cases. Methodology/Principal Findings 45 unrelated fetuses, stillbirths or infants with lethal BRAHD were ascertained through a single regional paediatric pathology service (male∶female 34∶11 or 3.1∶1). The previously reported phenotypic overlaps with VACTERL, caudal dysgenesis, hemifacial microsomia and Müllerian defects were confirmed. A new finding is that 16/45 (35.6%; m∶f 13∶3 or 4.3∶1) BRAHD cases had one or more extrarenal malformations indicative of a disoder of laterality determination including; incomplete lobulation of right lung (seven cases), malrotation of the gut (seven cases) and persistence of the left superior vena cava (five cases). One such case with multiple laterality defects and sirelomelia was found to have a de novo apparently balanced reciprocal translocation 46,XY,t(2;6)(p22.3;q12). Translocation breakpoint mapping was performed by interphase fluorescent in-situ hybridization (FISH) using nuclei extracted from archival tissue sections in both this case and an isolated bilateral renal agenesis case associated with a de novo 46,XY,t(1;2)(q41;p25.3). Both t(2;6) breakpoints mapped to gene-free regions with no strong evidence of cis-regulatory potential. Ten genes localized within 500 kb of the t(1;2) breakpoints. Wholemount in-situ expression analyses of the mouse orthologs of these genes in embryonic mouse kidneys showed strong expression of Esrrg, encoding a nuclear steroid hormone receptor. Immunohistochemical analysis showed that Esrrg was restricted to proximal ductal tissue within the embryonic kidney. Conclusions/Significance The previously

  20. A case of PSF-TFE3 gene fusion in Xp11.2 renal cell carcinoma with melanotic features.

    PubMed

    Zhan, He-Qin; Chen, Hong; Wang, Chao-Fu; Zhu, Xiong-Zeng

    2015-03-01

    Xp11.2 translocation renal cell carcinoma (Xp11.2 RCC) with PSF-TFE3 gene fusion is a rare neoplasm. Only 22 cases of Xp11.2 RCCs with PSF-TFE3 have been reported to date. We describe an additional case of Xp11.2 RCC with PSF-TFE3 showing melanotic features. Microscopically, the histologic features mimic clear cell renal cell carcinoma. However, the dark-brown pigments were identified and could be demonstrated as melanins. Immunohistochemically, the tumor cells were widely positive for CD10, human melanoma black 45, and TFE3 but negative for cytokeratins, vimentin, Melan-A, microphthalmia-associated transcription factor, smooth muscle actin, and S-100 protein. Genetically, we demonstrated PSF-TFE3 fusion between exon 9 of PSF and exon 5 of TFE3. The patient was free of disease with 50 months of follow-up. The prognosis of this type of tumor requires more cases because of limited number of cases and follow-up period. Xp11.2 RCC with PSF-TFE3 inevitably requires differentiation from other kidney neoplasms. Immunohistochemical and molecular genetic analyses are essential for accurate diagnosis. PMID:25582502

  1. Primary adenocarcinoma of the renal pelvis, ureter and the urinary bladder: A case report and review of the literature

    PubMed Central

    XIONG, XING; JIA, LINGHUA; WANG, JINGEN

    2016-01-01

    Primary adenocarcinoma is a rare type of urological neoplasm. The present study reports the case of a 55-year-old man with multifocal adenocarcinoma of the renal pelvis, ureter and urinary bladder that occurred in association with a large cystic calculus and perinephric abscess. The patient had suffered from gross hematuria for 2 years and right flank pain for 2 months. Following a series of investigations, a large cystic calculus with multiple tumors in the renal pelvis and ureter was identified. Multifocal tumors and a large calculus were located in the bladder using a cystoscope. The pathological report of 3 individual biopsies revealed a moderately differentiated tubular adenocarcinoma. Right nephrectomy, ureterectomy, radical cystectomy and left ureterocutaneostomy were performed. The pathological investigation revealed a moderately differentiated adenocarcinoma of the renal pelvis, ureter and urinary bladder. No additional treatment was administered and the patient remains alive at follow-up without disease recurrence or metastasis. Although uncommon, the development of a tumor is possible in patients that possess long-standing urolithiasis, particularly when accompanied by hydronephrosis or infection. PMID:26998081

  2. Spectrum of bacterial pathogens and their antibiogram from cases of urinary tract infection among renal disorder patients.

    PubMed

    Shakya, R; Amatya, R; Karki, B M S; Mandal, P K; Shrestha, K K

    2014-09-01

    Urinary tract infection (UTI) is the commonest bacterial infection occurring in renal disorder patients and is associated with significant morbidity. Resistance to antibiotics is highly prevalent in bacterial isolates and is an emerging problem in UTI. A hospital based cross sectional study was conducted from April 2011 to September 2011 to determine the frequency and bacterial profile of urinary tract infections in the patients with renal disorders visiting KIST Hospital along with their antimicrobial susceptibility pattern. Urine samples were collected from 300 clinically-suspected cases of UTI among renal disorder patients and investigated by conventional semi-quantitative culture technique, microscopy and antibiotic susceptibility test. Significant bacteriuria were detected in 34% of the total subjects, mostly from patients with Chronic Kidney Disease. Incidence of bacteriuria was found higher in females (40.40%) than in males (27.52%) and mostly occurred in elderly patients. Escherichia coli (62.75%) was the predominant isolate followed by Klebsiella pneumoniae (10.78%), Staphylococcus aureus (9.80%), Coagulase negative Staphylococcus aureus (CoNS) (5.88%), Enterococcus spp (3.92%), Klebsiella oxytoca (2.00%), Pseudomonas aeruginosa (2.00%), Proteus mirabilis (2.00%) and Proteus vulgaris (1.00%). Multidrug resistance was observed in 68.82% of the total bacterial isolates. PMID:25799818

  3. Two clinical cases of renal syndrome caused by Dobrava/Saaremaa hantaviruses imported to the Netherlands from Poland and Belarus, 2012-2014.

    PubMed

    GeurtsvanKessel, Corine H; Goeijenbier, Marco; Verner-Carlsson, Jenny; Litjens, Eline; Bos, Willem-Jan; Pas, Suzan D; Melo, Mariana Medonça; Koopmans, Marion; Lundkvist, Åke; Reusken, Chantal B E M

    2016-01-01

    We report the rare event of two imported cases in the Netherlands presenting with renal syndrome caused by Dobrava (DOBV)/Saaremaa (SAAV) hantaviruses. DOBV/SAAV hantaviruses are not circulating in the Netherlands and their clinical manifestation is typically more severe than that of the endemic Puumala virus (PUUV). This report aims to increase awareness among healthcare professionals and diagnostic laboratories to consider different hantaviruses as a cause of renal failure. PMID:26818411

  4. Two clinical cases of renal syndrome caused by Dobrava/Saaremaa hantaviruses imported to the Netherlands from Poland and Belarus, 2012–2014

    PubMed Central

    GeurtsvanKessel, Corine H.; Goeijenbier, Marco; Verner-Carlsson, Jenny; Litjens, Eline; Bos, Willem-Jan; Pas, Suzan D.; Medonça Melo, Mariana; Koopmans, Marion; Lundkvist, Åke; Reusken, Chantal B. E. M.

    2016-01-01

    We report the rare event of two imported cases in the Netherlands presenting with renal syndrome caused by Dobrava (DOBV)/Saaremaa (SAAV) hantaviruses. DOBV/SAAV hantaviruses are not circulating in the Netherlands and their clinical manifestation is typically more severe than that of the endemic Puumala virus (PUUV). This report aims to increase awareness among healthcare professionals and diagnostic laboratories to consider different hantaviruses as a cause of renal failure. PMID:26818411

  5. Case Report on Renal Failure Reversal in Lambda Chain Multiple Myeloma with Bortezomib and Dexamethasone

    PubMed Central

    Patibandla, Bhanu K.; Alwassia, Ahmad A.; Bartley, Anthony; Sandhu, Gurprataap S.; Rooney, James; Black, Robert M.

    2014-01-01

    Renal failure (RF) reversal in multiple myeloma (MM) is associated with an improved prognosis. Light chain myeloma, serum creatinine (SCr) > 4 mg/dL, extensive proteinuria, early infections, and certain renal biopsy findings are associated with lower rates of RF reversal. Our patient is a 67-year-old female with multiple poor prognostic factors for RF reversal who demonstrated a rapid renal response with bortezomib and dexamethasone (BD) regimen. She presented initially with altered mental status. On exam, she appeared lethargic and dehydrated and had generalized tenderness. She had been taking ibuprofen as needed for pain for a few weeks. Labs showed a white cell count—18,900/μL with no bandemia, hemoglobin 10.8 gm/dL, potassium—6.7 mEq/L, bicarbonate—15 mEq/L, blood urea nitrogen—62 mg/dL, SCr—5.6 mg/dL (baseline: 1.10), and corrected calcium—11.8 mg/dL. A rapid flu test was positive. Imaging studies were unremarkable. Her EKG showed sinus tachycardia and her urinalysis was unremarkable. The unexplained RF in an elderly individual in conjunction with hypercalcemia and anemia prompted a MM work-up; eventually, lambda variant MM was diagnosed. An immediate (4 days) renal response defined as 50% reduction in SCr was noticed after initiation of the BD regimen. PMID:25045553

  6. Renal-type clear cell carcinoma of the prostate: A case report

    PubMed Central

    WANG, QIULAN; XUE, YONGJIE

    2015-01-01

    Renal-type clear cell carcinoma of the prostate is a rare and novel tumor that has only been identified in recent years. The present study describes a lesion in the prostate of a 64-year-old male with a two-year history of urinary frequency, urgency and difficulty, who was admitted to the San Ai Tang Hospital for benign prostatic hyperplasia, and subsequently underwent transurethral resection of the prostate. In total, 12 g of tissue was resected, which demonstrated morphological and immunohistochemical similarities to clear cell carcinoma of the kidney. Ultrasound inspection and computed tomography revealed prostate enlargement. Although no renal-enclosed mass was identified, metastatic lesions were revealed in the lungs, sternum and clavicles. In addition, right pleural thickening and a small amount of effusion in the pleural cavity were detected. Clear cell carcinoma was identified throughout the prostate, with surrounding regions of ordinary-type prostatic adenocarcinoma (Gleason score, 4+4). The urinary bladder exhibited no dysplasia or neoplasia. It was therefore concluded that the tumor represented a primary renal-type clear cell carcinoma that had arisen in the prostate. To the best of our knowledge, this type of extra-renal tumor has only been reported in three other previous studies. PMID:26137029

  7. A case report of hepatic and renal dysfunction complicating midgut malrotation in an adult

    PubMed Central

    Samaraee, Ahmad Al; Kilgour, Alixe H M; Goulbourne, Ian A; Robson, Rita; Hayat, Mumtaz

    2009-01-01

    A 39-year-old man had an unusual presentation of jaundice and acute renal dysfunction complicating midgut malrotation. Diagnosis by computed tomography scan enabled prompt surgery and functional correction of the malrotation, with a full return to normal life. PMID:21686902

  8. A case of invasive cytomegalovirus duodenitis in an immunosuppressed patient 15 months after renal transplantation.

    PubMed

    Kazanji, N; Davila, F; Manickam, P; Wang, Y; Bossory, L

    2015-06-01

    Cytomegalovirus (CMV) remains one of the most important infections in kidney transplantation. Only a handful of images have been reported in the literature thus far. We present classic pathologic and gross images of CMV duodenitis in an immunosuppressed patient more than one year post-renal transplantation. PMID:25582982

  9. Not All Acute Abdomen Cases in Early Pregnancy Are Ectopic; Expect the Unexpected: Renal Angiomyolipoma Causing Massive Retroperitoneal Haemorrhage.

    PubMed

    Rana, Muhammad Asim; Mady, Ahmed F; Jakaraddi, Nagesh; Mumtaz, Shahzad A; Ahmad, Habib; Naser, Kamal

    2016-01-01

    Retroperitoneal haemorrhage (or retroperitoneal haematoma) refers to an accumulation of blood found in the retroperitoneal space. It is a rare clinical entity with variable aetiology including anticoagulation, ruptured aortic aneurysm, acute pancreatitis, malignancy, and bleeding from renal aneurysm. Diagnosis of retroperitoneal bleed is sometimes missed or delayed as presentation is often nonspecific. Multislice CT and arteriography are important for diagnosis. There is no consensus about the best management plan for patients with retroperitoneal haematoma. Stable patients can be managed with fluid resuscitation, correction of coagulopathy if any, and blood transfusion. Endovascular options involving selective intra-arterial embolisation or stent-grafts are clearly getting more and more popularity. Open repair is usually reserved for cases when there is failure of conservative or endovascular measures to control the bleeding or expertise is unavailable and in cases where the patient is unstable. Mortality of patients with retroperitoneal haematoma remains high if appropriate and timely measures are not taken. Haemorrhage from a benign renal tumour is a rarer entity which is described in this case report which emphasizes that physicians should have a wide index of suspicion when dealing with patients presenting with significant groin, flank, abdominal, or back pain, or haemodynamic instability of unclear cause. Our patient presented with features of acute abdomen and, being pregnant, was thought of having a ruptured ectopic pregnancy. PMID:27429809

  10. Not All Acute Abdomen Cases in Early Pregnancy Are Ectopic; Expect the Unexpected: Renal Angiomyolipoma Causing Massive Retroperitoneal Haemorrhage

    PubMed Central

    Mady, Ahmed F.; Jakaraddi, Nagesh; Naser, Kamal

    2016-01-01

    Retroperitoneal haemorrhage (or retroperitoneal haematoma) refers to an accumulation of blood found in the retroperitoneal space. It is a rare clinical entity with variable aetiology including anticoagulation, ruptured aortic aneurysm, acute pancreatitis, malignancy, and bleeding from renal aneurysm. Diagnosis of retroperitoneal bleed is sometimes missed or delayed as presentation is often nonspecific. Multislice CT and arteriography are important for diagnosis. There is no consensus about the best management plan for patients with retroperitoneal haematoma. Stable patients can be managed with fluid resuscitation, correction of coagulopathy if any, and blood transfusion. Endovascular options involving selective intra-arterial embolisation or stent-grafts are clearly getting more and more popularity. Open repair is usually reserved for cases when there is failure of conservative or endovascular measures to control the bleeding or expertise is unavailable and in cases where the patient is unstable. Mortality of patients with retroperitoneal haematoma remains high if appropriate and timely measures are not taken. Haemorrhage from a benign renal tumour is a rarer entity which is described in this case report which emphasizes that physicians should have a wide index of suspicion when dealing with patients presenting with significant groin, flank, abdominal, or back pain, or haemodynamic instability of unclear cause. Our patient presented with features of acute abdomen and, being pregnant, was thought of having a ruptured ectopic pregnancy. PMID:27429809

  11. IgA-dominant post-infectious glomerulonephritis; making another case in support of renal biopsy in type 2 diabetic nephropathy

    PubMed Central

    Nayer, Ali; Davda, Gargi; Pai, Rima; Ortega, Luis M.

    2016-01-01

    Background: Approximately one-third of individuals with type 2 diabetes mellitus will eventually develop diabetic nephropathy (DN). Impaired renal function in type 2 diabetics may also be secondary to non-diabetic renal disease (NDRD). NDRD in type 2 diabetics may occur alone in the absence of DN or may be superimposed on DN. Renal biopsy maybe indicated to establish the correct diagnosis and to ascertain the severity of glomerular and tubulointerstitial pathology. Case: We report a patient with type 2 diabetes mellitus and chronic renal insufficiency who developed worsening of renal function in the setting of staphylococcal infection and antibiotic use. Conclusion: Renal biopsy revealed IgA-dominant post-infectious glomerulonephritis and acute interstitial nephritis superimposed on diabetic glomerulosclerosis. Accumulating evidence indicates that, NDRD accounts for impaired renal function in a significant number of patients with type 2 diabetes mellitus. The presence of clinical, biochemical, and radiological features that suggest NDRD should prompt pathological evaluation of the kidney. PMID:27069968

  12. Myeloid sarcoma presenting with acute renal failure and bilateral ureteral obstruction: a case report and review of the literature.

    PubMed

    Usmani, Saad Z; Shahid, Zainab; Saleh, Husain; Nasser, Kamal A

    2007-08-01

    Myeloid sarcoma (MS) is a very rare disease that either presents with acute myeloid leukemia or as relapse of acute myeloid leukemia. The common sites include the small intestine, skin, bone, and lymph nodes. We present an unusual case of MS presenting with acute renal failure (ARF) and bilateral ureteral obstruction. Ultrasonography showed bilateral hydronephrosis and a large pelvic mass displacing the uterus. Pelvic mass biopsy showed fibroadipose tissue with diffuse neoplastic cell infiltration and immunostaining was positive for leukocyte common antigen (LCA) and myeloperoxidase consistent with myeloid sarcoma. Bone marrow biopsy revealed 63% myeloblasts. The patient died the 17th day of induction therapy. We came across only four MS cases in English literature that presented with ARF. To our knowledge, this case is the first description of myeloid sarcoma presenting with ARF and bilateral ureteral obstruction not originating from urogenital system. Physicians should consider possible hematological malignancies in patients with similar presentation. PMID:17700206

  13. Hereditary renal adysplasia, pulmonary hypoplasia and Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: a case report

    PubMed Central

    2010-01-01

    Background Hereditary renal adysplasia is an autosomal dominant trait with incomplete penetrance and variable expression that is usually associated with malformative combinations (including Müllerian anomalies) affecting different mesodermal organs such as the heart, lung, and urogenital system. Case report A case showing pulmonary hypoplasia, hip dysplasia, hereditary renal adysplasia, and Mayer-Rokitansky-Kuster-Hauser syndrome in adulthood is reported here. The i.v. pyelography showed right renal agenesis with a normal left kidney and ureter. Ultrasound and Magnetic Resonance Imaging also showed right renal agenesis with multicystic embryonary remnants in the right hemipelvis probably corresponding to a dysgenetic kidney. An uretrocystoscopy showed absence of ectopic ureter and of the right hemitrigone. She was scheduled for a diagnostic laparoscopy and creation of a neovagina according to the McIndoe technique with a prosthesis and skin graft. Laparoscopy confirmed the absence of the uterus. On both sides, an elongated, solid, rudimentary uterine horn could be observed. Both ovaries were also elongated, located high in both abdominal flanks and somewhat dysgenetics. A conventional cytogenetic study revealed a normal female karyotype 46, XX at a level of 550 GTG bands. A CGH analysis was performed using a 244K oligoarray CGH detecting 11 copy number variants described as normal variants in the databases. The 17q12 and 22q11.21 microdeletions described in other MRKH patients were not present in this case. Four years after operation her evolution is normal, without symptoms and the neovagina is adequately functional. The geneticists have studied her family history and the pedigree of the family is shown. Conclusions We suggest that primary damage to the mesoderm (paraaxil, intermediate, and lateral) caused by mutations in a yet unidentified gene is responsible for: 1) skeletal dysplasia, 2) inappropriate interactions between the bronchial mesoderm and endodermal

  14. Factors influencing general practitioner referral of patients developing end-stage renal failure: a standardised case-analysis study

    PubMed Central

    Montgomery, Anthony J; McGee, Hannah M; Shannon, William; Donohoe, John

    2006-01-01

    Background To understand why treatment referral rates for ESRF are lower in Ireland than in other European countries, an investigation of factors influencing general practitioner referral of patients developing ESRF was conducted. Method Randomly selected general practitioners (N = 51) were interviewed using 32 standardised written patient scenarios to elicit referral strategies. Main outcome measures: General practitioner referral levels and thresholds for patients developing end-stage renal disease; referral routes (nephrologist vs other physicians); influence of patient age, marital status and co-morbidity on referral. Results Referral levels varied widely with the full range of cases (0–32; median = 15) referred by different doctors after consideration of first laboratory results. Less than half (44%) of cases were referred to a nephrologist. Patient age (40 vs 70 years), marital status, co-morbidity (none vs rheumatoid arthritis) and general practitioner prior specialist renal training (yes or no) did not influence referral rates. Many patients were not referred to a specialist at creatinine levels of 129 μmol/l (47% not referred) or 250 μmol/l (45%). While all patients were referred at higher levels (350 and 480 μmol/l), referral to a nephrologist decreased in likelihood as scenarios became more complex; 28% at 129 μmol/l creatinine; 28% at 250 μmol/l; 18% at 350 μmol/l and 14% at 480 μmol/l. Referral levels and routes were not influenced by general practitioner age, sex or practice location. Most general practitioners had little current contact with chronic renal patients (mean number in practice = 0.7, s.d. = 1.3). Conclusion The very divergent management patterns identified highlight the need for guidance to general practitioners on appropriate management of this serious condition. PMID:16970805

  15. Calcified renal oncocytoma

    SciTech Connect

    Wasserman, N.F.; Ewing, S.L.

    1983-10-01

    Renal oncocytoma, a neoplasm thought to derive from cells of the proximal convoluted tubules, exhibits benign clinical features. Its preoperative distinction from typical renal cell carcinoma would enable the surgeon to perform a more limited procedure. In a patient who is a poor operative candidate, surgery might be deferred. However, preoperative diagnosis has been elusive. A rare case of bilateral renal oncocytoma is reported. One of these tumors represents the first reported oncocytoma showing radiologically demonstrable calcification.

  16. A case of successful renal transplantation for hydatid disease after surgical treatment of disseminated cysts.

    PubMed

    Özdemir, M; Ringe, K I; Schrem, H; Kleine, M; Meyer Zu Vilsendorf, A; Klempnauer, J; Lehner, F; Jäger, M; Bektas, H

    2015-06-01

    Hydatid disease is a systemic disorder affecting especially the liver and lungs. Although it is not endemic in Europe, it can be seen sporadically, particularly because of travel and immigration. Severe, multiple organ involvement is quite rare. A 39-year-old Kurdish male patient presented with the previous diagnosis of hydatid disease and disseminated cysts in the liver, lung, and left kidney, leading to renal failure and the need for hemodialysis. Following multiple operations, complete eradication of infectious cysts was achieved, and kidney transplantation was performed. After 4 years of follow-up, the patient is in good condition, especially with normal renal function and no sign of recurrent hydatid disease. PMID:25704879

  17. Clinical implications of concomitant variations of the testicular, suprarenal and renal veins: a case report.

    PubMed

    Malcic-Gürbüz, Jasna; Akalin, Aytül; Gümüşcü, Burak; Cavdar, Safiye

    2002-01-01

    Multiple venous anomalies have been observed during dissection of the posterior abdominal wall in a 65-year-old, white male cadaver. The left testicular and suprarenal veins united inferior to the superior mesenteric artery, coursed anterior to the abdominal aorta and drained into the inferior vena cava (IVC). Further the left renal vein coursed retroaortically and divided into three branches. The superior branch coursed on the vertebral column and drained into the azygos vein while middle and inferior branches drained into the IVC. The right renal vein was double and both drained into the IVC separately. Due to implications for numerous therapeutical and diagnostic procedures in the retroperitoneal region knowledge of these variations could be useful for clinicians in its recognition and protection. PMID:11876480

  18. Forty years abuse of baking soda, rhabdomyolysis, glomerulonephritis, hypertension leading to renal failure: a case report.

    PubMed

    Forslund, Terje; Koistinen, Arvo; Anttinen, Jorma; Wagner, Bodo; Miettinen, Marja

    2008-01-01

    We present a patient who had ingested sodium bicarbonate for treatment of alcoholic dyspepsia during forty years at increasing doses. During the last year he had used more than 50 grams daily. He presented with metabolic alkalosis, epileptic convulsions, subdural hematoma, hypertension and rhabdomyolysis with end stage renal failure, for which he had to be given regular intermittent hemodialysis treatment. Untreated hypertension and glomerulonephritis was probably present prior to all these acute incidents. Examination of the kidney biopsy revealed mesangial proliferative glomerulonephritis and arterial wall thickening causing nephrosclerosis together with interstitial calcinosis. The combination of all these pathologic changes might be responsible for the development of progressive chronic renal failure ending up with the need for continuous intermittent hemodialysis treatment. PMID:24179353

  19. [A case of renal cell carcinoma associated with idiopathic thrombocytopenic purpura].

    PubMed

    Yoshinaga, Atsushi; Hayashi, Tetsuo; Ohno, Rena; Yoshida, Soichiro; Ishii, Nobuyuki; Terao, Toshiya; Watanabe, Toru; Yamada, Takumi

    2005-06-01

    A 29-year-old woman was referred to another hospital with complaints of bruising and ecchymosis and thrombocytopenia (12,000/microl) was pointed out. After some examinations, the patient was diagnosed with idiopathic thrombocytopenic purpura and was started on steroid therapy. Then the patient consulted our hospital and computerized tomography revealed a left renal tumor 4 cm in diameter. Under the diagnosis of left renal neoplasm we performed left nephrectomy and splenectomy with preoperative high-dose intravenous gammaglobulin treatment. Pathological examination revealed clear cell carcinoma. After the operation, the platelet count increased gradually. We should consider bleeding tendency by thrombocytopenia and side effect of long-term steroid treatment when we perform operations on patients with idiopathic thrombocytopenic purpura. PMID:16050475

  20. An unusual case of left renal artery compression: a rare type of median arcuate ligament syndrome.

    PubMed

    Arazińska, Agata; Polguj, Michał; Wojciechowski, Andrzej; Trębiński, Łukasz; Stefańczyk, Ludomir

    2016-04-01

    Compression from median arcuate ligament was observed during multidetector 64-row computed tomography in a Caucasian 30-year-old female. The patient was referred for examination to exclude anatomical pathologies causing hypertension. The examination demonstrated that left renal artery, which had its origin in the chest (at the level of upper one-third of Th12), was compressed as it passed by median arcuate ligament of the diaphragm. In addition, aortic compression and kinked shape was also revealed. PMID:25940812

  1. [A case of acute renal failure following compartment syndrome after the surgery for femoral neck fracture].

    PubMed

    Koda, Kenichiro; Uzawa, Masashi; Ide, Yasuo; Harada, Masaki; Sanbe, Norie; Sugano, Takayuki; Satoh, Yasuo; Tagami, Megumi

    2013-02-01

    Compartment syndrome is known to develop after a prolonged surgery in the lithotomy position. We experienced acute renal failure following compartment syndrome after the surgery in hemilithotomy position. A 62-year-old man underwent a left hip fixation for femoral neck fracture. The surgical leg was placed into traction in a foot piece and the intact leg was placed in the hemilithotomy position. Because of the difficulty in repositioning and the trouble with fluoroscope, the surgery took over 5 hours. He suffered acute pain, swelling and spasm in his intact leg placed into hemilithotomy after the surgery. Creatine kinase, blood urea nitrogen and creatinine markedly increased and myoglobinuria was recognized. We diagnosed an acute renal failure following compartment syndrome and treated him in the ICU on close monitoring. In spite of the treatment with massive transfusion and diuretics, he needed hemodialysis twice and then his renal function improved. Prevention is most essential for compartment syndrome after a prolonged surgery in the lithotomy position. Risk factors should be recognized before surgery and appropriate action should be taken such as using Allen stirrups and avoiding hypotension, hypovolemia and the prolonged lithotomy position with exaggerated elevation of legs. PMID:23479927

  2. [A Case of Abdominal Wall Desmoid Tumor after Radical Nephrectomy for Renal Cancer].

    PubMed

    Ohtake, Shinji; Namura, Kazuhiro; Fujikawa, Atsushi; Sawada, Takuto; Ohta, Junichi; Moriyama, Masatoshi; Hayashi, Hiroyuki

    2015-09-01

    A 71-year-old man with a right renal tumor underwent nephrectomy. The procedure was converted from laparoscopy to open surgery due to profound bleeding from the renal vein. Pathological diagnosis was clear cell carcinoma G2pT3b v1 ly1 INFα. Three years after surgery, a 5 cm tumor in the abdominal wall was found on computed tomography (CT). A mild uptake was shown on positron emission tomography/CT and as the tumor was located near the surgical wound, recurrence of the renal cell carcinoma was suspected. However, desmoid tumor was suggested by the pathological examination of the tumor biopsy. En-bloc resection of the mass was carried out and the pathological examination showed an array of proliferating and tangling atypical spindle-shaped tumor cells. Immunohistochemical staining of the tumor cells was positive for vimentin, but negative for CD34, c-kit, and s100. Pathological diagnosis was desmoid tumor. There has been no recurrence so far. Desmoid tumor, despite its extremely low incidence, should be considered in a postoperative neoplasm. PMID:26497861

  3. Spontaneous large renal pelvis hematoma in ureteropelvic junction obstruction presenting as an acute abdomen: Rare case report.

    PubMed

    Sawant, Ajit; Kasat, Gaurav; Pawar, Prakash; Tamhankar, Ashwin

    2016-01-01

    Patients with ureteropelvic junction (UPJ) obstruction can present with flank pain or hematuria. We present 20-year-old male presenting with acute pain in lumbar and right fossa with tenderness and guarding, this case was clinically mimicking general surgical emergency. On computed tomography with urography and angiography, there was 15 cm × 11 cm × 10 cm size non-enhancing hyperdense lesion (average Hounsfield units - +64) in right renal pelvis suggestive of hematoma. Patient's diethylenetriaminepentaacetic acid diuretic renography was suggestive of right kidney glomerular function rate of 48.4 ml/min with the relative function of 43%, Peak to half peak was not achieved. The patient was managed by retrograde ureteropyelography and double J stenting. After 1 month, clot size decreased to 4 cm × 3 cm × 2 cm. The patient had undergone open reduction Anderson hynes dismembered pyeloplasty with the removal of pelvis clot after 6 weeks. We report the first case of UPJ obstruction presenting as an acute abdomen and spontaneous hematuria with large pelvis clot without rupture of the renal pelvis. PMID:27141202

  4. A Rare Case of Fatal Endocarditis and Sepsis Caused by Pseudomonas aeruginosa in a Patient with Chronic Renal Failure

    PubMed Central

    Vijan, Vikrant; Vupputuri, Anjith; Nandakumar, Sandya; Mathew, Navin

    2016-01-01

    Nosocomial catheter-related and Arteriovenous fistula (AV)-related infections are significant concern in patients undergoing haemodialysis. These infections are associated with multiple complications as well as mortality and demands immediate and appropriate management. While coagulase-negative staphylococci, S.aureus, and Escherichia coli are the most common causes of catheter-related infections in haemodialysis patients, such infections caused by Pseudomonas aeruginosa are relatively rare. Here, we present an unusual case of 36-year-old male patient with chronic renal failure, who developed endocarditis and sepsis from Pseudomonas aeruginosa infection of the left hand arteriovenous fistula. The bacteraemia in the present case caused multiple complications including dry gangrene of bilateral lower limbs, stroke, endophthalmitis, left brachial artery thrombosis and vegetations on the interventricular septum and aortic wall. Despite antibiotic treatment, the patient suffered a cardiac arrest and could not be revived.

  5. Synchronous perivesical and renal malignant rhabdoid tumor in a 9-year-old boy: a case report and review of literature.

    PubMed

    Szymanski, Konrad M; Tabib, Christian H; Idrees, Muhammad T; Cain, Mark P

    2013-11-01

    Pediatric extrarenal malignant rhabdoid tumors (MRTs) are rare and aggressive (20% 5-year survival). Only 2 cases of bladder MRTs have been published. We report on a 9-year-old boy presenting with gross hematuria, palpable pelvic mass, and an obstructed, nonfunctional kidney. Evaluation was consistent with a 9.7 cm extrarenal MRT invading the bladder and prostate. He underwent a cystoprostatectomy, Indiana pouch continent urinary reservoir creation, and a left nephroureterectomy. A discrete 2.5 cm focus of renal MRT was found. To our knowledge, this is the first case of simultaneous perivesical and renal MRT. We review the current management of pediatric extrarenal MRTs. PMID:23830079

  6. A case report of laparoscopic ipsilateral ureteroureterostomy in children with renal duplex

    PubMed Central

    Wong, Yuen Shan; Tam, Yuk Him; Pang, Kristine Kit Yi

    2016-01-01

    We report on two children aged 2 and 6 years, who underwent laparoscopic ipsilateral ureteroureterostomy for their renal duplex anomalies. Both patients had complete duplex and were investigated by ultrasound, micturating cystourethrogram, magnetic resonance urography, and radioisotope scan. One patient had high-grade vesicoureteral reflux to lower moiety complicated with recurrent urinary tract infections, while the other had obstruction to upper moiety due to ectopic ureter. The pathological moieties of both patients were functional. Both patients underwent laparoscopic ipsilateral ureteroureterostomy uneventfully without any intraoperative complications. Postoperative imagings confirmed successful outcomes after surgery. PMID:27014651

  7. [Renal needle biopsy in the Department of Nephrology in Fès: indications and results in 522 cases].

    PubMed

    Mbarki, Houda; Belghiti, Khadija Alaoui; Harmouch, Taoufiq; Najdi, Adil; Arrayhani, Mohamed; Sqalli, Tarik

    2016-01-01

    The contribution of renal needle biopsy (RNB) to make a diagnosis, a treatment selection and a prognostic evaluation of nephropathies is significant. No Moroccan study has evaluated the practice and the contribution of RNB. Our aim was to study RNB indications, to determine the frequency of kidney diseases identified by RNB in our region and make a comparison between clinical and biological data and histological diagnosis. This is a retrospective study conducted between January 2009 and December 2012. We included all patients in the Department of Nephrology, CHU Hassan II, Fez, who underwent biopsy of native kidneys. 522 RNB were performed. We excluded 8 biopsies due to lack of informations and 514 were retained. The average age of the patients at the time of RNB was 39±17 years (3-82 years). Sex ratio was 0.9. Nephrotic syndrome was the most common clinical diagnosis to all ages (58.2%). Glomerular nephropathies represent 94,2% of diagnosed renal diseases, their distribution varies according to patients' age. RNB confirmed the first clinically suspected diagnosis in 40.65% of cases, whereas it revealed an unexpected diagnosis in 22.5% of them. Syndromic diagnosis can orient the clinician toward the most probable kidney disease and guide any emergency treatment while awaiting RNB results. But it can never replace RNB which remains the gold standard. PMID:27583085

  8. [Obstructed hemivagina and ipsilateral renal anomaly: unusual cause of piocolpos. Report a case and review of literature ].

    PubMed

    Cortés-Contreras, Diana Karen; Juárez-Cruz, Patricio Manuel; Vázquez-Flores, José; Vázquez-Flores, Al David

    2014-10-01

    OHVIRA (Obstructed hemivagina and ipsilateral renal anomaly) by acronym and abbreviations in English or Herlyn Werner Wunderlich syndrome is a rare congenital malformation caused by an alteration in the Mullerian ducts and Wolffian Ducts. Which is characterized by a triad: uterus didelphys, obstructed and ipsilateral renal agenesis hemivagina still uncertain etiology. Patients are usually asymptomatic until menarche where the most common clinical presentation is pelvic pain, followed by a vaginal or abdominal mass, normal menstrual periods, infertility, and vaginal discharge rarely appears. The case of a female patient of 15 years, nubile with chronic fetid vaginal discharge, initially diagnosed and treated as pelvic inflammatory disease occurs, however because it is an exceptional condition with the background of the patient, by complementary studies were conducted where pelvic ultrasound revealed pyocolpos and absence of left kidney, uterus didelphys, blind hemivagina by other imaging studies, where we could integrate Herlyn-Werner-Wunderlich syndrome. In conclusion, abnormalities in the development of the Miillerian ducts are difficult to diagnose early, so you must have the embryological knowledge, conduct thorough clinical assessment and detailed picture in whom the coridition is suspected to identify malformations coexisting urinary tract and vaginal defects with the importance of preserving reproductive success through appropriate planning of surgical approach, given that the fertility rate in these patients is comparable to the average. PMID:25510063

  9. [A Case of an Orbital Metastasectomy in a Renal Cell Carcinoma after Sunitinib Treatment : A Case Report].

    PubMed

    Kuroki, Hiroo; Oyama, Norihide; Koike, Hiroshi

    2015-08-01

    An 81-year-old man had undergone radical nephrectomy for a renal cell carcinoma (RCC) in October 1998. Twelve years postoperatively, he developed diplopia and photophobia. Orbital metastasis of RCC was suspected and sunitinib treatment was given for 16 months. Computer tomography revealed a partial response of metastatic tumor for the first 2 months and stable disease for the next 12 months. However, it enlarged in the last 2 months. Total resection of right metastatic orbital tumor with deep lateral orbital decompression was done in January 2012. He has been well and without any local recurrence, distant metastasis or vision loss for 24 months. PMID:26411656

  10. [Arthrogryposis, renal tubular dysfunction, cholestasis (ARC) syndrome: case report and review of the literature].

    PubMed

    Denecke, J; Zimmer, K P; Kleta, R; Koch, H G; Rabe, H; August, C; Harms, E

    2000-01-01

    The ARC-syndrome is a rare disease with the obligatory symptoms arthrogryposis, renal tubular dysfunction and cholestasis. Optional further symptoms like ichthyosis, diarrhea, central nervous system defects and recurrent infections have been reported. The ARC-syndrome was first reported by Lutz-Richner and Landolt in 1973. The pathophysiology is still unknown, an autosomal recessive inheritance is postulated. Patients rarely exceed an age of six month. We report a boy of consanguineous Turkish parents who suffered from congenital deformities of the lower extremities, a metabolic acidosis and failure to thrive. In the sequel he developed a renal Fanconi syndrome and cholestasis. Histology of liver and muscle biopsy specimen showed the typical findings of the disease with giant cell hepatitis and neurogenous muscle atrophy. His condition could be stabilized and he increased in weight by substituting fluid, electrolytes, buffer and parenteral nutrition. Total enteral nutrition of the 280 ml/kg/d he required failed even by nasogastric tube and percutaneous endoscopic gastrostomy. Additional fluid substitution by central venous catheter remained necessary. At the age of 7 month he died. PMID:10812557

  11. Allograft dysfunction in a patient with an odd-looking kidney: case of renal lipomatosis and review of literature

    PubMed Central

    Posadas, Maria Aurora; Chua, Elizabeth; Thomas, Beje; Savage, Stephen J.; Baliga, Prabhakar

    2012-01-01

    Renal lipomatosis was diagnosed in a kidney transplant recipient who presented with acute kidney injury (AKI) several years after transplantation. The patient had an odd-looking kidney transplant on ultrasound and computed tomography (CT) scan, showing a medullary mass with resultant compression of the surrounding renal parenchyma. A biopsy of the renal medulla confirmed fatty infiltration of the renal parenchyma. The patient underwent percutaneous nephrostomy and AKI resolved with relief of the obstruction. Renal lipomatosis is a rare condition that should be differentiated from other neoplasms of the kidney. When it occurs in a functioning transplant kidney, the treatment approach proves to be very challenging. PMID:25874099

  12. A Rare Case of the Simultaneous, Multifocal, Metastatic Renal Cell Carcinoma to the Ipsilateral Left Testes, Bladder, and Stomach

    PubMed Central

    Kongnyuy, Michael; Lawindy, Samuel; Martinez, Daniel; Parker, Justin; Hall, Mary

    2016-01-01

    We describe the rare case of a 68-year-old gentleman with the history of a hand-assisted laparoscopic left radical nephrectomy for a T2bN0M1 clear cell renal cell carcinoma (RCC). Seven years after surgery and with clean surveillance imaging for metastasis/recurrence the patient presented with three separate tumors suspicious for malignancy. A bladder lesion was found during workup for hematuria, a stomach lesion during diagnostic endoscopy, and a testicular lesion during self-exam. He underwent transurethral resection of bladder tumor, left inguinal orchiectomy, and upper endoscopic ensnarement. All specimens surprisingly showed RCC by histology and immunostaining. These three sites are rare for RCC metastasis and simultaneous presentation is even rarer, further emphasizing the importance of continuous and careful follow-up in this patient population, despite what could appear as complete remission. PMID:26904352

  13. Two cases of gastrointestinal perforation after radiotherapy in patients receiving tyrosine kinase inhibitor for advanced renal cell carcinoma

    PubMed Central

    2012-01-01

    We report two cases of gastrointestinal perforation (GIP) after radiotherapy in patients receiving tyrosine kinase inhibitor (TKI) for advanced renal cell carcinoma (RCC). Case 1 was a 61-year-old woman with lung metastases after a radical nephrectomy for a right RCC (cT3aN0M0) treated with interferon-alpha (OIF, 5 MIU, three times per week). She developed lytic metastases of the left femur and the left acetabulum. She was treated with palliative radiotherapy to the metastatic portion (3 Gy × 10 fractions), and 400 mg sorafenib twice per day plus continuing interferon alpha. She experienced sudden left lower abdominal pain after four weeks of treatment, and was diagnosed with a perforation of the sigmoid colon with fecal peritonitis. Case 2 was a 48-year-old man with lung, lymph node, and bone metastases after a radical nephrectomy for a right RCC (cT2N0M0), and was treated with 400 mg sorafenib twice per day. He developed lytic bone metastases of the lumbar vertebrae, which was treated with palliative radiotherapy to L2-4 (3 Gy × 10 fractions). He experienced sudden abdominal pain after two months of radiation treatment, and was diagnosed with a perforation of the sigmoid colon with fecal peritonitis. These cases underwent radiotherapy, and therefore this may be related to the radiosensitivity of TKI. PMID:22906119

  14. [Favism presenting as an acute renal failure: report of one case].

    PubMed

    Torres C, Demetrio; Chandía C, Mauricio

    2012-08-01

    We report a 67-year-old man presenting with abdominal pain of acute onset, pallor, jaundice and behavioral changes after ingestion of fava beans. In the initial evaluation he appeared acutely ill and had resting dyspnea, edema and jaundice. His initial laboratory assessment disclosed azotemia, elevated lactate dehydrogenase levels, a low hemoglobin concentration (4.9 /dL) and a high corrected reticulocyte count (4,7%) with negative direct and indirect Coombs' test. The patient was transferred to the ICU, where he received support therapy with hemodialysis, mechanical ventilation, vasoactive drugs and transfusions of packed red cells. The evolution after 1 month was favorable and he was discharged without anemia and with normal renal function. Three months after discharge, the glucose-6-phosphate-dehydrogenase screening study did not demonstrate detectable enzymatic activity. PMID:23282778

  15. Herlyn-Werner-Wunderlich syndrome (uterus didelphys, blind hemivagina and ipsilateral renal agenesis) - a case report

    PubMed Central

    Arıkan, İlker İnan; Harma, Müge; Harma, Mehmet İbrahim; Bayar, Ülkü; Barut, Aykut

    2010-01-01

    Uterovaginal duplication with obstructed hemivagina and ipsilateral renal agenesis is referred to as the Herlyn-Werner-Wunderlich (HWW) syndrome. A 17 year old woman presented with right pelvic pain and dysmenorrhea, present since menarche at 13 and worsening over the past year. Ultrasound examination revealed a right pelvic mass (5×5 cm), double endometrial echoes, and hematocolpos. A right pelvic mass, agenesis of the right kidney, double uterus, and blind hemivagina with hematocolpos were detected by magnetic resonance imaging and intravenous pyelography. A right tubo-ovarian abscess with dense adhesions and a double uterus were observed on diagnostic laparoscopy. Adhesiolysis was carried out and purulent material irrigated. After a course of antibiotics, a vaginal septum resection was performed and the pyocolpos drained. She remained symptom free after four months of follow-up. Prompt and accurate diagnosis and treatment of this syndrome can significantly improve the lives of sufferers and prevent future complications. PMID:24591910

  16. Cardiac-surgery associated acute kidney injury requiring renal replacement therapy. A Spanish retrospective case-cohort study

    PubMed Central

    2009-01-01

    Background Acute kidney injury is among the most serious complications after cardiac surgery and is associated with an impaired outcome. Multiple factors may concur in the development of this disease. Moreover, severe renal failure requiring renal replacement therapy (RRT) presents a high mortality rate. Consequently, we studied a Spanish cohort of patients to assess the risk factors for RRT in cardiac surgery-associated acute kidney injury (CSA-AKI). Methods A retrospective case-cohort study in 24 Spanish hospitals. All cases of RRT after cardiac surgery in 2007 were matched in a crude ratio of 1:4 consecutive patients based on age, sex, treated in the same year, at the same hospital and by the same group of surgeons. Results We analyzed the data from 864 patients enrolled in 2007. In multivariate analysis, severe acute kidney injury requiring postoperative RRT was significantly associated with the following variables: lower glomerular filtration rates, less basal haemoglobin, lower left ventricular ejection fraction, diabetes, prior diuretic treatment, urgent surgery, longer aortic cross clamp times, intraoperative administration of aprotinin, and increased number of packed red blood cells (PRBC) transfused. When we conducted a propensity analysis using best-matched of 137 available pairs of patients, prior diuretic treatment, longer aortic cross clamp times and number of PRBC transfused were significantly associated with CSA-AKI. Patients requiring RRT needed longer hospital stays, and suffered higher mortality rates. Conclusion Cardiac-surgery associated acute kidney injury requiring RRT is associated with worse outcomes. For this reason, modifiable risk factors should be optimised and higher risk patients for acute kidney injury should be identified before undertaking cardiac surgery. PMID:19772621

  17. Multiple Brain Abscesses Due to Phialemonium in a Renal Transplant Recipient: First Case Report in the Literature.

    PubMed

    Aydın, Mehtap; Özçelik, Ümit; Çevik, Halime; Çınar, Özlem; Evren, Ebru; Demirağ, Alp

    2015-11-01

    Fungal brain abscesses are a rare but serious complication in transplant recipients. Phialemonium organisms are rare causes of invasive mold infections. Here, we present the first case of a renal transplant recipient with multiple brain abscesses caused by Phialemonium infection A. A 51-year-old female kidney transplant recipient was admitted with pneumonia of an unknown cause and treated with empiric intravenous antibiotics. Her treatment was uneventful, and she was discharged 1010 days later. After 5 days, she was readmitted with fever, cerebral palsy, and speech disorder. The patient had undergone living-donor renal transplant 7 months earlier. A cranial computed tomography and magnetic resonance imaging were performed for a possible cerebrovascular pathology. The magnetic resonance imaging scan showed multiple brain abscesses located at the left parietal, frontal and occipital lobes; right parietal and occipital lobes; right basal ganglia; and left cerebellum. The patient received meropenem, linezolid, sulfamethoxazole and trimethoprim, and AmBisome for probable pathogenic infection, and immunosuppressive agents dosage was reduced increasingly immunosuppressed. We identified Phialemonium in cerebrospinal fluid culture. The patient received voriconazole 200 mg twice daily. Lesions could not be drained due to lack of capsula formation. The patient died on the 30th day of antifungal therapy. Phialemonium organisms, although a rare cause of fungal infections, are associated with a high mortality rate in immunocompromised patients. To our knowledge, this is the first case report in the literature describing multiple brain abscesses due to Phialemonium in a transplant recipient. Clinicians recipient should be alert about these rare opportunistic fungi in the differential diagnosis of brain abscess, and bronchoscopy and bronchoalveolar lavage are recommended for transplant patients when they are admitted with pneumonia exclude fungal infections. PMID:26640919

  18. Tubulocystic renal cell carcinoma with poorly differentiated foci is indicative of aggressive behavior: clinicopathologic study of two cases and review of the literature

    PubMed Central

    Zhao, Ming; Teng, Xiaodong; Ru, Guoqing; Zhao, Zhongsheng; Hu, Qinqin; Han, Likai; He, Xianglei

    2015-01-01

    Tubulocystic renal cell carcinoma (TCRCC) is a rare, recently characterized RCC subtype with distinctive clinicopathologic and genetic characterizations as well as typical behaviors in an indolent fashion. However, sporadic case reports in the literature have indicated that TCRCC with sarcomatoid differentiation or poorly differentiated (PD) foci could behave aggressively. Herein, we reported two cases of TCRCC with PD foci indentified from our consultative service. Both patients were male and aged 66 y and 47 y, respectively. The first patient experienced radical nephrectomy while the other was treated by partial nephrectomy. Macroscopically, both tumors were described as partly cystic and solid with the greatest diameter measuring of 12-cm and 4.5-cm, respectively. Histologically, both lesions had classic areas of TCRCC occupying most part of the tumor with small papillary RCC component. In case one, PD foci were scatteredly distributed and mixed with TCRCC and papillary RCC components, while in the other case the PD foci were adjacent to the areas of TCRCC. In both tumors, the PD foci were composed of irregular, often angulated, small tubules lined by atypical eosinophilic cells and surrounded by desmoplastic stroma, resembling collecting duct carcinoma. Immunohistochemistry, in both tumors, both TCRCC component and PD foci showed the similar immunoprofiles, i.e., labeling strongly and diffusely with PAX8, AMACR and Vimentin, and focally with CK34βE12 but not with renal cell carcinoma marker or P63. In case one, the tumor invaded extensively into the adjacent renal parenchyma and focally into both renal sinusal and perirenal adipose tissues. The patient had metastasis in the pelvic cavity at the time of diagnosis and succumbed to the disease without further treatment 3 months later. The other case was organ confined but with focal positive renal parenchymal margin. The patient subsequently underwent radical nephrectomy and was in a good status without evidence

  19. Sorafenib treatment for recurrent stage T1 bilateral renal cell carcinoma in patients with Von Hippel- Lindau disease: A case report and literature review

    PubMed Central

    Choi, Kyung Hwa; Yu, Young Dong; Kang, Moon Hyung; Park, Dong Soo

    2015-01-01

    Renal cell carcinoma (RCC) with Von Hippel-Lindau (VHL) syndrome is associated with multiple recurrences and a young age at diagnosis. Therefore the primary goal of treatment is to stabilize the disease, minimizing the surgical resection and preserving the renal function in the patients with VHL who have developing RCC nodules after initial treatment. This is the first case report of VHL disease, with long-term stable disease, treated with a half dose of sorafenib after surgical resection and radiofrequency ablation for multiple recurrent stage T1 masses. We discuss the efficacy and safety of low-dose sorafenib treatment and review RCC in a patient with VHL disease. PMID:26425233

  20. Simultaneous bilateral testicular metastases from renal clear cell carcinoma: A case report and review of the literature.

    PubMed

    Moriyama, Shingo; Takeshita, Hideki; Adachi, Akiko; Arai, Yoshiaki; Higuchi, Saori; Tokairin, Takuo; Chiba, Koji; Nakagawa, Koji; Noro, Akira

    2014-04-01

    Metastasis from renal cell carcinoma (RCC) to the testis is rare. This case report presented an extremely rare case of simultaneous bilateral testicular metastases from RCC in a 65-year-old man who had experienced indolent scrotal enlargement over a period of several months. Scrotal ultrasonography showed 4.0- and 2.0-cm-sized masses in the left and right testes, respectively. Contrast-enhanced computed tomography identified multiple tumors in the kidneys, the pancreas and the left adrenal gland. Left orchiectomy and pathological examination were performed and indicated testicular metastasis from clear cell RCC. The patient underwent complete surgical resection of all residual lesions. Postoperative follow-up examination without adjuvant therapy identified no recurrence over 11 months. This study also reviewed existing literature and determined that retrograde venous spread from the primary kidney tumor to the testis may be an important pathway for testicular metastasis from RCC. In conclusion, RCC can result in testicular metastases not only unilaterally, but also bilaterally, as was observed in the present case. PMID:24944706

  1. Haemostatic dysfunction and acute renal failure following envenoming by Merrem's hump-nosed viper (Hypnale hypnale) in Sri Lanka: first authenticated case.

    PubMed

    de Silva, A; Wijekoon, A S; Jayasena, L; Abeysekera, C K; Bao, C X; Hutton, R A; Warrell, D A

    1994-01-01

    A five years old boy was bitten by a Merrem's hump-nosed viper (Hypnale hypnale) in Central Province, Sri Lanka. He developed local swelling, incoagulable blood, thrombocytopenia, bleeding into the gastrointestinal tract, and acute renal failure. Treatment with Serum Institute of Indian polyspecific antivenom (specific for venoms of cobra, common krait, Russell's viper and saw-scaled viper) had no effect on the coagulopathy, which persisted for more than a week. The boy recovered after 27 d in hospital, during which he was treated with peritoneal dialysis for renal failure. Laboratory studies demonstrated that the venom of H. hypnale was procoagulant, fibrinolytic and aggregated platelets. This first authenticated case of life-threatening acute renal failure and haemostatic disturbances caused by H. hypnale, a species responsible for 27% of snake bites in Sri Lanka, demonstrates the need for a new antivenom with specific activity against the venom of this species. PMID:8036678

  2. Primary Renal Rhabdomyosarcoma in an Adolescent With Tumor Thrombosis in the Inferior Vena Cava and Right Atrium: A Case Report and Review of the Literature.

    PubMed

    Lin, Wei-Ching; Chen, Jeon-Hor; Westphalen, Antonio; Chang, Han; Chiang, I-Ping; Chen, Cheng-Hong; Wu, Hsi-Chin; Lin, Chien-Heng

    2016-05-01

    Although the second peak of the age distribution of rhabdomyosarcoma (RMS) is at adolescence, renal RMS is extremely rare at this age group. This tumor is indistinguishable from other renal tumors based on clinical and imaging findings, and the diagnosis relies on histology and immunohistochemical staining. We report a unique case of adolescent renal RMS associated with tumor thrombus extending into the inferior vena cava (IVC) and right atrium.An 18-year-old female adolescent presented with shortness of breath and palpitations, associated with right flank discomfort, and hematuria. A pleomorphic-type renal RMS with Budd-Chiari syndrome and arrhythmia induced by IVC and RA thrombosis was diagnosed. Despite complete tumor resection, the patient developed multiple lung metastases a month after surgery. Chemotherapy was recommended, but the patient declined. She died within a year of the initial operation.Adolescent renal RMS is rare and associated with poor outcome. Early aggressive multimodal therapy seems to be appropriate, in particular, in the presence of tumor thrombosis. PMID:27227946

  3. Calciphylaxis in end-stage renal disease prior to dialytic treatment: a case report and literature review

    PubMed Central

    Tamayo-Isla, Ramón Alberto; Cuba de la Cruz, Mauro

    2015-01-01

    Introduction Calciphylaxis is a rare medical condition that is usually diagnosed in patients suffering from end-stage renal disease who are already receiving renal replacement therapy and in those post-transplantation. The pathogenesis still remains to be fully elucidated; hence, the treatment is not uniform. The prognosis is generally poor. The ulcerative stage exhibits a worse prognosis than the nonulcerative one. Calciphylaxis presenting in terminal kidney disease prior to dialytic treatment has only rarely been reported. Case presentation A 32-year-old female Caucasian clerk sought medical attention for increasing tiredness and lower limb skin ulcers. Polycystic kidney disease was diagnosed in her late father and two of her siblings. At the first nephrology consultation, obesity, pallor, bilateral flank masses with ballottement, and two ulcers with a dark necrotic center on the distal left leg were noted. In addition, another indurated light bluish lesion of 5 cm just above the right knee with intact skin was observed. All lesions were very tender and warm on touch. Laboratory results yielded hypercalcemia, hyperphosphatemia, anemia, and parathyroid hormone levels that were more than ten times the normal values in the patient, and with a glomerular filtration rate of 4 mL/minute. Skin biopsy confirmed the suspicion of calciphylaxis. The patient was placed on peritoneal dialysis with low Ca concentration baths, cinacalcet, and aluminum hydroxide. The results included correction of hypercalcemia, improvement of phosphate levels, and the product of both Ca and phosphate, but only a transitory decrease in serum parathyroid hormone levels. The ulcerations were completely healed after 2 months of treatment. Cinacalcet was discontinued after 18 months, but multiple large-size, nonulcerative indurated areas appeared 3 months later in the lower limbs after discontinuation of the drug. A parathyroidectomy performed 17 months later revealed a four-gland hyperplastic

  4. [Multiple calcium oxalate stone formation in a patient with glycogen storage disease type I (von Gierke's disease) and renal tubular acidosis type I: a case report].

    PubMed

    Kanematsu, A; Segawa, T; Kakehi, Y; Takeuchi, H

    1993-07-01

    A case of multiple urinary stones in a patient with glycogen storage disease type 1 (GSD-1) is reported. In spite of the presence of hyperuricemia, these stones did not consist of uric acid, but mainly of calcium oxalate. Laboratory studies revealed distal renal tubular acidosis and hypocitraturia, but no significant abnormality in calcium metabolism. We discussed the mechanism of calcium stone formation in our case, and its prophylactic treatment by oral administration of citrate compound. PMID:8362684

  5. Clear cell papillary renal cell carcinoma in patients with von Hippel-Lindau syndrome--clinicopathological features and comparative genomic analysis of 3 cases.

    PubMed

    Rao, Priya; Monzon, Federico; Jonasch, Eric; Matin, Surena F; Tamboli, Pheroze

    2014-09-01

    Clear cell papillary renal cell carcinoma (CCPRCC) is a renal neoplasm that has recently received widespread recognition in the literature. There have been several reports of this tumor arising in a sporadic setting and in patients with end-stage renal disease; however, there is limited information available about the clinical, pathologic, and genetic characteristics of this tumor in the setting of von Hippel-Lindau (VHL) disease. We herein report a series of 3 patients who developed CCPRCC in this unique clinical setting. The histology and immunohistochemical profile for all 3 cases was similar to that which has been previously reported for CCPRCC. All tumors were diffusely and strongly positive for cytokeratin 7, negative for α-methyl-CoA-racemase, and showed at least focal staining for CD10. Comparative genomic analysis was performed on tumors from all 3 patients. One tumor demonstrated monosomy 3, and the other 2 tumors showed normal chromosomal content. All 3 patients were alive without evidence of disease progression 5, 3, and 3 years after surgery. CCPRCC represents a distinct tumor type that may occur in the setting of VHL disease and should be considered in the differential diagnosis of extensively cystic renal tumors arising in this clinical setting. Molecular analysis in our series of cases suggests that CCPRCC does indeed represent a unique histologic subtype and must be distinguished from clear cell renal cell carcinoma due to different biological potentials. Ancillary studies for accurate classification are recommended due to significant morphologic overlap with clear cell renal cell carcinoma. PMID:25081542

  6. Predictive factors for flexible ureterorenoscopy requirement after rigid ureterorenoscopy in cases with renal pelvic stones sized 1 to 2 cm

    PubMed Central

    Gülpinar, Ömer; Özcan, Cihat; Göğüş, Çağatay; Kerimov, Seymur; Şafak, Mut

    2015-01-01

    Purpose To evaluate the outcomes of rigid ureterorenoscopy (URS) for renal pelvic stones (RPS) sized 1 to 2 cm and to determine the predictive factors for the requirement for flexible URS (F-URS) when rigid URS fails. Materials and Methods A total of 88 patients were included into the study. In 48 patients, the RPS were totally fragmented with rigid URS and F-URS was not required (group 1). In 40 patients, rigid URS was not able to access the renal pelvis or fragmentation of the stones was not completed owing to stone position or displacement and F-URS was utilized for retrograde intrarenal surgery (RIRS) (group 2). The predictive factors for F-URS requirement during RIRS for RPS were evaluated. Both groups were compared regarding age, height, sex, body mass index, stone size, stone opacity, hydronephrosis, and previous treatments. Results The mean patient age was 48.6±16.5 years and the mean follow-period was 39±11.5 weeks. The overall stone-free rate in the study population was 85% (75 patients). In groups 1 and 2, the overall stone-free rates were 83% (40 patients) and 87% (35 patients), respectively (p>0.05). The independent predictors of requirement for F-URS during RIRS were male gender, patient height, and higher degree of hydronephrosis. Conclusions Rigid URS can be utilized in selected patients for the fragmentation of RPS sized 1 to 2 cm with outcomes similar to that of F-URS. In case of failure of rigid URS, F-URS can be performed successfully in this group of patients. PMID:25685301

  7. Living Related Donor Renal Transplant in Human Immunodeficiency Virus Infected Patient: Case Reports from Tertiary Care Hospital in Western India

    PubMed Central

    Dalal, Sonal; Patel, Atul K; Patel, Ketan K; Shukla, Ketan D; Darji, Prakash

    2014-01-01

    Renal transplantation (TX) in human immunodeficiency virus (HIV) infected patients with end stage renal disease (ESRD) is increasingly performed in developed countries in the era of antiretroviral therapy (ART). Management of HIV infected patients during and post-transplant is very complex and challenging due to drug interaction, infection risk and associated co-infections. We described our experience with living related donor renal TX in three HIV infected patients. PMID:25191053

  8. Living related donor renal transplant in human immunodeficiency virus infected patient: case reports from tertiary care hospital in Western India.

    PubMed

    Dalal, Sonal; Patel, Atul K; Patel, Ketan K; Shukla, Ketan D; Darji, Prakash

    2014-07-01

    Renal transplantation (TX) in human immunodeficiency virus (HIV) infected patients with end stage renal disease (ESRD) is increasingly performed in developed countries in the era of antiretroviral therapy (ART). Management of HIV infected patients during and post-transplant is very complex and challenging due to drug interaction, infection risk and associated co-infections. We described our experience with living related donor renal TX in three HIV infected patients. PMID:25191053

  9. Effects of Parvovirus B19 Infection in Renal Transplant Recipients: A Retrospective Review of Three Cases.

    PubMed

    Krishnan, Prathik; Ramadas, Poornima; Rajendran, Prejith P; Madhavan, Parvathy; Alex, Asha; Jayaschandran, Vivek; Humayun, Shaesta G; Ali, Nicole; Sachdeva, Mala; Flecha, Antonette; Basu, Amit; Bhaskaran, Madhu; Molmenti, Ernesto P

    2015-06-01

    Parvovirus B19 (PVB19) is a DNA virus which causes clinically relevant infection in renal transplant recipients (RTR) leading to significant morbidity. Manifestations include erythropoietin resistant anemia, proteinuria, and glomerulosclerosis in the allograft. Severe infection may require administration of intravenous immunoglobulin, reduction in immunosuppression and transfusions. The major challenge in managing and preventing the infection in RTR involves the act of balancing the decreased level of immunosuppression and the risk of rejection. The objective of this article is to understand the importance of PVB19 infection and its outcome in RTR. We reviewed the medical records of three RTR with confirmed PVB19 infection and recorded patient information including demographics, clinical and laboratory data, management, and outcome. The average time of occurrence of PVB19 infection as transplant was 8.6 weeks and they presented with symptomatic anemia. Elevated creatinine values were noted in two of them. Following treatment, anemia improved and creatinine values returned to baseline. One of them developed an early relapse and had to be treated once again similarly. We emphasize the importance of maintaining a high index of suspicion for PVB19 infection in patients with anemia in the posttransplant phase, especially in patients on higher doses of immunosuppressants. Early and proper treatment can prevent worsening clinical condition and possible effects on the allograft. PMID:26060378

  10. [A Case of Severe Hyponatremia Caused by Renal Salt Wasting Syndrome in Oropharyngeal Cancer].

    PubMed

    Fujikawa, Taro; Shirakura, Satoru; Hatanaka, Akio; Okano, Wataru; Tokumaru, Takao; Yamada, Masato; Saito, Yoshihiro; Beppu, Takeshi

    2015-08-01

    Hyponatremia is one of the electrolyte abnormalities frequently encountered in cancer therapy. Cisplatin is a well-known drug which can raise various adverse events, including hyponatremia. A male with advanced oropharyngeal cancer is presented in the present report, who was treated with radiotherapy with concurrent administration of cisplatin and who underwent a total of three episodes of severe hyponatremia in the course of therapy. The first two attacks of hyponatremia following cisplatin administration were accompanied by dehydration and excessive urination, and the patient recovered in one week with rehydration and salt supplementation. Excessive loss of salt in urine confirmed that these events were caused by renal salt wasting syndrome after cisplatin administration. On the other hand, the third attack was due to the syndrome of inappropriate antidiuretic hormone secretion after surgery for a bone fracture. Estimation of the extracellular fluid volume and salt intake/output balance is always believed to be necessary for the diagnosis and proper management of severe hyponatremia after chemotherapy-based treatment with cisplatin. PMID:26548098

  11. The pathogenesis of renal dysplasia. I. Quantification of hypoplasia and dysplasia.

    PubMed

    Schwarz, R D; Stephens, F D; Cussen, L J

    1981-09-01

    In order to assess the relative effects of abnormal ureteric orifice position and abnormal urodynamics on the morphogenesis of hypoplasia and dysplasia in kidneys obtained from infants, we devised a method of quantifying the renal structures. The method was based on radial glomerular counts which ranged from zero to normal (seven to nine), a score for dysplastic structures, and the ratio of normal to abnormal tissues present. These three values, when plotted against each other, correlated closely. The glomerular count, with occasional minor adjustment for inconsistencies, was the best parameter of hypodysplasia. Severe to moderate grades of hypodysplasias fell in the low and middle ranges and hypoplasia through to normal in the highest range. By grading kidneys in this way, we were able to compare the effects of ureteral ectopy and abnormal urinary dynamics on the developing kidney. PMID:7024184

  12. [IgG4-related kidney disease: a long-term follow up case of pseudotumor of the renal pelvis].

    PubMed

    Tsuzaka, Yasuo; Ookubo, Kazuki; Sugiyama, Kazutaka; Morimoto, Hirohiko; Amano, Hiroyuki; Oota, Nobutaka; Kuriki, Ken; Homma, Yukio

    2014-04-01

    A 69-year-old man had undergone left ureteronephrectomy because of a left renal pelvic tumor, however the pathological diagnosis was inflammatory pseudotumor. About 1 year later, computed tomography showed a mass at the right kidney near the hilar. Ureterorenoscopy and urine cytology were performed, and their results showed no evidence of malignancy. He had been followed closely without therapy. The mass increased in size during follow-up, and we reviewed the surgical specimen of the left ureteronephrectomy. Immunohistochemical studies revealed diffuse infiltration by IgG4 positive plasma cell. His serum IgG4 was high. We diagnosed him as IgG4-related kidney disease. In response to treatment with corticosteroid, the size of the tumor and serum IgG4 levels decreased. Most reported cases of IgG4-related disease involving kidney have a history of prior pancreatic involvement. We report a rare long term follow-up case of IgG4-related kidney disease without pancreatic involvement. PMID:24908817

  13. A Case of Atrial Tachycardia Circulating around a Left Atrial Roof Scar with Diabetes Mellitus and Renal Failure on Hemodialysis.

    PubMed

    Hijioka, Naoko; Kamioka, Masashi; Suzuki, Hitoshi; Takeishi, Yasuchika

    2016-01-01

    Introduction. Little is known about the effects of volume change by hemodialysis (HD) and mechanical stress caused by an anatomical structure being in contact with the left atrium on the progression of atrial remodeling. We experienced a case of atrial tachycardia (AT) in a patient who had left atrial (LA) scarring at the LA roof and a low-voltage area with slow conduction around the LA scar as components of AT circuit. Here, we present the conceivable hypothesis of the LA scar and the low-voltage area formation. Our concept can be useful in developing a strategy for ablation in a patient with chronic renal failure (CRF) on HD. Case Report. A 65-year-old man with CRF on HD was referred for AT ablation. Three-dimensional electroanatomical mapping revealed that the AT conducted around an LA scar in a counterclockwise fashion. There was a slow conduction area at the superior side of the LA scar, where the AT was terminated during the ablation. Computed tomography indicated a close relationship between the LA and the anatomical structures (ascending aorta and pulmonary artery). Conclusion. Volume change by HD and close contact of anatomical structures to the LA can promote atrial remodeling, resulting in AT occurrence. PMID:27148367

  14. A Case of Atrial Tachycardia Circulating around a Left Atrial Roof Scar with Diabetes Mellitus and Renal Failure on Hemodialysis

    PubMed Central

    Hijioka, Naoko; Kamioka, Masashi; Suzuki, Hitoshi; Takeishi, Yasuchika

    2016-01-01

    Introduction. Little is known about the effects of volume change by hemodialysis (HD) and mechanical stress caused by an anatomical structure being in contact with the left atrium on the progression of atrial remodeling. We experienced a case of atrial tachycardia (AT) in a patient who had left atrial (LA) scarring at the LA roof and a low-voltage area with slow conduction around the LA scar as components of AT circuit. Here, we present the conceivable hypothesis of the LA scar and the low-voltage area formation. Our concept can be useful in developing a strategy for ablation in a patient with chronic renal failure (CRF) on HD. Case Report. A 65-year-old man with CRF on HD was referred for AT ablation. Three-dimensional electroanatomical mapping revealed that the AT conducted around an LA scar in a counterclockwise fashion. There was a slow conduction area at the superior side of the LA scar, where the AT was terminated during the ablation. Computed tomography indicated a close relationship between the LA and the anatomical structures (ascending aorta and pulmonary artery). Conclusion. Volume change by HD and close contact of anatomical structures to the LA can promote atrial remodeling, resulting in AT occurrence. PMID:27148367

  15. Ligation of left renal vein as a salvage procedure for splenorenal shunt after living donor liver transplantation: a case report.

    PubMed

    Cho, S Y; Kim, S H; Lee, K W; Park, S J; Han, S-S; Kim, Y-K

    2009-12-01

    We describe a case of recovered portal flow by ligation of the left renal vein (LRV) as a salvage procedure for a spontaneous splenorenal shunt (SRS) occurring the next day after right liver living donor transplantation (LDLT). Doppler ultrasonography showed normal graft portal venous flow immediately after LDLT, but nearly total diversion of portal flow into the existing splenorenal shunt was observed on the next day. Portal flow normalized after ligation of the LRV by relaparotomy. The patient recovered fully without complication and was discharged on the 17th postoperative day. He remains well at 14 months after the operation, returning to his previous occupation. This case was neither associated with acute rejection nor with small-for-size graft, which may increase intrahepatic vascular resistance, causing portal flow steal through shunts. Even though patients with preoperative SRS show normal portal flow immediately after transplantation, close monitoring is necessary for a possible decrease or loss of portal flow. If portal flow becomes insufficient, ligation of LRV as a salvage procedure is an important option that can be considered even after transplantation. PMID:20005377

  16. Whole exome sequencing identifies causative mutations in the majority of consanguineous or familial cases with childhood-onset increased renal echogenicity

    PubMed Central

    Halbritter, Jan; Gee, Heon Yung; Porath, Jonathan D.; Lawson, Jennifer A.; Airik, Rannar; Shril, Shirlee; Allen, Susan J.; Stein, Deborah; Al Kindy, Adila; Beck, Bodo B.; Cengiz, Nurcan; Moorani, Khemchand N.; Ozaltin, Fatih; Hashmi, Seema; Sayer, John A.; Bockenhauer, Detlef; Soliman, Neveen A.; Otto, Edgar A.; Lifton, Richard P.; Hildebrandt, Friedhelm

    2015-01-01

    Chronically increased echogenicity on renal ultrasound is a sensitive early finding of chronic kidney disease that can be detected before manifestation of other symptoms. Increased echogenicity, however, is not specific for a certain etiology of chronic kidney disease. Here, we performed whole exome sequencing in 79 consanguineous or familial cases of suspected nephronophthisis in order to determine the underlying molecular disease cause. In 50 cases, there was a causative mutation in a known monogenic disease gene. In 32 of these cases whole exome sequencing confirmed the diagnosis of a nephronophthisis-related ciliopathy. In 8 cases it revealed the diagnosis of a renal tubulopathy. The remaining 10 cases were identified as Alport syndrome (4), autosomal-recessive polycystic kidney disease (2), congenital anomalies of the kidney and urinary tract (3), and APECED syndrome (1). In 5 families, in whom mutations in known monogenic genes were excluded, we applied homozygosity mapping for variant filtering, and identified 5 novel candidate genes (RBM48, FAM186B, PIAS1, INCENP, and RCOR1) for renal ciliopathies. Thus, whole exome sequencing allows the detection of the causative mutation in 2/3 of affected individuals, thereby presenting the etiologic diagnosis and allows identification of novel candidate genes. PMID:26489029

  17. Whole exome sequencing identifies causative mutations in the majority of consanguineous or familial cases with childhood-onset increased renal echogenicity.

    PubMed

    Braun, Daniela A; Schueler, Markus; Halbritter, Jan; Gee, Heon Yung; Porath, Jonathan D; Lawson, Jennifer A; Airik, Rannar; Shril, Shirlee; Allen, Susan J; Stein, Deborah; Al Kindy, Adila; Beck, Bodo B; Cengiz, Nurcan; Moorani, Khemchand N; Ozaltin, Fatih; Hashmi, Seema; Sayer, John A; Bockenhauer, Detlef; Soliman, Neveen A; Otto, Edgar A; Lifton, Richard P; Hildebrandt, Friedhelm

    2016-02-01

    Chronically increased echogenicity on renal ultrasound is a sensitive early finding of chronic kidney disease that can be detected before manifestation of other symptoms. Increased echogenicity, however, is not specific for a certain etiology of chronic kidney disease. Here, we performed whole exome sequencing in 79 consanguineous or familial cases of suspected nephronophthisis in order to determine the underlying molecular disease cause. In 50 cases, there was a causative mutation in a known monogenic disease gene. In 32 of these cases whole exome sequencing confirmed the diagnosis of a nephronophthisis-related ciliopathy. In 8 cases it revealed the diagnosis of a renal tubulopathy. The remaining 10 cases were identified as Alport syndrome (4), autosomal-recessive polycystic kidney disease (2), congenital anomalies of the kidney and urinary tract (3), and APECED syndrome (1). In 5 families, in whom mutations in known monogenic genes were excluded, we applied homozygosity mapping for variant filtering and identified 5 novel candidate genes (RBM48, FAM186B, PIAS1, INCENP, and RCOR1) for renal ciliopathies. Thus, whole exome sequencing allows the detection of the causative mutation in 2/3 of affected individuals, thereby presenting the etiologic diagnosis, and allows identification of novel candidate genes. PMID:26489029

  18. TASER® Electronic Control Device-Induced Rhabdomyolysis and Renal Failure: A Case Report

    PubMed Central

    Ahmad, Ibrahim

    2015-01-01

    Many law enforcement agencies around the United States are employing the use of TASER® electronic control devices (TASER® International Inc.) to subdue combative suspects. Since its inception the TASER® has had a temporal association with reports of rhabdomyolysis. Case reports have reported TASER® induced rhabdomyolysis as mild but serious cases have also been reported. Herein we present the case of a single patient who was admitted to our health network with severe rhabdomyolysis after receiving TASER® shocks and review the pertinent literature. No direct link has been established between clinically significant rhabdomyolysis and TASER® device application but this case serves as an example of a sparsely documented but serious complication that may occur in patients who are at risk for restraint by an electronic control device. PMID:26557540

  19. TASER(®) Electronic Control Device-Induced Rhabdomyolysis and Renal Failure: A Case Report.

    PubMed

    Gleason, James Benjamin; Ahmad, Ibrahim

    2015-10-01

    Many law enforcement agencies around the United States are employing the use of TASER(®) electronic control devices (TASER(®) International Inc.) to subdue combative suspects. Since its inception the TASER(®) has had a temporal association with reports of rhabdomyolysis. Case reports have reported TASER(®) induced rhabdomyolysis as mild but serious cases have also been reported. Herein we present the case of a single patient who was admitted to our health network with severe rhabdomyolysis after receiving TASER(®) shocks and review the pertinent literature. No direct link has been established between clinically significant rhabdomyolysis and TASER(®) device application but this case serves as an example of a sparsely documented but serious complication that may occur in patients who are at risk for restraint by an electronic control device. PMID:26557540

  20. Renal arteriography

    MedlinePlus

    ... Read More Acute arterial occlusion - kidney Acute kidney failure Aneurysm Atheroembolic renal disease Blood clots Renal cell carcinoma Renal venogram X-ray Update Date 4/7/2014 Updated by: Jason ... Failure Kidney Tests X-Rays Browse the Encyclopedia A. ...

  1. Renal venogram

    MedlinePlus

    ... 2008:chap 6. Rankin S. Renal parenchymal disease, including renal failure, renovascular disease and transportation. In: Grainger RC, Allison D, Adam, Dixon AK, eds. Diagnostic Radiology: A Textbook of Medical Imaging . 5th ed. New York, NY: Churchill Livingstone; 2008:chap 39. Read ... arteriography Renal vein thrombosis Tumor Venogram Wilms ...

  2. Multicystic renal dysplasia.

    PubMed

    Nagaraj, V P; Ratnakar, K S

    2001-07-01

    Multicystic renal dysplasia, the most common form of cystic renal disease in the newborn period, is a clinically important consequence of abnormal nephrogenesis. It usually presents as an abdominal mass. The dysplasias are usually unilateral, but it can be bilateral, segmental or focal. The clinical presentation usually depends on the extent of the dysplastic involvement and the degree of the associated urinary obstruction. Here, we present a case of histologically multicystic renal dysplasia, which is ?bilateral. The left kidney showed typical radiological, gross and histopathological features of multicystic dysplasia, but the right kidney showed only radiological features of dysplastic cystic kidney. PMID:11479648

  3. Acute Kidney Injury, Renal Function, and the Elderly Obese Surgical Patient: A Matched Case-Control Study

    PubMed Central

    Kelz, Rachel R.; Reinke, Caroline E.; Zubizarreta, José R.; Wang, Min; Saynisch, Philip; Even-Shoshan, Orit; Reese, Peter P.; Fleisher, Lee A.; Silber, Jeffrey H.

    2014-01-01

    Objective To investigate the association between obesity and perioperative acute kidney injury (AKI), controlling for preoperative kidney dysfunction. Summary Background Data More than 30% of patients over the age of 60 are obese, and therefore at risk for kidney disease. Post-operative AKI is a significant problem. Methods We performed a matched case control study of patients enrolled in the Obesity and Surgical Outcomes Study (OBSOS), using Medicare claims data enriched with detailed chart review. Each AKI patient was matched to a non-AKI control similar in procedure type, age, sex, race, emergency status, transfer status, baseline eGFR, admission APACHE score, and the risk of death score with fine balance on hospitals. Results We identified 514 AKI cases and 694 control patients. Of the cases, 180 (35%) followed orthopedic procedures and 334 (65%) followed colon or thoracic surgery. After matching, obese patients undergoing a surgical procedure demonstrated a 65% increase in odds of AKI within 30 days from admission (OR=1.65, p<0.005) when compared to the non-obese patients. After adjustment for potential confounders, the odds of post-operative AKI remained elevated in the elderly obese (OR=1.68, p=0.01.) Conclusions Obesity is an independent risk factor for post-operative AKI in patients over 65 years of age. Efforts to optimize kidney function pre-operatively should be employed in this at risk population along with keen monitoring and maintenance of intra-operative hemodynamics. When subtle reductions in urine output or a rising creatinine are observed post-operatively, timely clinical investigation is warranted to maximize renal recovery. PMID:23676533

  4. Unusual case of severe late-onset cytomegalovirus-induced hemorrhagic cystitis and ureteritis in a renal transplant patient.

    PubMed

    Ersan, Sibel; Yorukoglu, Kutsal; Sert, Mehmet; Atila, Koray; Celik, Ali; Gulcu, Aytac; Cavdar, Caner; Sifil, Aykut; Bora, Seymen; Gulay, Hüseyin; Camsari, Taner

    2012-01-01

    Cytomegalovirus (CMV) infection is common in solid organ transplant recipients and accounts for the majority of graft compromise. Major risk factors include primary exposure to CMV infection at the time of transplantation and the use of antilymphocyte agents such as OKT3 (the monoclonal antibody muromonab-CD3) and antithymocyte globulin. It most often develops during the first 6 months after transplantation. Although current prophylactic strategies and antiviral agents have led to decreased occurrence of CMV disease in early posttransplant period, the incidence of late-onset CMV disease ranges from 2% to 7% even in the patients receiving prophylaxis with oral ganciclovir. The most common presentation of CMV disease in transplant patients is CMV pneumonitis followed by gastrointestinal disease. Hemorrhagic cystitis is a common complication following hematopoietic stem cell transplantation. The condition is usually due to cyclophosphamide-based myeloablative regimens and infectious agents. Even in these settings, CMV-induced cases occur only sporadically. Ureteritis and hemorrhagic cystitis due to CMV infection after kidney transplantation is reported very rarely on a case basis in the literature so far. We report here a case of late-onset CMV-induced hemorrhagic cystitis and ureteritis presenting with painful macroscopic hematuria and ureteral obstruction after 4 years of renal transplantation. The diagnosis is pathologically confirmed by the demonstration of immunohistochemical staining specific for CMV in a resected ureteral section. We draw attention to this very particular presentation of CMV hemorrhagic cystitis with ureteral obstruction in order to emphasize atypical presentation of tissue-invasive CMV disease far beyond the timetable for posttransplant CMV infection. PMID:22251223

  5. Disappearing renal calculus

    PubMed Central

    Cui, Helen; Thomas, Johanna; Kumar, Sunil

    2013-01-01

    We present a case of a renal calculus treated solely with antibiotics which has not been previously reported in the literature. A man with a 17 mm lower pole renal calculus and concurrent Escherichia coli urine infection was being worked up to undergo percutaneous nephrolithotomy. However, after a course of preoperative antibiotics the stone was no longer seen on retrograde pyelography or CT imaging. PMID:23580676

  6. Categorizing renal oncocytic neoplasms on core needle biopsy: a morphologic and immunophenotypic study of 144 cases with clinical follow-up.

    PubMed

    Alderman, Megan A; Daignault, Stephanie; Wolf, J Stuart; Palapattu, Ganesh S; Weizer, Alon Z; Hafez, Khaled S; Kunju, Lakshmi P; Wu, Angela J

    2016-09-01

    There is limited literature on renal oncocytic neoplasms diagnosed on core biopsy. All renal oncocytic neoplasm core biopsies from 2006 to 2013 were retrospectively reviewed. Morphologic features and an immunohistochemical panel of CK7, c-KIT, and S100A1 were assessed. Concordance with resection diagnosis, statistical analysis including a random forest classification, and follow-up were recorded. The post-immunohistochemical diagnoses of 144 renal oncocytic core biopsies were favor oncocytoma (67%), favor renal cell carcinoma (RCC) (12%), and cannot exclude RCC (21%). Diagnosis was revised following immunohistochemistry in 7% of cases. The most common features for oncocytoma (excluding dense granular cytoplasm) were nested architecture, edematous stroma, binucleation and tubular architecture; the most common features for favor RCC were sheet-like architecture, nuclear pleomorphism, papillary architecture, and prominent cell borders. High nuclear grade, necrosis, extensive papillary architecture, raisinoid nuclei, and frequent mitoses were not seen in oncocytomas. Comparing the pathologist and random forest classification, the overall out-of-bag estimate of classification error dropped from 23% to 13% when favor RCC and cannot exclude RCC were combined into 1 category. Resection was performed in 19% (28 cases) with a 94% concordance (100% of favor RCC biopsies and 90% of cannot exclude RCC biopsies confirmed as RCC; 83% of favor oncocytomas confirmed); ablation in 23%; and surveillance in 46%. Follow-up was available in 92% (median follow-up, 33months) with no adverse outcomes. Renal oncocytic neoplasms comprise a significant subset (16%) of all core biopsies, and the majority (78%) can be classified as favor oncocytoma or favor RCC. PMID:27085554

  7. Acute pancreatitis and development of pancreatic pseudo cyst after extra corporeal shock wave lithotripsy to a left renal calculus: A rare case with review of literature

    PubMed Central

    Mylarappa, Prasad; Javali, Tarun; Prathvi; Ramesh, D.

    2014-01-01

    Extracorporeal shock wave lithotripsy (SWL) is considered the standard of care for the treatment of small upper ureteric and renal calculi. A few centers have extended its use to the treatment of bile duct calculi and pancreatic calculi. The complication rates with SWL are low, resulting in its wide spread acceptance and usage. However, some of the serious complications reported in 1% of patients include acute pancreatitis, perirenal hematoma, urosepsis, venous thrombosis, biliary obstruction, bowel perforation, lung injury, rupture of aortic aneurysm and intracranial hemorrhage. To our knowledge, only six cases of acute pancreatitis or necrotizing pancreatitis following SWL have been documented in the literature. Herein, we report a rare case of acute pancreatitis and formation of a pseudo cyst following SWL for left renal pelvic calculus. PMID:24497695

  8. Cryoglobulinemia in a patient with chronic lymphocytic leukemia - A case report and review of literature of renal involvement in CLL.

    PubMed

    Arora, Swaty; Levitan, Daniel; Regmi, Narottam; Sidhu, Gurinder; Gupta, Raavi; Nicastri, Anthony D; Saggi, Subodh J; Braverman, Albert

    2016-09-01

    The incidence of glomerulonephritis, as a manifestation of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), has always been considered low. Though renal infiltration is usually detected at post-mortem, it does not often interfere with kidney function [1]. Though immunoglobulin (Ig) levels in most CLL patients are subnormal, small monoclonal Ig peaks are occasionally detected in serum. They were present in a number of reported CLL nephropathy patients, and not all were cryoglobulins; serum and glomerular staining were concordant for Ig type [2,3,4]. Myeloma, which secretes monoclonal light chains, causes nephropathy in 25% of patients. But the little presumably secreted by small plasma cell clones, without myeloma, may also be nephrotoxic. The same is true of the low secretory CLL cells, which may occasionally be associated with cryoglobulins and other nephrotoxic Igs [5]. We report a patient with early stage CLL (Rai stage 0) with cryoglobulins, which led to membranoproliferative glomerulonephritis (MPGN), and death. We located reports of 51 patients with CLL-associated nephrotic syndrome or nephropathy, mostly from MPGN related to local Ig deposits. In those patients screened for cryoglobulins, about half tested positive. Many were early stage cases, where MPGN developed long after CLL presentation, and responded to its treatment. As early diagnosis and treatment CLL-related nephropathy may be curative, we propose a prospective study to determine the incidence of hyperalbuminuria development after presentation. PMID:27519936

  9. Uncommon cause of chest pain in a renal transplantation patient with autosomal dominant polycystic kidney disease: a case report.

    PubMed

    Rodrigues, L; Neves, M; Machado, S; Sá, H; Macário, F; Alves, R; Mota, A; Campos, M

    2012-10-01

    Autosomal dominant polycystic kidney disease (ADPKD) is a common cause of end-stage renal disease (ESRD) and, because of its intrinsic systemic involvement, its treatment can be a medical and surgical challenge. This condition is often associated with the presence of hepatic cysts and their prevalence generally increases with age. Most patients remain asymptomatic, but some of these will develop complications associated with enlargement and infection of their cysts. Chest pain is a rare manifestation of these complications and, after exclusion of more common cardiovascular and pulmonary causes, should raise the suspicion of an infected hepatic cyst in these patients. We report the case of a 62-year-old male who underwent a kidney transplantation from a cadaveric donor in 1997 (etiology of the ESRD was ADPKD), and was admitted to the emergency department with complaints of chest pain radiating to both shoulders and the interscapular region. An echocardiogram was showed compression of the right atrium by a large liver cyst without associated ventricular dysfunction. Computer tomography-guided drainage of the cyst was performed and an Enterobacter aerogenes sensitive to carbamapenemes was isolated from respective cultures. The patient presented a favorable clinical outcome with prolonged administration of antibiotic therapy according to the antibiotic susceptibility testing. There was no need for surgical intervention. PMID:23026633

  10. Renal Transplantation in Systemic Lupus Erythematosus: Outcome and Prognostic Factors in 50 Cases from a Single Centre

    PubMed Central

    Cairoli, Ernesto; Sanchez-Marcos, Carolina; Espinosa, Gerard; Glucksmann, Constanza; Ercilla, Guadalupe; Oppenheimer, Federico; Cervera, Ricard

    2014-01-01

    Background. End-stage renal disease (ESRD) is an important cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Objectives. To analyze the outcome and prognostic factors of renal transplantation in patients with ESRD due to SLE from January 1986 to December 2013 in a single center. Results. Fifty renal transplantations were performed in 40 SLE patients (32 female (80%), mean age at transplantation 36 ± 10.4 years). The most frequent lupus nephropathy was type IV (72.2%). Graft failure occurred in a total of 15 (30%) transplantations and the causes of graft failure were chronic allograft nephropathy (n = 12), acute rejection (n = 2), and chronic humoral rejection (1). The death-censored graft survival rates were 93.9% at 1 year, 81.5% at 5 years, and 67.6% at the end of study. The presence of deceased donor allograft (P = 0.007) and positive anti-HCV antibodies (P = 0.001) negatively influence the survival of the renal transplant. The patient survival rate was 91.4% at the end of the study. Recurrence of lupus nephritis in renal allograft was observed in one patient. Conclusion. Renal transplantation is a good alternative for renal replacement therapy in patients with SLE. In our cohort, the presence of anti-HCV antibodies and the type of donor source were related to the development of graft failure. PMID:25013800

  11. [A Case Report of Suspected Tuberculous Granuloma in the Kidney after BCG Perfusion Therapy for Urothelial Carcinoma of the Renal Pelvis].

    PubMed

    Kobayashi, Shin; Hori, Junichi; Okazaki, Satoshi; Hashizume, Kazumi; Watanabe, Masaki; Wada, Naoki; Kita, Masafumi; Azumi, Makoto; Iwata, Tatsuya; Matsumoto, Seiji; Kakizaki, Hidehiro

    2016-01-01

    A 66-year-old male patient was referred to our hospital for bilateral renal pelvic tumors. Ureteroscopic biopsy revealed urothelial carcinoma (UC) of low grade (G1) of the renal pelvis. Renal sparing treatment with systemic chemotherapy and percutaneous tumor resection was performed. However, during subsequent follow up, a recurrent tumor was found on the left ureter. After ureteroscopic laser ablation of the tumor, Bacillus Calmette-Guerin (BCG) perfusion therapy (once a week, total 6 weeks) was performed via a single J ureteral catheter with no adverse events. Later, another recurrent recurrence was found on the right ureter, and was managed by ureteroscopic laser ablation followed by BCG perfusion therapy via a single J ureteral catheter. However, the patient developed high fever with chill from the day after initial BCG perfusion therapy on the right side. Although we started antibiotics, high fever continued. Then antituberculous drugs were administered and his condition was improved. Computed tomographic scan revealed a right renal mass 57 mm in diameter, which was consistent with tuberculous granuloma. The tuberculous granuloma persisted despite the continuation of anti-tuberculous drugs. In exceptional cases of upper tract UC such as single kidney and bilateral tumor, BCG perfusion therapy has been used as adjunctive treatment to cure or prevent UC. However, dosages and administration methods of BCG perfusion therapy for upper tract UC still remain to be standardized. Serious adverse events after BCG perfusion therapy require prompt and proper management including the use of anti-tuberculous drugs. PMID:26932332

  12. Radiographic Kinetics of Sarcomatoid Renal Cell Carcinoma.

    PubMed

    Syed, Ali; Raval, Amar; Pridjian, Andrew; Birbe, Ruth; Trabulsi, Edouard J

    2016-07-01

    Renal cell carcinoma is a common entity often managed surgically with excellent survival benefits. We report a rare case of sarcomatoid renal cell carcinoma with aggressive growth kinetics after palliative resection captured radiographically. PMID:27041470

  13. Paraneoplastic Cough and Renal Cell Carcinoma

    PubMed Central

    Sullivan, Stephen

    2016-01-01

    A case of patient with intractable cough due to renal cell carcinoma is reported. The discussion reviews the literature regarding this unusual paraneoplastic manifestation of renal malignancy. PMID:27445553

  14. T-Stenting-and-Small-Protrusion Technique for Bifurcation Stenoses After End-to-Side Anastomosis of Transplant Renal Artery and External Iliac Artery: Report of Two Cases

    SciTech Connect

    Chen, Yong Ye, Peng; Jiang, Wen-jin; Ma, Shuo-yi Zhao, Jian-bo Zeng, Qing-le

    2015-10-15

    Bifurcation stenoses after end-to-side anastomosis of transplant renal artery (TRA) and external iliac artery (EIA), including stenoses at the anastomosis and the iliac artery proximal to the TRA, are rare. In the present article, we report two successfully managed cases of bifurcation stenoses after end-to-side anastomosis of the TRA and EIA using the technique of T-stenting and small protrusion (TAP stenting)

  15. Determination of the optimal case definition for the diagnosis of end-stage renal disease from administrative claims data in Manitoba, Canada

    PubMed Central

    Komenda, Paul; Yu, Nancy; Leung, Stella; Bernstein, Keevin; Blanchard, James; Sood, Manish; Rigatto, Claudio

    2015-01-01

    Introduction End-stage renal disease (ESRD) is a major public health problem with increasing prevalence and costs. An understanding of the long-term trends in dialysis rates and outcomes can help inform health policy. We determined the optimal case definition for the diagnosis of ESRD using administrative claims data in the province of Manitoba over a 7-year period. Methods We determined the sensitivity, specificity, predictive value and overall accuracy of 4 administrative case definitions for the diagnosis of ESRD requiring chronic dialysis over different time horizons from Jan. 1, 2004, to Mar. 31, 2011. The Manitoba Renal Program Database served as the gold standard for confirming dialysis status. Results During the study period, 2562 patients were registered as recipients of chronic dialysis in the Manitoba Renal Program Database. Over a 1-year period (2010), the optimal case definition was any 2 claims for outpatient dialysis, and it was 74.6% sensitive (95% confidence interval [CI] 72.3%–76.9%) and 94.4% specific (95% CI 93.6%–95.2%) for the diagnosis of ESRD. In contrast, a case definition of at least 2 claims for dialysis treatment more than 90 days apart was 64.8% sensitive (95% CI 62.2%–67.3%) and 97.1% specific (95% CI 96.5%–97.7%). Extending the period to 5 years greatly improved sensitivity for all case definitions, with minimal change to specificity; for example, for the optimal case definition of any 2 claims for dialysis treatment, sensitivity increased to 86.0% (95% CI 84.7%–87.4%) at 5 years. Conclusion Accurate case definitions for the diagnosis of ESRD requiring dialysis can be derived from administrative claims data. The optimal definition required any 2 claims for outpatient dialysis. Extending the claims period to 5 years greatly improved sensitivity with minimal effects on specificity for all case definitions. PMID:26457290

  16. Laparoscopic simple nephrectomy patient with situs inversus totalis and left renal hypoplasia: A case report

    PubMed Central

    Cimen, Haci Ibrahim; Atik, Yavuz Tarik; Adsan, Oztug

    2015-01-01

    Situs inversus totalis (SIT) is a relatively rare anatomical condition characterized by the transposition of thoracic and abdominal organs from the normal side to the opposite position. Most reports of laparoscopic procedures in patients with SIT cite technical difficulties and longer operative times due to disorientation because of the reversed abdominal organs and necessary modification of the surgeon’s movements and techniques. We present a case of a patient with SIT in whom a transperitoneal laparoscopic simple nephrectomy was performed. PMID:26279730

  17. A Case of Severe Chlorite Poisoning Successfully Treated With Early Administration of Methylene Blue, Renal Replacement Therapy, and Red Blood Cell Transfusion

    PubMed Central

    Gebhardtova, Andrea; Vavrinec, Peter; Vavrincova-Yaghi, Diana; Seelen, Mark; Dobisova, Anna; Flassikova, Zora; Cikova, Andrea; Henning, Robert H.; Yaghi, Aktham

    2014-01-01

    Abstract The case of a 55-year-old man who attempted suicide by ingesting <100 mL of 28% sodium chlorite solution is presented. On arrival in the intensive care unit, the patient appeared cyanotic with lowered consciousness and displayed anuria and chocolate brown serum. Initial laboratory tests revealed 40% of methemoglobin. The formation of methemoglobin was effectively treated with methylene blue (10% after 29 hours). To remove the toxin, and because of the anuric acute renal failure, the patient received renal replacement therapy. Despite these therapeutic measures, the patient developed hemolytic anemia and disseminated intravascular coagulation, which were treated with red blood cell transfusion and intermittent hemodialysis. These interventions led to the improvement of his condition and the patient eventually fully recovered. Patient gave written informed consent. This is the third known case of chlorite poisoning that has been reported. Based upon this case, we suggest the management of sodium chlorite poisoning to comprise the early administration of methylene blue, in addition to renal replacement therapy and transfusion of red blood cells. PMID:25144325

  18. [Giant renal angiomyolipoma disclosed by mild lumbar trauma and treated with nephrectomy: report of a case].

    PubMed

    Rosselló Barbará, M; Mus Malleu, A; Rebassa Llul, M; Casals Armada, J

    2004-02-01

    A case of giant angiomyolipoma of the kidney discovered during the study of a light lumbar trauma is presented. Disseminated tuberous sclerosis lesions are demonstrated at the brain, cerebellum, liver and contralateral kidney. External cutaneous stigmas of this illness are shown at the face. The size of the viscera and the loss of function of the left kidney conditioned the nephrectomy. The piece weighed upon extracting 6300 g, without malignant signs. To the microscopic exam atrophic sclerosis for compression was demonstrated. The postoperative course was satisfactory. Actually his arterial tension is controlled by medical treatment. PMID:15074062

  19. Hypokalemic paralysis and osteomalacia secondary to renal tubular acidosis in a case with primary Sjögren's syndrome.

    PubMed

    Kawashima, Masanori; Amano, Tetsuki; Morita, Yoshitaka; Yamamura, Masahiro; Makino, Hirofumi

    2006-01-01

    A 39-year-old Japanese woman was admitted to our hospital for severe weakness owing to potassium deficiency caused by type 1 renal tubular acidosis (RTA1). Sicca complex, serological tests, and lip biopsy revealed that she had Sjögren's syndrome (SS). Acidosis was corrected by alkali supplement treatment. She also had an impaired renal function with proteinuria, and high absorbance on Ga scintigram was recognized in both kidneys. She was taking warfarin potassium after aortic valve substitution due to aortic regurgitation, therefore renal biopsy was not performed. Prednisone (20 mg/day) was administered for renal inflammation. One month later, she suffered severe chest wall pains with some local tender points over the costae of both sides, which was presumed to be due to pseudo-fractures based on osteomalacia. Hypokalemic paralysis and osteomalacia should be taken into consideration in the diagnosis of SS with RTA1. PMID:16622725

  20. Analgesic use and risk of renal cell carcinoma: A case-control, cohort and meta-analytic assessment.

    PubMed

    Karami, Sara; Daughtery, Sarah E; Schwartz, Kendra; Davis, Faith G; Ruterbusch, Julie J; Wacholder, Sholom; Graubard, Barry I; Berndt, Sonja I; Hofmann, Jonathan N; Purdue, Mark P; Moore, Lee E; Colt, Joanne S

    2016-08-01

    Analgesics are the most commonly consumed drugs worldwide. Evidence that analgesics increase kidney cancer risk has been mixed. We investigated the association between renal cell carcinoma (RCC) and analgesic use in a large population-based case-control study and a post-trial observational cohort study. Findings were used to update a recent meta-analytic review. We analyzed data from 1,217 RCC cases and 1,235 controls in the US Kidney Cancer Study and 98,807 participants in the US Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO: n = 137 RCCs). Self-reported acetaminophen, aspirin and nonsteroid anti-inflammatory drug (NSAID) use and duration information was assessed in relation to RCC. For the US Kidney Cancer Study, we calculated odds ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regression. For PLCO, we computed hazard ratios (HRs) and 95%CIs using Cox regression. Among case-control participants, RCC risk was associated with over-the-counter acetaminophen use (OR = 1.35, 95%CI = 1.01-1.83). There was a positive trend with increasing duration (p-trend = 0.01), with a two-fold risk for use ≥10 years (OR = 2.01, 95%CI = 1.30-3.12). No association with prescription acetaminophen use was detected. In PLCO, acetaminophen use was also associated with increased RCC risk (HR = 1.68, 95%CI = 1.19-2.39), although elevated risk was absent among the few long-term users. No association with RCC risk was detected for aspirin or NSAIDs use in either study. An association between acetaminophen use and kidney cancer was supported by meta-analytic cohort (n = 4; summary relative risk = 1.34; 95%CI = 1.13-1.59; p-heterogeneity  = 0.40) and case-control (n = 9, summary OR = 1.20; 95%CI = 1.01-1.42; p-heterogeneity  = 0.05) findings. In brief, acetaminophen use may increase the risk of developing RCC. PMID:27009534

  1. Multiple oncocytomas and renal carcinoma

    SciTech Connect

    Velasquez, G.; Glass, T.A.; D'Souza, V.J.; Formanek, A.G.

    1984-01-01

    Renal oncocytoma, although rare, is being diagnosed more frequently, and criteria to differentiate it from other tumors have been described. Multiple oncocytomas have been reported, but an association between multiple oncocytomas and renal carcinoma in the same kidney has not been described. The authors report a case with two oncocytomas and a renal carcinoma in the right kidney as well as a right adrenal adenoma.

  2. Impact of High-Cut-Off Dialysis on Renal Recovery in Dialysis-Dependent Multiple Myeloma Patients: Results from a Case-Control Study

    PubMed Central

    Görlich, Dennis; Thölking, Gerold; Kropff, Martin; Berdel, Wolfgang E.; Pavenstädt, Hermann; Brand, Marcus; Kümpers, Philipp

    2016-01-01

    Background High-cut-off hemodialysis (HCO-HD) can effectively reduce high concentrations of circulating serum free light chains (sFLC) in patients with dialysis-dependent acute kidney injury (AKI) due to multiple myeloma (MM). Therefore, the aim of this study was to analyze renal recovery in a retrospective single-center cohort of dialysis-dependent MM patients treated with either conventional HD (conv. HD) or HCO-HD. Methods and Results The final cohort consisted of 59 patients treated with HCO-HD (n = 42) or conv. HD (n = 17). A sustained sFLC response was detected in a significantly higher proportion of HCO-HD patients (83.3%) compared with conv. HD patients (29.4%; p = 0.007). The median duration of sFLC required to reach values <1000 mg/l was 14.5 days in the HCO-HD group and 36 days in the conv. HD group. The corresponding rates of renal recovery were 64.3% and 29.4%, respectively (chi-squared test, p = 0.014). Multivariate regression and decision tree analysis (recursive partitioning) revealed HCO-HD (adjusted odds ratio [OR] 6.1 [95% confidence interval (CI) 1.5–24.5], p = 0.011) and low initial uric acid values (adjusted OR 1.3 [95%CI 1.0–1.7], p = 0.045) as independent and paramount variables associated with a favorable renal outcome. Conclusions In summary, the results from this retrospective case-control study suggest in addition to novel agent-based chemotherapy a benefit of HCO-HD in sFLC removal and renal outcome in dialysis-dependent AKI secondary to MM. This finding was especially pertinent in patients with low initial uric acid values, resulting in a promising renal recovery rate of 71.9%. Further prospective studies are warranted. PMID:27152520

  3. [Renal transplantation in Maastricht II asystole: report of a first case in Mexico].

    PubMed

    González-Aguirre, Daniel; Jaramillo-Gante, Miguel Ángel; Muruato-Araiza, Sebastián; Sánchez-Aguilar, Jesús Martín; Montes de Oca-Arce, Jorge Luis

    2014-01-01

    On May 6, 2012, an 18-year-old patient was admitted to the emergency room with sever traumatic brain injury and cardiovascular arrest; resuscitation maneuvers were started with a compressor table AUTOPULSE®. After 30 minutes, death was pronounced. Later, compressions were restarted. After the family agreed with the donation, blood samples were obtained to do serology tests and to obtain blood group and Rh factor and a cardiopulmonary bypass was started by femoral approach. After 2 hours and 35 minutes, extraction of the kidneys was performed. This case represented the first organ procurement from a non-heart-beating Maastricht II donor in our country. After 60 days, both receptors remained free of dialysis. PMID:25098220

  4. An imported case of P. falciparum malaria presenting as black water fever with acute renal failure.

    PubMed

    Khan, Fahmi Yousef; Al-Haddad, Dalia

    2009-11-01

    This is a report of a case of blackwater fever in a 28-year-old Nigerian man who was admitted to hospital with fever, jaundice and passing dark urine. Abdominal examination revealed splenomegaly and an examination of the peripheral smear of the patient showed the ring form of the trophozoites of Plasmodium falciparum (P. falciparum). Serum creatinine was 200micromol/L. Treatment with quinine and doxycycline was started and intravenous fluids were administered with close monitoring of the urine output and serum electrolytes. Due to the alarming amount of fluid accumulation and his exacerbated azotaemia the decision was made to haemodialyse the patient; the patient required five haemodialysis sessions during his stay in the hospital. He was discharged on the sixteenth day after admission with a serum creatinine level of 160micromol/L. PMID:19945017

  5. Madelung's disease in a patient with chronic renal insufficiency: a case report and review of literature.

    PubMed

    Bergler-Czop, Beata; Wcisło-Dziadecka, Dominika; Brzezińska-Wcisło, Ligia

    2014-05-01

    Madelung's disease (benign symmetric lipomatosis, Launois-Bensaude syndrome) was described for the first time in the middle of the 19(th) century. This disorder concerns mainly men between 30 and 60 years of age. Patients often suffer from coexisting ailments, such as hepatic function disorders, polyneuropathy, diabetes, gynecomastia, hyperuricemia and deviations of lipid management parameters. Treatment of benign symmetric lipomatosis consists mainly in fat tissue sucking or injection lipolysis. Patients often have to wear special clothes correcting the deformed figure. We are presenting a case of a female patient with diagnosed Madelung's disease, without alcohol abuse. Such abuse is reported in 90% of patients with this disease. Nevertheless, the patient has other typical (and described in the literature) hepatic and pancreatic function impairments, but also glomerular nephritis, which very rarely co-exists with benign symmetric lipomatosis. PMID:25097480

  6. Madelung's disease in a patient with chronic renal insufficiency: a case report and review of literature

    PubMed Central

    Wcisło-Dziadecka, Dominika; Brzezińska-Wcisło, Ligia

    2014-01-01

    Madelung's disease (benign symmetric lipomatosis, Launois-Bensaude syndrome) was described for the first time in the middle of the 19th century. This disorder concerns mainly men between 30 and 60 years of age. Patients often suffer from coexisting ailments, such as hepatic function disorders, polyneuropathy, diabetes, gynecomastia, hyperuricemia and deviations of lipid management parameters. Treatment of benign symmetric lipomatosis consists mainly in fat tissue sucking or injection lipolysis. Patients often have to wear special clothes correcting the deformed figure. We are presenting a case of a female patient with diagnosed Madelung's disease, without alcohol abuse. Such abuse is reported in 90% of patients with this disease. Nevertheless, the patient has other typical (and described in the literature) hepatic and pancreatic function impairments, but also glomerular nephritis, which very rarely co-exists with benign symmetric lipomatosis. PMID:25097480

  7. [Renal injury in Takayasu's arteritis].

    PubMed

    Boubaker, Karima; Kaaroud, Hayet; Goucha, Rim; Kheder, Adel

    2014-11-01

    Renal involvement in Takayasu's arteritis is frequent and worsens the progression of the disease. This is primarily a renal artery stenosis causing renovascular hypertension. The glomerular disease is exceptional. This study was undertaken to determine the clinical, radiological, biological features and therapeutic response in patients with kidney disease associated with Takayasu arteritis. A retrospective chart review was conducted on 11 patients (five men and six females), with a mean age of 31.1 years (19-40 years). The discovery of kidney disease preceded the diagnosis of Takayasu's arteritis in eight cases. Ten patients developed hypertension. Laboratory finding showed proteinuria in five cases of which one case was due to nephrotic syndrome. Renal failure was found in six cases including four cases in stage of terminal chronic renal failure. Impairment of the renal artery was present in nine patients, proximal in seven cases and distal in two cases, bilateral in five cases and unilateral in four cases. Narrowing renal artery was found in seven cases. The renal biopsy revealed membranoproliferative glomerulonephritis in one case and nephrosclerosis in another case. Eleven patients were followed for an average period of 155 months (3-335 months). Remission of nephrotic syndrome was concomitant with the remission of the disease. Seven patients developed outbreaks of Takayasu's arteritis of which six were in care. Relapse of nephrotic syndrome was concomitant with the outbreak of the disease followed by spontaneous remission of both diseases. Improved pressure was obtained in 5 cases and worsening renal function in seven cases. Death was observed in two cases. PMID:25440941

  8. Delayed diagnosis of Townes-Brocks syndrome with multicystic kidneys and renal failure caused by a novel SALL1 nonsense mutation: A case report

    PubMed Central

    LIN, FU-JUN; LU, WEI; GALE, DANIEL; YAO, YAO; ZOU, REN; BIAN, FAN; JIANG, GENG-RU

    2016-01-01

    Townes-Brocks syndrome (TBS) is a rare autosomal dominant congenital anomaly syndrome characterized by the triad of anorectal, hand and external ear malformations. Kidney involvement is less common and may progress to end-stage renal failure (ESRF) early in life. The present study reports the case of a male patient presenting with multiple bilateral cortical kidney cysts at the age of 4 years, at which time the kidneys were of normal size and function. A clinical diagnosis of autosomal recessive polycystic kidney disease was made initially as the patient's parents are clinically healthy. However, the consideration of extra-renal involvements (imperforate anus at birth, preaxial polydactyly and dysplastic right ear) following the progression of the patient to ESRF at the age of 16 years, led to the diagnosis of TBS. This prompted sequencing of the SALL1 gene, which identified a novel heterozygous nonsense mutation in the mutational ‘hotspot’ of exon 2 (c.874C>T, p.Q292X), and this mutation was not detected in healthy controls. The current case highlights that TBS may present with normal sized, cystic kidneys in childhood, while recognition of extra-renal features of cystic kidney diseases, such as TBS, and genetic testing may facilitate the correct diagnosis and transmission mode. Reaching a correct diagnosis of as TBS is important since this condition has a 50% rate of transmission to offspring and can progress to ESRF early in life. PMID:27073431

  9. Spontaneous regression of multiple pulmonary nodules in a patient with unclassified renal cell carcinoma following laparoscopic partial nephrectomy: A case report

    PubMed Central

    UEDA, KOSUKE; SUEKANE, SHIGETAKA; MITANI, TOMOTARO; CHIKUI, KATSUAKI; EJIMA, KAZUHISA; SUYAMA, SHUNSUKE; NAKIRI, MAKOTO; NISHIHARA, KIYOAKI; MATSUO, MITSUNORI; IGAWA, TSUKASA

    2016-01-01

    Spontaneous regression of metastatic renal cell carcinoma (RCC) is rare, but well-documented in clear cell RCC. However, there are no reports on spontaneous regression of unclassified RCC. Since the radiological findings of pulmonary infarcts and inflammatory pseudotumors are similar to those of metastases from RCC, a definitive diagnosis is difficult without performing a histological examination. A 56-year-old woman underwent medical examination by a physician. An abdominal computed tomography (CT) scan revealed a 22-mm mass with a cystic area in the right kidney, as well as multiple enlarged lymph nodes in the common iliac, external iliac and groin areas, bilaterally. A chest CT revealed multiple pulmonary nodules bilaterally, the largest measuring 15 mm. Since the right renal tumor was suspected to be an RCC, laparoscopic partial nephrectomy was performed. The final pathological diagnosis of the renal tumor was unclassified RCC. One month following surgery, a CT scan revealed spontaneous regression of the pulmonary nodules. We herein present a rare case of spontaneous regression of pulmonary nodules in a patient with unclassified RCC following laparoscopic partial nephrectomy. To the best of our knowledge, this is the first case of spontaneous regression in unclassified RCC. PMID:27330764

  10. Technical feasibility of robot-assisted laparoscopic radical prostatectomy in renal transplant recipients: Results of a series of 12 consecutive cases

    PubMed Central

    Le Clerc, Quentin-Côme; Lecornet, Emilie; Leon, Gregoire; Rigaud, Jerome; Glemain, Pascal; Branchereau, Julien; Karam, Georgess

    2015-01-01

    Introduction: We evaluate the technical feasibility of robotic prostatectomy in renal transplant recipients. Methods: We retrospectively analyzed preoperative and perioperative settings, as well as functional and oncologic results of 12 patients operated on between 2009 and 2013. Prostatectomy was performed via a transperitoneal approach without any changing in the ports position. The average age was 61.92 ± 2.98 years. The period between transplant and the diagnosis of adenocarcinoma was 79.7 months. The mean PSA was 7.34 ng/mL (range: 4.9–11). Results: The operative time was 241.3 ± 35.6 minutes with only one conversion and one transfusion. The intervention was difficult due to adhesions on the side of the graft in 50% of cases. There was a case of obstructive acute renal failure resulting from a hematoma of the Retzius treated by percutaneous nephrostomy at D20. There was a majority of pT2c (72.7%), including 3 positive margins (27.3%) and 2 biochemical relapses treated with radiotherapy and hormonotherapy, respectively. The end point prostate-specific antigen was undetectable. There was no significant difference between preoperative and J7 creatinine (p = 0. 22). Conclusions: Robotic prostatectomy in renal transplant recipients is a safe technique with no serious effects on the allograft. PMID:26279722

  11. Successful treatment with lenalidomide of secondary multiple myeloma with extramedullary liver plasmacytoma in a renal transplant recipient: A case report and review of the literature

    PubMed Central

    XIE, XIAOBAO; WU, WEI; ZHU, YUANDONG; LIU, DELIANG; DONG, WEIMIN; LI, HAIQIAN; LI, QING; GU, WEIYING

    2015-01-01

    Multiple myeloma (MM) represents a rare form of post-transplantation lymphoproliferative disorder, and the presence of plasma cells in the liver is generally associated with aggressive forms of MM. In the present study, an unusual case of extramedullary plasmacytoma, affecting the liver and vertebrae of a recipient of a renal transplant, is reported. The patient had been previously treated with bortezomib for an MM following renal transplantation, as diagnosed by percutaneous needle biopsy of the hepatic lesion. He was then treated with 5 cycles of RCD regimen (lenalidomide, 25 mg, days 1–21; cyclophosphamide. 50–100 mg, days 1–21; and dexamethasone, 20 mg, days 1, 8, 15 and 22). The patient achieved partial clinical remission without any severe therapy-associated toxicity effects, indicating that lenalidomide is an effective and safe treatment for extramedullary liver plasmacytoma in renal recipients. In conclusion, the present case study indicated that the RCD regimen was effective and safe in the treatment of relapsed and refractory MM. PMID:26722266

  12. First Case Report of Acute Renal Failure After Mesh-Plug Inguinal Hernia Repair in a Kidney Transplant Recipient

    PubMed Central

    Veroux, Massimiliano; Ardita, Vincenzo; Zerbo, Domenico; Caglià, Pietro; Palmucci, Stefano; Sinagra, Nunziata; Giaquinta, Alessia; Veroux, Pierfrancesco

    2016-01-01

    Abstract Acute renal failure due to ureter compression after a mesh-plug inguinal repair in a kidney transplant recipient has not been previously reported to our knowledge. A 62-year-old man, who successfully underwent kidney transplantation from a deceased donor 6 years earlier, was admitted for elective repair of a direct inguinal hernia. The patient underwent an open mesh-plug repair of the inguinal hernia with placement of a plug in the preperitoneal space. We did not observe the transplanted ureter and bladder during dissection of the inguinal canal. Immediately after surgery, the patient became anuric, and a graft sonography demonstrated massive hydronephrosis. The serum creatinine level increased rapidly, and the patient underwent an emergency reoperation 8 hours later. During surgery, we did not identify the ureter but, immediately after plug removal, urine output increased progressively. We completed the hernia repair using the standard technique, without plug interposition, and the postoperative course was uneventful with complete resolution of graft dysfunction 3 days later. Furthermore, we reviewed the clinical features of complications related to inguinal hernia surgery. An increased risk of urological complications was reported recently in patients with a previous prosthetic hernia repair undergoing kidney transplantation, mainly due to the mesh adhesion to surrounding structures, making the extraperitoneal dissection during the transplant surgery very challenging. Moreover, older male kidney transplant recipients undergoing an inguinal hernia repair may be at higher risk of graft dysfunction due to inguinal herniation of a transplanted ureter. Mesh-plug inguinal hernia repair is a safe surgical technique, but this unique case suggests that kidney transplant recipients with inguinal hernia may be at higher risk of serious urological complications. Surgeons must be aware of the graft and ureter position before proceeding with hernia repair. A prompt

  13. Factors associated with chronic renal failure in 121 patients with diffuse proliferative lupus nephritis: a case-control study.

    PubMed

    Arce-Salinas, C A; Villa, A R; Martínez-Rueda, J O; Muñoz, L; Cardiel, M H; Alcocer-Varela, J; Alarcón-Segovia, D

    1995-06-01

    Lupus nephritis remains an important problem in patients with systemic lupus erythematosus (SLE). Some patients with diffuse proliferative lupus nephritis (DPLN) develop chronic renal failure (CRF). A case-control study was designed to determine the variables associated with CRF in patients with DPLN. We studied 121 patients with biopsy-proven DPLN seen in our institution from 1970 to 1988. There were 34 patients who developed CRF, the remaining were their controls. Clinical charts were reviewed and a pathologist re-scored blindly both activity and chronicity indices. The mean of age at SLE onset was 24.1 +/- 7.9 years; the mean disease duration was 9.2 +/- 6.1 years for controls and 6.1 +/- 5 years for patients. The main variables associated with CRF were male sex. HR (hazard ratio): 12.6 (95% CI 1.6-98.2); activity index, HR 2.59 (1.07-6.3); severe infections, HR 2.9 (1.2-7.3): number of antihypertensive drugs, HR 2.5 (1.4-4.7); cellular crescents, HR 1.6 (1.2-2): and interstitial inflammation, HR 2.7 (1.5-5.1). A protective effect was observed with longer use of < or = 20 mg of prednisone, HR 0.53 (95% CI 0.34-08): azathioprine, HR 0.6 (0.4-0.8); and length of formal education. HR 0.3 (0.09-0.94). Our results indicate that maleness, activity index, extracapillary proliferation and interstitial inflammation, as well as hypertension and severe infections associate with CRF in patients with DPLN, and treatment and higher education, perhaps through better therapeutic compliance, may be protective. PMID:7655489

  14. A rare case of regression of brown tumors of tertiary hyperparathyroidism after parathyroidectomy and renal transplant: A 5-year follow-up

    PubMed Central

    Noleto, José Wilson; Ramos, Ivana Alencar Svenson; Rocha, Julierme Ferreira; Garcia, Idelmo Rangel; Salvador Roberto, Berthiene M.

    2016-01-01

    Tertiary hyperparathyroidism (HPT) is a rare condition that affects patients with secondary HPT, which develop hyperplasia of the parathyroid glands, thus causing an increase in parathyroid hormone levels. Bone alterations are the main consequences of this condition including the development of osteolytic lesions called brown tumor. This article reports an unusual case of brown tumors located in the maxilla and mandible in a 19-year-old man with chronic renal failure with hyperplasia of the parathyroid glands. The lesions regressed approximately 5 months after the parathyroidectomy. At this same time, the patient underwent renal transplant. The patient was followed for 5 years, showing improvement in overall clinical status. There was also improvement of the results of laboratory tests and the pattern of trabecular bone. The correct diagnosis of oral lesions was of great relevance for the conservative treatment could have been chosen. PMID:27563621

  15. A rare case of asymptomatic radioiodine-avid renal and brain metastases 20 years after hemi-thyroidectomy for adenomatous goiter.

    PubMed

    Santhosh, Sampath; Bhattacharya, Anish; Verma, Roshan Kumar; Lal, Anupam; Mittal, Bhagwant Rai

    2016-01-01

    A 65-year-old patient, with a history of left hemi-thyroidectomy for adenomatous goiter 20 years previously, was found to have pulmonary lesions on chest X-ray, a brain lesion on computerized tomography (CT), and elevated serum thyroglobulin (Tg). While completion thyroidectomy revealed that no pathological evidence of thyroid malignancy, radioiodine-avid pulmonary, brain, and renal and bone lesions were identified on diagnostic as well as posttherapy whole body planar scintigraphy and single photon emission computed tomography-CT. Subsequent ultrasonography-guided biopsy of a renal nodule showed thyroid follicular cells. This case suggests that metastatic differentiated thyroid carcinoma should be suspected in asymptomatic patients with incidentally detected lesions, raised serum Tg, and history of thyroid lesions. PMID:26917894

  16. A rare case of asymptomatic radioiodine-avid renal and brain metastases 20 years after hemi-thyroidectomy for adenomatous goiter

    PubMed Central

    Santhosh, Sampath; Bhattacharya, Anish; Verma, Roshan Kumar; Lal, Anupam; Mittal, Bhagwant Rai

    2016-01-01

    A 65-year-old patient, with a history of left hemi-thyroidectomy for adenomatous goiter 20 years previously, was found to have pulmonary lesions on chest X-ray, a brain lesion on computerized tomography (CT), and elevated serum thyroglobulin (Tg). While completion thyroidectomy revealed that no pathological evidence of thyroid malignancy, radioiodine-avid pulmonary, brain, and renal and bone lesions were identified on diagnostic as well as posttherapy whole body planar scintigraphy and single photon emission computed tomography-CT. Subsequent ultrasonography-guided biopsy of a renal nodule showed thyroid follicular cells. This case suggests that metastatic differentiated thyroid carcinoma should be suspected in asymptomatic patients with incidentally detected lesions, raised serum Tg, and history of thyroid lesions. PMID:26917894

  17. Synchronous renal cell carcinoma metastasis to the contralateral adrenal gland and pancreas: A case report with 7-year follow-up subsequent to surgical therapy

    PubMed Central

    WU, CUNZAO; ZHOU, ZHENXU; YE, XUETING; HU, WEILIE

    2016-01-01

    Metastatic renal cell carcinoma (RCC) disseminates to a number of organ sites and few patients demonstrate long-term survival following surgery. However, synchronous metastasis of RCC to the contralateral adrenal gland and pancreas is rare. In the present report, a case of synchronous RCC metastasis to the contralateral adrenal gland and pancreas in a 55-year-old patient, with an 116×92×61 mm right renal tumor and a 96×79×57 mm left adrenal lesion, is described. In April 2007, right nephrectomy was performed to treat the RCC, left adrenalectomy was performed to treat the adrenal tumor and the pancreatic metastases were resected. The patient remained alive at the 7-year follow-up appointment. PMID:27313756

  18. A rare case of regression of brown tumors of tertiary hyperparathyroidism after parathyroidectomy and renal transplant: A 5-year follow-up.

    PubMed

    Noleto, José Wilson; Ramos, Ivana Alencar Svenson; Rocha, Julierme Ferreira; Garcia, Idelmo Rangel; Salvador Roberto, Berthiene M

    2016-01-01

    Tertiary hyperparathyroidism (HPT) is a rare condition that affects patients with secondary HPT, which develop hyperplasia of the parathyroid glands, thus causing an increase in parathyroid hormone levels. Bone alterations are the main consequences of this condition including the development of osteolytic lesions called brown tumor. This article reports an unusual case of brown tumors located in the maxilla and mandible in a 19-year-old man with chronic renal failure with hyperplasia of the parathyroid glands. The lesions regressed approximately 5 months after the parathyroidectomy. At this same time, the patient underwent renal transplant. The patient was followed for 5 years, showing improvement in overall clinical status. There was also improvement of the results of laboratory tests and the pattern of trabecular bone. The correct diagnosis of oral lesions was of great relevance for the conservative treatment could have been chosen. PMID:27563621

  19. Small renal tumor with lymph nodal enlargement: A histopathological surprise

    PubMed Central

    Thottathil, Mujeeburahiman; Verma, Ashish; D’souza, Nischith; Khan, Altaf

    2016-01-01

    Renal cancer with lymph nodal mass on the investigation is clinically suggestive of an advanced tumor. Small renal cancers are not commonly associated with lymph nodal metastasis. Association of renal cell carcinoma with renal tuberculosis (TB) in the same kidney is also rare. We report here a case of small renal cancer with multiple hilar and paraaortic lymph nodes who underwent radical nephrectomy, and histopathology report showed renal and lymph nodal TB too. PMID:27453671

  20. The scintigraphic pattern of renal angiomyolipoma

    SciTech Connect

    Jaikishen, P.; Oster, Z.H.; Atkins, H.L. )

    1990-03-01

    The patterns of renal and gallium scintigraphy in a patient with renal angiomyolipoma are presented. Renal study with Tc-99m DTPA demonstrated a photopenic area in the flow and delayed images. Ga-67 citrate imaging did not show any evidence of increased activity. Although this pattern is also seen in renal cysts, scintigraphy seems to be valuable in the evaluation of angiomyolipoma. It helps differentiate it from renal carcinoma or renal abscess (which may be gallium avid), especially when the tumor is characterized by a paucity of adipose tissue and complicated by hemorrhage, in which case CT and ultrasonographic patterns are not diagnostic.

  1. Improvement of renal function after opening occluded atherosclerotic renal arteries.

    PubMed

    Kanamori, Hiroshi; Toma, Masanao; Fukatsu, Atsushi

    2009-09-01

    Percutaneous transluminal renal angioplasty (PTRA) with stenting has been effective in the control of hypertension, renal function and pulmonary edema caused by atherosclerotic renal artery stenosis (ARAS). However, concerning the viability of renal function, this procedure has not been fully established, especially in the presence of renal atrophy or severe renal parenchymal disease. We report a dramatically improved case of acute renal failure caused by acute worsening ARAS treated by stenting. A 72-year-old female was admitted for accelerated renal dysfunction (serum ceatinine; 1.2-2.3 mg/dl) and hypertension (190/100 mmHg). At 10 days after admission, the patient's serum ceatinine increased to 6.7 mg/dl, her pulmonary edema was exaggerated and hemodialysis was required. Ultrasonography showed bilateral high-echoic kidneys, but no apparent finding of renal artery stenosis (RAS). At day 15, computed tomographic angiography indicated bilateral ostial RAS. Renal angiography demonstrated total occlusion of the right and severe (90%) disease in the left. ARAS was diagnosed by intravascular ultrasonography. The guidewire was inserted in both renal arteries, PTRA with stenting was performed in the right and a stent was directly implanted in the left. Immediately, each kidney enlarged to almost normal size, leading to satisfactory urination. She was released from hemodialysis the next day since her serum creatinine was normal and the pulmonary edema was improved. Although there is still no reliable prognostic factor including resistive index or kidney size, it is important that PTRA with stenting in ARAS should be considered in a case of accelerated renal dysfunction because of the possible improvement. PMID:19726830

  2. Renal Anomalies Associated with Ectopic Neurohypophysis

    PubMed Central

    Özen, Samim; Şişmek, Damla Gökşen; Önder, Asan; Darcan, Şükran

    2011-01-01

    Objective: Although the etiology of ectopic neurohypophysis that leads to pituitary hormone deficiencies is not yet clearly understood, birth trauma or genetic factors have been considered responsible. Concurrent cranial and extracranial congenital anomalies have been reported in such cases. The aim of the present study was to investigate the frequency of renal anomalies in nonsyndromic cases with ectopic neurohypophysis. Methods: We retrospectively evaluated the medical records of 20 patients with ectopic neurohypophysis who were followed up between January 1990 and December 2007 in a tertiary University Hospital. Results: Renal anomalies were identified in three (15%) cases including unilateral renal agenesis in one case, renal hypoplasia in one case, and double collecting system and unilateral renal agenesis in one case. Conclusions: In the present study, the increased frequency of renal anomalies in cases of ectopic neurohypophysis was highlighted, and it was emphasized that there might be common genetic factors that lead to such associations. Conflict of interest:None declared. PMID:21750632

  3. Seeking an optimal renal replacement therapy for the chronic kidney disease epidemic: the case for on-line hemodiafiltration.

    PubMed

    Gatti, Emanuele; Ronco, Claudio

    2011-01-01

    the overall costs incurred by payers of renal care. In short, optimal care needs to be provided with shrinking resources and without compromising the medical appropriateness of the therapy. Additionally, we believe ensuring improved quality of life is just as important as prolonging patient survival. Therefore, a balanced compromise between optimal and affordable technology is required in order to reach the targets of achieving good medical care and meeting the expectations of patients, their families, healthcare providers, and society as a whole. Under these premises, and focusing on the aforementioned targets, we believe that on-line hemodiafiltration (HDF) represents the most advanced and clinically appropriate RRT modality available to best cope with the CKD epidemic. Together with the guidance and recommendations of those taking care of CKD patients on dialysis therapy, the contribution of industry is indispensable for the availability of highly reliable and affordable solutions to the impending dilemma. As representatives of the academic-medical community and of industry, we present a joint case for the application of on-line HDF towards meeting the challenge of large-scale provision of dialysis under an increasingly restrictive financial climate. PMID:22188699

  4. Ledipasvir and sofosbuvir for treatment of post- renal transplant hepatitis C infection: A case report with review of literature

    PubMed Central

    Jha, R.; Fatima, R.; Lakhtakia, S.; Jha, A.; Srikant, P.; Narayan, G.

    2016-01-01

    Liver disease due to hepatitis C infection in renal transplant recipients is difficult to treat and often associated with reduced patient survival. A 43-year-old male, a renal allograft recipient, presented at 6 years follow-up with significant weight loss over 3 months. He was detected to have new onset diabetes mellitus together with hepatitis C virus (HCV) infection (genotype 1). His HCV load remained high despite the change of immuno-suppression from tacrolimus to cyclosporine. A decision to treat with a new anti-viral combination of ledipasvir and sofosbuvir for 12 weeks was taken. Within 3 weeks, his raised serum transaminases levels normalized and viral load became undetectable. At the end of 16 weeks, he continues to do well with normal renal function, has sustained remission from hepatitis C infection and resolution of diabetes. PMID:27194839

  5. Ledipasvir and sofosbuvir for treatment of post- renal transplant hepatitis C infection: A case report with review of literature.

    PubMed

    Jha, R; Fatima, R; Lakhtakia, S; Jha, A; Srikant, P; Narayan, G

    2016-01-01

    Liver disease due to hepatitis C infection in renal transplant recipients is difficult to treat and often associated with reduced patient survival. A 43-year-old male, a renal allograft recipient, presented at 6 years follow-up with significant weight loss over 3 months. He was detected to have new onset diabetes mellitus together with hepatitis C virus (HCV) infection (genotype 1). His HCV load remained high despite the change of immuno-suppression from tacrolimus to cyclosporine. A decision to treat with a new anti-viral combination of ledipasvir and sofosbuvir for 12 weeks was taken. Within 3 weeks, his raised serum transaminases levels normalized and viral load became undetectable. At the end of 16 weeks, he continues to do well with normal renal function, has sustained remission from hepatitis C infection and resolution of diabetes. PMID:27194839

  6. Nephron sparing endoscopic treatment for primary carcinoma of the renal calyx: A case report and literature review

    PubMed Central

    WANG, QI; OU, TONG-WEN; XU, JIA-WEI; LI, JIN; BORAZJANI, ALI; JIA, CHUN-SONG; WANG, XU; YAN, HAO

    2016-01-01

    Primary carcinoma of the renal calyx is extremely rare. The present study reported nephron sparing endoscopic treatment for primary carcinoma of the renal calyx. An 81-year-old female presented with a 1-year history of intermittent painless gross hematuria. Computed tomography and X-ray of the urinary tract were unable to definitively identify any lesion. Flexible ureteroscopic examination revealed a tumor with epicenter in the lower calyx of the right kidney, with additional involvement around the calyx. Biopsies were obtained and pathology revealed low-grade urothelial carcinoma. Considering additional co-morbidities, the patient elected to undergo endoscopic management with thulium laser. The present report described the feasibility of flexible ureteroscopic thulium laser resection for the treatment of renal calyx carcinoma. PMID:27330785

  7. Acute Renal Failure after Uterine Artery Embolization

    SciTech Connect

    Rastogi, Sachin; Wu, Yu-Hsin; Shlansky-Goldberg, Richard D.; Stavropoulos, S. William

    2004-09-15

    Renal failure is a potential complication of any endovascular procedure using iodinated contrast, including uterine artery embolization (UAE). In this report we present a case of acute renal failure (ARF) following UAE performed as a treatment for uterine fibroids. The likely causes of ARF in this patient are explored and the possible etiologies of renal failure in patients undergoing UAE are reviewed.

  8. [A Case of Xp.11.2 Traslocational Renal Cell Carcinoma Diagnosed by Fluorescence in Situ Hybridization (FISH)].

    PubMed

    Iinuma, Koji; Kojima, Keitaro; Okamoto, Kiyohisa; Yuhara, Kazuya

    2016-08-01

    A 72-year-old woman was referred to our hospital with complaints of macro-hematuria. The radiographic evaluation including computed tomography (CT) and magnetic resonance imaging (MRI) suggested it to be renal cell carcinoma (RCC) in her right kidney. She underwent laparoscopic nephrectomy. We diagnosed her with renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion, based on pathological findings and break apart of transcription factor E3 (TFE3)by fluorescence in situ hybridization. She was free of recurrence at 8 months postoperatively. PMID:27624107

  9. [Bilateral Granulomatous Renal Masses after Intravesical BCG Therapy for Non-muscle-invasive Bladder Cancer and Carcinoma in Situ of the Upper Urinary Tract: A Case Study].

    PubMed

    Higashioka, Kazuhiko; Miyake, Noriko; Nishida, Ruriko; Chong, Yong; Shimoda, Shinji; Shimono, Nobuyuki

    2015-07-01

    Bacillus Calmette-Guèrin (BCG) is commonly used not only as an infant vaccination, but also as a treatment of and prophylaxis to prevent recurrence in the management of non-muscle-invasive bladder cancer. However, the use of "live" BCG is sometimes complicated by associated infection. We present a case study of a 77-year-old man who developed bilateral renal masses after intravesical BCG therapy was initiated in November 2013, following transurethral resection of non-muscle-invasive bladder cancer. After four courses of BCG (Japan strain, 80 mg per treatment) instillations, a computed tomography examination for febrile episodes showed multiple bilateral renal masses, accompanied by a histological finding of a granulomatous reaction. An acid fast bacterium was cultured from only urine among blood, urine, and microscopic samples. Using the cultured strain, BCG infection was confirmed by the specific gene deletion pattern based on allele-specific polymerase chain reaction analysis. Anti-tuberculosis treatment, including isoniazid (300 mg/day), rifampicin (600 mg/day), and ethambutol (1,000 mg/day), was started for the BCG-related renal granuloma in February 2014. After 3 months, antibiotic therapy was discontinued owing to severe appetite loss, though the masses remained solid. No rapid growth has been detected after anti-BCG therapy. Intravesical BCG therapy is recommended worldwide as one of standard treatments for non-muscle-invasive bladder cancer. We should closely observe patients undergoing this approach for emerging BCG complications. PMID:26554225

  10. When less is more--case report of successful renal transplantation from a living unrelated donor to a high-risk female recipient.

    PubMed

    Lewandowska, D; Gałązka, Z; Pazik, J; Szmidt, J; Durlik, M

    2014-10-01

    Qualification for kidney transplantation for patients with a long history of renal replacement therapy and numerous medical complications requires individual analysis of all contraindications and limitations as well as advantages of the procedure. In this case report, we analyze the qualification process and posttransplantation course of a 28-year-old female patient with end-stage renal failure due to reflux nephropathy, treated with renal replacement therapy since early childhood, who received her second kidney transplant with glomerular filtration rate <40 mL/min/1.73 m(2) from a living, unrelated donor in 2009. Despite the high risk of immunological and surgical complications, transplanting organs of borderline excretory capacity, and no human leukocyte antigen matching, significant health benefits were achieved. Procurement of a kidney with borderline filtering function reduces the risk of potential negative consequences of impaired remnant filtration in the living donor. Following the principle of procuring a kidney with worse parameters from the living donors, it is necessary to perform an examination evaluating the function of each kidney. Procurement of a kidney with significantly worse parameters requires an individual assessment of benefits for the recipient. PMID:25380953

  11. Renal Infarction Caused by Isolated Spontaneous Renal Artery Intramural Hematoma

    PubMed Central

    Park, Sihyung; Lee, Ga Hee; Jin, Kyubok; Park, Kang Min; Kim, Yang Wook; Park, Bong Soo

    2015-01-01

    Patient: Male, 46 Final Diagnosis: Renal infarction Symptoms: Flank pain Medication: — Clinical Procedure: CT Specialty: Nephrology Objective: Rare disease Background: Acute renal infarction is an uncommon condition resulting from an obstruction or a decrease in renal arterial blood flow. Isolated spontaneous renal artery intramural hematoma is a rare cause of renal infarction. Case Report: A 46-year-old healthy man presented to our emergency room because of sudden onset of severe right flank pain. An enhanced abdominal computed tomography scan showed a low-attenuated lesion in the lateral portion of the right kidney but no visible thromboembolisms in the main vessels. Computed tomography angiography revealed acute infarction resulting from intramural hematoma of the anterior segmental artery of the right kidney, with distal occlusion. Conclusions: The rarity and non-specific clinical presentation of renal infarction often lead to a delayed diagnosis that may result in impaired renal function. Clinical suspicion is important in the early diagnosis, and intramural hematoma of the renal artery should be considered the cause of renal infarction even in healthy patients without pre-disposing factors. PMID:26596500

  12. Long-Term Outcome after Rehabilitation of Bilateral Total Hip Arthroplasty in Renal Transplant Recipient – A Case Report

    PubMed Central

    Dimitrova, Erieta Nikolikj; Adamov, Aleksandar; Koevska, Valentina; Mitrevska, Biljana; Gacevikj, Ivan; Agushi, Arsim

    2016-01-01

    INTRODUCTION: Total hip replacement is generally proposed for renal transplant patients with avascular osteonecrosis of the femoral head. PURPOSE: The purpose of the study is to report the long-term outcome after rehabilitation of bilateral total hip arthroplasty in a patient with renal transplantation suffering from avascular osteonecrosis of the both femoral heads. MATERIAL AND METHOD: The patient S.D, 49 years old at follow-up. Few months after renal transplantation, the patient had got avascular osteonecrosis of both femoral head. One year after transplantation the total hip arthroplasty for both hip joints were performed. Three years later repeat total hip arthroplasty surgery for left hip was performed. After any surgery intervention the patient was referred for inpatient rehabilitation. For clinical assessment the clinical findings and Harris Hip Score have been used. The rehabilitation program consisted of exercises, occupational therapy, and patient education. RESULTS: After any rehabilitation treatment the patient had improvement of clinical findings. At follow-up assessment outcome for both hip function was good - Harris Hip Score was 81 points. CONCLUSION: Rehabilitation is integral part of multidisciplinary treatment of renal transplant recipient after total hip arthroplasty. Regular exercise training of these patients is very important for improving of their long-term outcome. PMID:27275350

  13. Primary carcinoma of renal calyx.

    PubMed

    Williams, Phillip A; Mai, Kien T

    2013-10-01

    Renal calyx carcinoma (RCXC) may mimic collecting duct carcinoma (CDC) or urothelial carcinoma (UC) of the renal pelvis. RCXC is distinguished from CDC and UC of the renal pelvis as having the tumor epicenter in the renal calyx, with limited involvement of the surrounding renal pelvis surface urothelium. In this study, we summarize our experience with this entity. Ten cases of RCXC, including 9 cases with urothelial differentiation (RCXC-UC) and 1 case with salivary gland-type differentiation (RCXC-SC), were identified. Ten consecutive cases of UC were selected for comparison, with extensive renal pelvis involvement and with secondary renal parenchymal invasion. Two cases of collecting duct carcinoma (CDC) were also examined. Immunohistochemistry (IHC) was performed on representative tissue blocks for PAX8, PAX2, CK5, CK7, CK20, p63, GATA3, AMACR, RCC, CD10, vimentin, S100, and MSA. The 10 cases of RCXC (M:F=4:6, ages: 62-91 years, mean: 76) presented with renal masses of 3-6cm. Ureteroscopic studies and renal pelvic washings showed atypical/malignant cells in three cases. Seven patients were treated with nephrectomy followed by radiation±chemotherapy, and all cases developed metastases to lymph nodes or liver/lung/bone. In all 7 cases with nephrectomy, there was extensive renal parenchymal involvement with infiltrating borders and diffuse spread along collecting ducts. Six RCXC-UC contained focal squamous differentiation. The RCXC-SC displayed features of adenoid cystic and basaloid features. In situ UC, with or without papillary components, was identified in the calyces in all 7 nephrectomy cases with remaining renal pelvis harboring small tumor burden in 5 cases, and no tumor in another 2 cases. Of the three cases without nephrectomy, no tumor in the renal pelvis could be visualized with endoscopy, however one case was associated with UC of the urinary bladder. Of 10 control UC cases, tumor was limited to the tip of renal papilla in 7 cases, extensive in 3

  14. [Renal elastography].

    PubMed

    Correas, Jean-Michel; Anglicheau, Dany; Gennisson, Jean-Luc; Tanter, Mickael

    2016-04-01

    Renal elastography has become available with the development of noninvasive quantitative techniques (including shear-wave elastography), following the rapidly growing field of diagnosis and quantification of liver fibrosis, which has a demonstrated major clinical impact. Ultrasound or even magnetic resonance techniques are leaving the pure research area to reach the routine clinical use. With the increased incidence of chronic kidney disease and its specific morbidity and mortality, the noninvasive diagnosis of renal fibrosis can be of critical value. However, it is difficult to simply extend the application from one organ to the other due to a large number of anatomical and technical issues. Indeed, the kidney exhibits various features that make stiffness assessment more complex, such as the presence of various tissue types (cortex, medulla), high spatial orientation (anisotropy), local blood flow, fatty sinus with variable volume and echotexture, perirenal space with variable fatty content, and the variable depth of the organ. Furthermore, the stiffness changes of the renal parenchyma are not exclusively related to fibrosis, as renal perfusion or hydronephrosis will impact the local elasticity. Renal elastography might be able to diagnose acute or chronic obstruction, or to renal tumor or pseudotumor characterization. Today, renal elastography appears as a promising application that still requires optimization and validation, which is the contrary for liver stiffness assessment. PMID:26976058

  15. Follow-up (99m)Tc EC renal dynamic scintigraphy and DMSA-III SPECT/CT in unmasking a masqueraded case of Horseshoe kidney.

    PubMed

    Jain, T K; Basher, R K; Mittal, B R; Bhatia, A; Rao, K L N

    2015-01-01

    Hydronephrosis is a common finding in urinary tract outflow obstruction. Chronically obstructed hydronephrotic system may be associated with parenchymal changes. Ultrasound, intravenous urography, micturating cysto-urethrogram and scintigraphy are commonly performed to evaluate the cause of obstruction. In childhood, pelviureteric junction obstruction is a common cause of the hydronephrosis. Hydronephrosis can also be present in horseshoe kidneys due to poor drainage. However, a large sized hydronephrotic cavity may obscure the finding of horseshoe kidney. A case was reported, and it was diagnosed as horseshoe kidney on follow-up renal dynamic scan and confirmed with the help of dimercaptosuccinic acid SPECT/CT. PMID:26139030

  16. Lamivudine or emtricitabine (XTC)/protease inhibitor dual therapy as a harm-reduction strategy in patients with tenofovir-related renal toxicity: a case-control study.

    PubMed

    Rossotti, Roberto; Moioli, Maria Cristina; Chianura, Leonardo; Errante, Isabella; Orcese, Carloandrea; Orso, Maurizio; Schiantarelli, Clara; Schlacht, Irene; Travi, Giovanna; Vigo, Beniamino; Villa, Maria Riccarda; Volonterio, Alberto; Puoti, Massimo

    2012-11-01

    Tenofovir disoproxil fumarate (TDF) is widely used in HIV-infected patients. It is associated with tubular toxicity, but its management is controversial. A possible strategy is to switch to a dual therapy based on lamivudine or emtricitabine (XTC) and protease inhibitors (PIs). A case-control study was designed to evaluate the switch to XTC + PI therapy in patients with TDF-related renal toxicity. A case was defined as a patient who was on TDF/XTC + PI and who switched to XTC + PI. A control was defined as a patient with the same clinical features who remained on TDF/XTC + PI. Twenty-one cases and 21 controls were included. After 48 weeks, no differences in efficacy were observed. No improvement in the glomerular filtration rate as estimated with the Cockroft-Gault formula (eGFR) was seen, but the number of times that patients had values below 60 ml/min was higher with standard TDF/XTC 1 PI treatment than with dual XTC + PI treatment. A switch to dual therapy could be an option for patients at risk of TDF-related renal damage with no relevant risk of virological or immunological failure. PMID:22804338

  17. Pancreatitis with pancreatic tail swelling associated with incretin-based therapies detected radiologically in two cases of diabetic patients with end-stage renal disease.

    PubMed

    Nakata, Hirosuke; Sugitani, Seita; Yamaji, Shuhei; Otsu, Satoko; Higashi, Yoshihito; Ohtomo, Yumiko; Inoue, Gen

    2012-01-01

    We herein report two cases of pancreatitis associated with incretin-based therapies in end-stage renal disease (ESRD) patients undergoing dialysis. A 75-year-old woman with a history of liraglutide use and a 68-year-old man with a history of vildagliptin use both presented with nausea. They showed elevated levels of pancreatic enzymes and pancreatic tail swelling on CT. Their symptoms improved after discontinuing the drugs. In the absence of any obvious secondary causes of pancreatitis, we believe that the pancreatitis observed in these cases was associated with the incretin-based therapies. Few reports have been published on the safety and efficacy of incretin-based therapies in ESRD patients, and it remains uncertain whether the changes in the pancreas observed in the present cases are characteristic of ESRD patients. PMID:23124148

  18. Renal fungal bezoar owing to Geotrichum candidum

    PubMed Central

    Yegneswaran Prakash, Peralam; Seetaramaiah, Venkatesh K; Thomas, Joseph; Khanna, Vinay; Rao, Sugandhi P

    2012-01-01

    Geotrichum candidum is yeast like fungi that cause infections in immunocompromised patients. We report a case of renal fungal ball with Geotrichum candidum in a 27 yr. old women post-partum. This case to our knowledge is the first case of renal fungal bezoar due to Geotrichum candidum reported in India.

  19. Fish, flesh and a good red herring: a case of ascending upper limb infection in a renal transplant patient.

    PubMed

    Lovric, S; Becker, J U; Kayser, D; Wagner, A; Haubitz, M; Kielstein, J T

    2009-11-01

    While newly developed potent immunosuppressive agents have dramatically reduced the incidence of rejection of transplanted organs, they have increased the patients' susceptibility to opportunistic infections and cancer. Here we report a rare skin infection caused by atypical mycobacterium marinum in a 50-year-old female renal transplant recipient. The patient presented with localized skin lesion on the dorsum of her hand, which was misdiagnosed as gout. Only after the lesions spread in a sporotrichoid pattern, a cutaneous infection with atypical mycobacteria was suspected. The diagnosis was based on histopathological analysis as well as mycobacterial culture, both showing infection with atypical mycobacterium. Three months of antimycobacterial treatment led to a marked regression of the lesions. Sporotrichoid lesions in renal transplant patients are rare and a diagnostic challenge for the physician. A thorough history and a low threshold for skin biopsies could prevent painful and unnecessary surgical interventions. PMID:19863885

  20. [Data collection about the case management of end-stage renal insufficiency. Feasibility study. Nephrology Epidemiologic and information Network (REIN)].

    PubMed

    Stengel, B; Landais, P

    1999-01-01

    End-stage renal failure (ESRD) is an important public health issue, because of both the increasing number of patients requiring renal replacement therapy and the cost of treatment. The need for a reliable data system, capable of describing the patient care network as a whole, including dialysis or transplantation, has often been reiterated. The Direction Générale de la Santé (the French Department of Health) commissioned INSERM (the National Institute of Health and Medical Research) to "study the feasibility of different scenarios of data collection about ESRD patient care in order to meet the priority needs of health care administration, physicians, and researchers". Analysis of these needs allowed the goals to be defined: to provide an accurate picture of ESRD patient care in order to guide and evaluate health care policy, to inform clinicians, and to provide a tool for more focused special studies in renal research issues. Three scenarios were studied: the first would use data systems of both the government and the National Health Insurance system for planning health care services, upon EfG (The French Transplant Agency) network to evaluate transplantation, and upon a few regional registries for epidemiology and research; the second is based on repeated cross-sectional surveys; the third would rely upon the organization of an information system, the Renal Epidemiology and Information Network (REIN). Regional centers and a national coordinating office would register and follow-up ESRD patients, principally to evaluate health care supply and quality. The REIN database would also be a resource for research. The advantage of the first scenario is its low cost; its principal drawback is that evaluations will not be possible in the regions without registries. The second suggestion is inadequate. The last project would fulfil the goals that were defined. The REIN data system would be a true public health project of interest to all the participants and institutions

  1. Early start renal replacement therapy for acute kidney injury-Universal panacea or another case of over medicalization?

    PubMed

    Davenport, Andrew

    2015-10-01

    Despite advances in medical practice and renal replacement therapy, the mortality of patients who develop acute kidney injury remains high. In the field of cardiology, the management of myocardial infarction has evolved from one of conservative bed rest to primary coronary intervention. As renal replacement therapy is now generally available, the question arises whether earlier intervention could lead to improved patient outcomes. The evidence to date is primarily centered on retrospective observational reports, with the majority reporting increased patient survival for earlier intervention. However, these reports are typically based on small numbers of patients and differ in the etiology of acute kidney injury, patient comorbidity, and definitions of what constitutes "early" start. To date, there is less than a handful of prospective randomized studies published in the modern era. Again these are small studies, with differing patient populations, and definitions of "early" start, but generally do not show any significant advantage for an "early" start approach. As such until adequately powered prospective trial data become available, the decision to initiate renal replacement therapy should be made by the traditional review of patient history, repeated clinical assessments, and trends in biochemical data. PMID:26448386

  2. Renal infarction due to polyarteritis nodosa in a patient with angioimmunoblastic T-cell lymphoma: a case report and a brief review of the literature

    PubMed Central

    2012-01-01

    Angioimmunoblastic T-cell lymphoma is one of the most common subtypes of peripheral T-cell lymphoma (15-20% of all cases), accounting for approximately 1-2% of all non-Hodgkin lymphomas. It often presents autoimmune phenomena including hemolytic anemia, thrombocytopenia, glomerulonephrities and circulating immune complexes. Polyarteritis nodosa is an autoimmune disease characterized by necrotizing vasculitis of medium vessels, which rarely develops in association with hematological malignant disorders. Herein we report the case of a 40-year-old man who underwent lymph node biopsy in the suspicious of sarcoidosis. On the basis of histological and immunohistochemical findings, the diagnosis of angioimmunoblastic T-cell lymphoma was performed. The patient was successfully treated with cytarabine-based regimen for 6 cycles. Three months after the initial diagnosis of angioimmunoblastic T-cell lymphoma, a whole body computed tomography showed a lesion in the lower pole of the left kidney. Renal cell carcinoma was suspected, thus a nephrectomy was carried out. The histological findings were compatible with polyarteritis nodosa. To the best of our knowledge, the association between polyarteritis nodosa and angioimmunoblastic T-cell lymphoma has been described only once. This relation may be secondary to the induction of an autoimmune phenomenon by the lymphoma with the formation of circulating immune complexes, leading to vessels walls injury. A careful evaluation is needed in the management of angioimmunoblastic T-cell lymphoma patients with signs of renal failure in order to avoid delay of treatment and organ damage. PMID:22568881

  3. t(6;11) renal cell carcinoma (RCC): expanded immunohistochemical profile emphasizing novel RCC markers and report of 10 new genetically confirmed cases.

    PubMed

    Smith, Nathaniel E; Illei, Peter B; Allaf, Mohamed; Gonzalez, Nilda; Morris, Kerry; Hicks, Jessica; Demarzo, Angelo; Reuter, Victor E; Amin, Mahul B; Epstein, Jonathan I; Netto, George J; Argani, Pedram

    2014-05-01

    Renal cell carcinomas (RCCs) harboring the t(6;11)(p21;q12) translocation were first described in 2001 and recently recognized by the 2013 International Society of Urological Pathology Vancouver Classification of Renal Neoplasia. Although these RCCs are known to label for melanocytic markers HMB45 and Melan A and the cysteine protease cathepsin K by immunohistochemistry (IHC), a comprehensive IHC profile has not been reported. We report 10 new t(6;11) RCCs, all confirmed by break-apart TFEB fluorescence in situ hybridization. A tissue microarray containing 6 of these cases and 7 other previously reported t(6;11) RCCs was constructed and immunolabeled for 21 different antigens. Additional whole sections of t(6;11) RCC were labeled with selected IHC markers. t(6;11) RCC labeled diffusely and consistently for cathepsin K and Melan A (13 of 13 cases) and almost always at least focally for HMB45 (12 of 13 cases). They labeled frequently for PAX8 (14 of 23 cases), CD117 (10 of 14 cases), and vimentin (9 of 13 cases). A majority of cases labeled at least focally for cytokeratin Cam5.2 (8 of 13 cases) and CD10 and RCC marker antigen (10 of 14 cases each). In contrast to a prior study's findings, only a minority of cases labeled for Ksp-cadherin (3 of 19 cases). The median H score (product of intensity score and percentage labeling) for phosphorylated S6, a marker of mTOR pathway activation, was 101, which is high relative to most other RCC subtypes. In summary, IHC labeling for PAX8, Cam5.2, CD10, and RCC marker antigen supports classification of the t(6;11) RCC as carcinomas despite frequent negativity for broad-spectrum cytokeratins and EMA. Labeling for PAX8 distinguishes the t(6;11) RCC from epithelioid angiomyolipoma, which otherwise shares a similar immunoprofile. CD117 labeling is more frequent in the t(6;11) RCC compared with the related Xp11 translocation RCC. Increased pS6 expression suggests a possible molecular target for the uncommon t(6;11) RCCs that

  4. Transcatheter Embolization of a Renal Arteriovenous Fistula Complicated by an Aneurysm of the Feeding Renal Artery

    SciTech Connect

    Kensella, Denise; Kakani, Nirmal Pocock, Richard; Thompson, John; Cowan, Andrew; Watkinson, A.

    2008-03-15

    Renal arteriovenous fistula (AVF) is rare. Renal AVF complicated by aneurysm of the feeding artery presents a technical challenge for endovascular treatment. We report a case managed by covered stenting of the renal artery aneurysm, coil embolization of the fistula, and bare stenting of the aorta.

  5. Twenty-one-year-old male with congenital anomalies, obstructive uropathy and chronic renal failure: is this a case of Townes Brocks syndrome?

    PubMed

    Unuigbe, E I; Azubike, C A; Okaka, E I; Osarenkhoe, J O; Onuora, V C

    2007-03-01

    Townes Brocks syndrome is an autosomal dominant multiple malformations syndrome comprising of ear anomalies/hearing loss, limb defects, anal, genitourinary, eye, spine anomalies, heart defects and sometimes mental retardation. This report presents the case of a 21-year-old secondary school leaver as a likely case of Townes-Brocks syndrome. He was born with congenital abnormalities consisting of fixed flexion deformities of hands, wrist and elbows, urethral meatal stenosis, scoliosis and aortic stenosis. He was diagnosed with obstructive uropathy at the age of 19 years and subsequently developed chronic renal failure. The report aims to highlight the need for early recognition of potentially preventable conditions, which, if left unattended to, can lead to unnecessary fatality. PMID:17668723

  6. Discovery of Renal Tuberculosis in a Partial Nephrectomy Specimen Done for Renal Tumor

    PubMed Central

    Saadi, Ahmed; Ayed, Haroun; Bouzouita, Abderrazak; Kerkeni, Walid; Cherif, Mohamed; Ben Slama, Riadh M.; Derouiche, Amine; Chebil, Mohamed

    2015-01-01

    The association of renal cancer and renal tuberculosis is uncommon. While the incidental discovery of renal cell carcinoma in a tuberculous kidney is a classical finding, the discovery of tuberculous lesions after nephrectomy for cancer is exceptional. We report the case of a female patient aged 60 who had a partial nephrectomy for a 5 cm exophytic kidney tumor. Pathological examination concluded that renal clear cell carcinoma associated with follicular caseo tuberculosis. PMID:26793504

  7. Renal Infarction Caused by Spontaneous Renal Artery Dissection: Treatment with Catheter-Directed Thrombolysis and Stenting

    SciTech Connect

    Jeon, Yong Sun Cho, Soon Gu; Hong, Ki Cheon

    2009-03-15

    Spontaneous renal artery dissection (SRAD) is rare and presents a diagnostic and therapeutic challenge. We report a case of a 36-year-old man who had an SRAD-complicated renal infarction. The patient experienced severe unilateral flank pain. Enhanced abdominal computed axial tomography scan showed renal infarction, and urinalysis showed no hematuria. Selective renal angiography was essential to evaluate the extent of dissection and suitability for repair. The patient was treated with catheter-directed thrombolysis and frenal artery stenting.

  8. Pseudotumor presentation of renal tuberculosis mimicking renal cell carcinoma: A rare entity

    PubMed Central

    Panwar, Anubhav; Ranjan, Raju; Drall, Nityasha; Mishra, Neha

    2016-01-01

    Tuberculosis can involve any part of the body. Urogenital tuberculosis is a fairly common extra-pulmonary manifestation of tuberculosis and renal tuberculosis is the most common form of urogenital tuberculosis. Renal tuberculosis seldom presents as a mass, usually due to hydronephrosis of the involved kidney. However in extremely rare cases it may present as an inflammatory pseudotumor which may mimic renal cell carcinoma. We present a case of a 65- year- old male who was provisionally diagnosed as renal cell carcinoma based on clinical and radiological findings and managed accordingly but was finally diagnosed as renal tuberculosis based on histopathological examination of surgical specimen.

  9. An Unusual Case of Extraosseous Accumulation of Bone Scan Tracer in a Renal Calculus - Demonstration by SPECT-CT

    PubMed Central

    Joshi, Prathamesh Vijay; Lele, Vikram; Gandhi, Rozil

    2012-01-01

    Extraosseous localization of radioisotope, used in bone scan, in a variety of physiological and pathological conditions is a well-known phenomenon. The causes of extraosseous accumulation of bone-seeking radiotracers should be kept in mind when bone-imaging studies are reviewed to avoid incorrect interpretations. We report an extremely rare occurrence of extraosseous accumulation of bone scintigraphy tracer in a renal calculus, in a patient with adenocarcinoma of prostate, that was demonstrated by Single Photon Emission Computed Tomography and Computed Tomography (SPECT-CT) fusion imaging. PMID:22439128

  10. Sequential treatments in hereditary leiomyomatosis and renal cell carcinoma (HLRCC): Case report and review of the literature.

    PubMed

    de Velasco, Guillermo; Munoz, Cesar; Sepulveda, Juan M; Castellano, Daniel

    2015-01-01

    The overall survival for patients with advanced papillary renal carcinoma (RCC) is still limited. Although multikinase inhibitors have recently been developed for clear cell carcinoma, response rates in other histology non-clear cell RCC are poor and patients often face dose-limiting toxicities which lead to a reduction in prognosis and treatment success. We present a patient with hereditary leiomyomatosis and RCC (HLRCC), showing a sustained response for more than 12 months to gemcitabine-bevacizumab therapy after failure tyrosine kinase inhibitors (TKIs) and mammalian target of rapamycin (mTOR) therapies. PMID:26085897

  11. Sequential treatments in hereditary leiomyomatosis and renal cell carcinoma (HLRCC): Case report and review of the literature

    PubMed Central

    de Velasco, Guillermo; Munoz, Cesar; Sepulveda, Juan M.; Castellano, Daniel

    2015-01-01

    The overall survival for patients with advanced papillary renal carcinoma (RCC) is still limited. Although multikinase inhibitors have recently been developed for clear cell carcinoma, response rates in other histology non-clear cell RCC are poor and patients often face dose-limiting toxicities which lead to a reduction in prognosis and treatment success. We present a patient with hereditary leiomyomatosis and RCC (HLRCC), showing a sustained response for more than 12 months to gemcitabine-bevacizumab therapy after failure tyrosine kinase inhibitors (TKIs) and mammalian target of rapamycin (mTOR) therapies. PMID:26085897

  12. IgG4-related tubulointerstitial nephritis associated with only lymphadenopathy and without elevated serum IgG4 or renal imaging abnormalities: a case report and literature review.

    PubMed

    Qiao, Xi; Wang, Lihua; Wang, Chen; Gao, Lifang; Yao, Shulei; Wu, Liran; Zhang, Xiaoqin

    2015-01-01

    IgG4-related tubulointerstitial nephritis (IgG4-TIN) is the most common renal manifestation of IgG4-related kidney disease (IgG4-RKD) and may cause acute or chronic renal dysfunction. Imaging often shows heterogeneous densities in the kidneys, such as a mass or multiple nodules. Serology usually demonstrates high levels of serum IgG4 and total IgG. Most patients have other organs involvement by IgG4 related disease. Although lymphadenopathy is frequently observed in patients with IgG4-TIN, it is rarely presented as the only extrarenal lesion. Herein, we present a rare case of IgG4-TIN associated with only lymphadenopathy and without elevated serum IgG4 or renal imaging abnormalities. A 61-year-old Chinese man was admitted to our hospital with seven months history of generalized lymphadenopathy and five months history of renal dysfunction. His renal imaging was normal. He had no current or previous clinical, radiographic, and/or histologic evidence of other organ involvement except for the lymphadenopathy. Renal biopsy indicated plasma cell-rich TIN with an increased number of IgG4-positive plasma cells and storiform fibrosis. Repeated lymph nodes biopsy revealed IgG4-related lymphadenopathy. However, he did not have elevated serum IgG4 or total IgG levels. Oral prednisone therapy improved his renal function and lymphadenopathy. These findings supported our final diagnosis of IgG4-TIN. Clinicians should be aware of this condition and steroid therapy should be considered for such patients. An early diagnosis and appropriate therapy can induce remission and preserve renal function. PMID:26770608

  13. [Renal disease].

    PubMed

    Espinosa-Cuevas, María de Los Ángeles

    2016-09-01

    Chronic renal failure in its various stages, requires certain nutritional restrictions associated with the accumulation of minerals and waste products that cannot be easily eliminated by the kidneys. Some of these restrictions modify the intake of proteins, sodium, and phosphorus. Milk and dairy products are sources of these nutrients. This article aims to inform the reader about the benefits including milk and dairy products relying on a scientific and critical view according to the clinical conditions and the stage of renal disease in which the patient is. PMID:27603894

  14. Renal organogenesis

    PubMed Central

    2011-01-01

    The increasing prevalence of chronic kidney disease in the absence of new treatment modalities has become a strong driver for innovation in nephrology. An increasing understanding of stem cell biology has kindled the prospects of regenerative options for kidney disease. However, the kidney itself is not a regenerative organ, as all the nephrons are formed during embryonic development. Here, we will investigate advances in the molecular genetics of renal organogenesis, including what this can tell us about lineage relationships, and discuss how this may serve to inform us about both the normal processes of renal repair and options for regenerative therapies. PMID:22198432

  15. [Renal colic].

    PubMed

    Pinheiro, J M

    1999-01-01

    The appropriate approach to renal colic, which should be known by the family doctor, is presented. The incidence of this condition in the emergency department of a large general hospital is described as well as the physiopathology of pain, its clinical aspects and the therapeutic attitudes. Renal colic is frequent, it is often possible to diagnose the clinical aspects and general practitioners have the competence for treatment. The use of analgesic drugs, in the correct dosage, is enough to relieve pain and suffering in most of the patients. PMID:10423866

  16. Cytogenomics and gene expression in a case of metachronous bilateral renal cell carcinomas with drop metastasis: Resolving a diagnostic dilemma with molecular technologies.

    PubMed

    Takei, Hidehiro; Barrios, Roberto; Monzon, Federico A

    2013-06-01

    Metachronous bilateral renal cell carcinomas (RCCs) are rare but well known. We present a case of metachronous bilateral RCCs with a ureter orifice metastasis, for which the pathological diagnosis was confirmed with single nucleotide polymorphism microarray (SNP-M) and gene expression assay (GEA). A 53-year-old man presented with a right ureteral obstruction. A cystoscopy showed a large pedunculated tumor emanating from the right ureteral orifice, consistent with a drop metastasis, which was biopsied. He had a history of a clear cell RCC (ccRCC) 1.5 years prior and a right renal pelvic mass found 8 months later. Histologically, the biopsied right ureteral tumor demonstrated sheets of poorly differentiated cancer cells composed of a mixture of spindled and focal clear cell components. The main differential diagnosis was metastatic RCC versus urothelial carcinoma, but the immunohistochemical profile was not contributory. SNP-M revealed a genomic profile consistent with a metastatic ccRCC with loss of chromosome 3p. GEA showed a gene expression pattern consistent with kidney origin. The cytogenomic array also identified chromosome copy number patterns that were shared between both kidney tumors. This finding suggests that both tumors had a common origin, and thus, the metachronous ccRCC in the contralateral kidney represents a metastasis. PMID:23782335

  17. A case of cardiopulmonary arrest caused by laxatives-induced hypermagnesemia in a patient with anorexia nervosa and chronic renal failure.

    PubMed

    Tatsumi, Hiroomi; Masuda, Yoshiki; Imaizumi, Hitoshi; Kuroda, Hiromitsu; Yoshida, Shin-ichiro; Kyan, Ryoko; Goto, Kyoko; Asai, Yasufumi

    2011-12-01

    We report a case of laxatives induced severe hypermagnesemia complicated with cardiopulmonary arrest. A 55-year-old woman, with nephritic syndrome and anorexia nervosa, was later transported to our emergency room (ER) because of oliguria and consciousness disturbance. During transfer to the intensive care unit from the ER, cardiopulmonary arrest suddenly occurred. Cardiopulmonary resuscitation was immediately performed, and spontaneous circulation was restored after 3 min. Thereafter, administration of dopamine, norepinephrine, and epinephrine was required to maintain systolic blood pressure at 80 mmHg. Arterial blood gas analysis showed severe metabolic alkalosis, and blood biochemical tests revealed hypermagnesemia (serum magnesium concentration, 18.5 mg/dl) and renal dysfunction. Continuous infusion of diuretics followed by massive hydration and continuous hemodiafiltration (CHDF) was started. Five days after starting CHDF, magnesium concentration was almost normalized and administration of catecholamine was stopped. It was thought that progression of renal dysfunction that occurred in the patient taking a magnesium product for chronic constipation caused reduction in magnesium excretion ability, resulting in hypermagnesemia-induced cardiopulmonary arrest. To avoid a rebound phenomenon following magnesium flux from cells, continuous blood purification seems to be an effective treatment for symptomatic hypermagnesemia. PMID:21904782

  18. Immediate financial impact of computerized clinical decision support for long-term care residents with renal insufficiency: a case study.

    PubMed

    Subramanian, Sujha; Hoover, Sonja; Wagner, Joann L; Donovan, Jennifer L; Kanaan, Abir O; Rochon, Paula A; Gurwitz, Jerry H; Field, Terry S

    2012-01-01

    In a randomized trial of a clinical decision support system for drug prescribing for residents with renal insufficiency in a large long-term care facility, analyses were conducted to estimate the system's immediate, direct financial impact. We determined the costs that would have been incurred if drug orders that triggered the alert system had actually been completed compared to the costs of the final submitted orders and then compared intervention units to control units. The costs incurred by additional laboratory testing that resulted from alerts were also estimated. Drug orders were conservatively assigned a duration of 30 days of use for a chronic drug and 10 days for antibiotics. It was determined that there were modest reductions in drug costs, partially offset by an increase in laboratory-related costs. Overall, there was a reduction in direct costs (US$1391.43, net 7.6% reduction). However, sensitivity analyses based on alternative estimates of duration of drug use suggested a reduction as high as US$7998.33 if orders for non-antibiotic drugs were assumed to be continued for 180 days. The authors conclude that the immediate and direct financial impact of a clinical decision support system for medication ordering for residents with renal insufficiency is modest and that the primary motivation for such efforts must be to improve the quality and safety of medication ordering. PMID:22101906

  19. Reflex Anuria After Renal Tumor Embolization

    SciTech Connect

    Kervancioglu, Selim Sirikci, Akif; Erbagci, Ahmet

    2007-04-15

    We report a case of reflex anuria after transarterial embolization of a renal tumor. Anuria developed immediately after embolization and resolved 74 hr following the procedure. We postulate that reflux anuria in our case was related to mechanoreceptors, chemoreceptors, or both, as these are stimulated by the occluded blood vessels, ischemia, and edema of the normal renal tissue of an embolized kidney.

  20. Bilateral renal calculi

    PubMed Central

    Sreenevasan, G

    1974-01-01

    Bilateral renal calculi were present in 114 (10.7%) of 1,070 cases of proved urinary calculus admitted to the Urological Department of the General Hospital, Kuala Lumpur, during the period November 1968—May 1973. The management of bilateral renal calculi is discussed with reference to the first 100 cases in this series. The introduction of renography has greatly facilitated the decision as to which kidney should be operated on first. The management of patients with and without uraemia is discussed and the use of the modified V and V—Y incisions for the removal of staghorn calculi is described. Complications and results are briefly reviewed. ImagesFig. 1Fig. 4Fig. 6Fig. 7 PMID:4845653

  1. A Case Report of Renal Sympathetic Denervation for the Treatment of Polymorphic Ventricular Premature Complexes: Expanding Horizons.

    PubMed

    Kiuchi, Márcio Galindo; Vitorio, Frederico Puppim; da Silva, Gustavo Ramalho; Paz, Luis Marcelo Rodrigues; Souto, Gladyston Luiz Lima

    2015-12-01

    Premature ventricular complexes are very common, appearing most frequently in patients with hypertension, obesity, sleep apnea, and structural heart disease. Sympathetic hyperactivity plays a critical role in the development, maintenance, and aggravation of ventricular arrhythmias. Recently, Armaganijan et al reported the relevance of sympathetic activation in patients with ventricular arrhythmias and suggested a potential role for catheter-based renal sympathetic denervation in reducing the arrhythmic burden. In this report, we describe a 32-year-old hypertensive male patient presenting with a high incidence of polymorphic premature ventricular complexes on a 24  hour Holter monitor. Beginning 1 year prior, the patient experienced episodes of presyncope, syncope, and tachycardia palpitations. The patient was taking losartan 100  mg/day, which kept his blood pressure (BP) under control, and sotalol 160  mg twice daily. Bisoprolol 10  mg/day was used previously but was not successful for controlling the episodes. The 24  hour Holter performed after the onset of sotalol 160  mg twice daily showed a heart rate ranging between 48 (minimum)-78 (average)-119 (maximum) bpm; 14,286 polymorphic premature ventricular complexes; 3 episodes of nonsustained ventricular tachycardia, the largest composed of 4 beats at a rate of 197 bpm; and 14 isolated atrial ectopic beats. Cardiac magnetic resonance imaging with gadolinium perfusion performed at rest and under pharmacological stress with dipyridamole showed increased left atrial internal volume, preserved systolic global biventricular function, and an absence of infarcted or ischemic areas. The patient underwent bilateral renal sympathetic denervation. The only drug used postprocedure was losartan 25  mg/day. Three months after the patient underwent renal sympathetic denervation, the mean BP value dropped to 132/86  mmHg, the mean systolic/diastolic 24  hour ambulatory BP measurement was reduced to 128/83

  2. NOCARDIA BEIJINGENSIS PSOAS ABSCESS AND SUBCUTANEOUS PHAEOHYPHOMYCOSIS CAUSED BY PHAEOACREMONIUM PARASITICUM IN A RENAL TRANSPLANT RECIPIENT: THE FIRST CASE REPORT IN THAILAND.

    PubMed

    Palavutitotai, Nattawan; Chongtrakoo, Piriyaporn; Ngamskulrungroj, Popchai; Chayakulkeeree, Methee

    2015-11-01

    We describe the first case of a psoas muscle abscess caused by Nocardia beijingensis and subcutaneous phaeohyphomycosis caused by Phaeoacremonium parasiticum in a renal transplant recipient. The patient was treated for nocardiosis with percutaneous drainage and intravenous trimethoprim/sulfamethoxazole (TMP/SMX) combined with imipenem for 2 weeks, followed by a 4-week course of intravenous TMP/SMX and then oral TMP/SMX. During hospitalization for the psoas muscle abscess the patient developed cellulitis with subcutaneous nodules of his right leg. Skin biopsy and cultures revealed a dematiaceous mold, subsequently identified as P. parasiticum by DNA sequencing. The subcutaneous phaeohyphomycosis was treated with surgical drainage and liposomal amphotericin B for 4 weeks followed by a combination of itraconazole and terbinafine. The patient gradually improved and was discharged home after 18 weeks of hospitalization. PMID:26867363

  3. Metabolomics and Renal Disease

    PubMed Central

    Rhee, Eugene P.

    2015-01-01

    Purpose of review This review summarizes recent metabolomics studies of renal disease, outlining some of the limitations of the literature to date. Recent findings The application of metabolomics in nephrology research has expanded from initial analyses of uremia to include both cross-sectional and longitudinal studies of earlier stages of kidney disease. Although these studies have nominated several potential markers of incident CKD and CKD progression, lack of overlap in metabolite coverage has limited the ability to synthesize results across groups. Further, direct examination of renal metabolite handling has underscored the substantial impact kidney function has on these potential markers (and many other circulating metabolites). In experimental studies, metabolomics has been used to identify a signature of decreased mitochondrial function in diabetic nephropathy and a preference for aerobic glucose metabolism in PKD; in each case, these studies have outlined novel therapeutic opportunities. Finally, as a complement to the longstanding interest in renal metabolite clearance, the microbiome has been increasingly recognized as the source of many plasma metabolites, including some with potential functional relevance to CKD and its complications. Summary The high-throughput, high-resolution phenotyping enabled by metabolomics technologies has begun to provide insight on renal disease in clinical, physiologic, and experimental contexts. PMID:26050125

  4. Thyroid-like Follicular Carcinoma of the Kidney and Papillary Renal Cell Carcinoma with Thyroid-like Feature: Comparison of Two Cases and Literature Review.

    PubMed

    Li, Congcong; Dong, Hongyan; Fu, Weiwei; Qi, Mei; Han, Bo

    2015-01-01

    Thyroid-like follicular carcinoma of the kidney (TLFCK) is a provisional new entity of renal cell carcinoma (RCC). We herein reported and compared one TLFCK case and one PRCC case with thyroid-like feature. The former entirely consisted of thyroid-like follicular architecture and the tumor cells were diffusely positive for PAX-8, but negative for CK7, AMACR, and CD10. By contrast, both papillary architecture (~60%) and thyroid-like follicular architecture (~40%) were identified in the latter. Tumor cells in both histological components exhibited diffusely positive staining for PAX-8, CK7, AMACR, but negative for CD10. FISH analysis showed no aberration in TLFCK case but trisomy of chromosome 17 in PRCC case. Along with a brief literature review, we presented that recognition of TLFCK is important to distinguish it from other conditions that show thyroid-like features. Additionally, a diagnosis of TLFCK should be cautiously made when papillary component is present in the tumor. PMID:26663803

  5. Tubulocystic renal cell carcinoma: is there a rational reason for targeted therapy using angiogenic inhibition? Analysis of seven cases.

    PubMed

    Steiner, Petr; Hora, Milan; Stehlik, Jan; Martinek, Petr; Vanecek, Tomas; Petersson, Fredrik; Michal, Michal; Korabecna, Marie; Travnicek, Ivan; Hes, Ondrej

    2013-02-01

    Generally, patients with renal cell carcinoma (RCC) are viewed as potential candidates for antiangiogenic targeted therapy. Tubulocystic RCC (TCRC) is a recently described entity which may behave aggressively, and the rationale for antiangiogenic therapy in this group of renal tumors has yet to be determined. Seven TCRCs and five non-tumor tissue samples from seven patients were subjected to relative expression analysis of mRNA levels of 16 genes involved in three angiogenic signal pathways: (1) VHL/HIF, (2) RTK/mitogen-activated protein kinase (MAPK), and (3) PI3K/Akt/mTOR. Two of them, pathways (2) and (3), are often targeted by antiangiogenic agents. We also determined the mutation and methylation status of the VHL gene. Finally, the levels of vascular endothelial growth factor A (VEGFA), HIF-1α, HIF-2α proteins, and phosphorylated mTOR protein were also determined. The comparison of tumor and control samples revealed no changes of mRNA levels of the following genes: VHL, HIF-1α, HIF-2α, PTEN, Akt2, Akt3, mTOR, VEGFA, KDR, HRas, C-Jun, EGFR, and FGF2. Significantly elevated mRNA level of TP53 was found, while the mRNA levels of FLT1 and C-FOS were reduced in tumor samples. No mutations or methylation in the VHL gene were found. Changes in levels of studied proteins VEGFA, HIF-1α, HIF-2α, and increased phosphorylation of mTOR protein were not found. Three studied angiogenic pathways (VHL/HIF, RTK/MAPK, and PI3K/Akt/mTOR) seem not to be upregulated in TCRC samples, so there appears to be no rationale for a general recommendation of antiangiogenic targeted therapeutic protocols for patients with these tumors. PMID:23296808

  6. Plasmapheresis Is Associated With Better Renal Outcomes in Lupus Nephritis Patients With Thrombotic Microangiopathy: A Case Series Study.

    PubMed

    Li, Qiu-Yu; Yu, Feng; Zhou, Fu-De; Zhao, Ming-Hui

    2016-05-01

    The aim of this study was to evaluate the efficacy of plasmapheresis in patients with lupus nephritis-combined thrombotic microangiopathy (TMA) in a Chinese cohort.Clinical and therapeutic data of patients with lupus nephritis-combined TMA were collected retrospectively. A comparison between those with and without plasmapheresis was performed.Seventy patients with renal biopsy-proven TMA in lupus nephritis were treated with conventional combined corticosteroid and immunosuppressive agents as induction therapy, 9 of the 70 patients received additional plasmapheresis. The plasmapheresis group presented with more severe SLE and renal activity indices, including a significant higher ratio of neurologic disorder (P = 0.025), lower level of platelet count (P = 0.009), higher value of serum creatinine (P = 0.038), higher percentage of anti-cardiolipin antibodies positive (P = 0.001), and higher Systemic Lupus Erythematosus Disease Activity Index scores (P = 0.012), than that of the nonplasmapheresis group. However, the plasmapheresis group had a significant higher rate of remission and a lower ratio of treatment failure than that of the nonplasmapheresis group (P = 0.03). As the baseline data were significantly different between the 2 groups, the propensity score match was further designed to avoid retrospective bias. After re-analysis, the plasmapheresis group still had a significant higher rate of remission and a lower ratio of treatment failure than that of the nonplasmapheresis group (P = 0.018). More importantly, the plasmapheresis group had significant less composite endpoints than that of the nonplasmapheresis group (P = 0.005).Our study suggested that additional plasmapheresis on conventional induction therapy may benefit patients with lupus nephritis-combined TMA, which warrants further explorations. PMID:27149490

  7. Acute renal failure due to falciparum malaria.

    PubMed

    Habte, B

    1990-01-01

    Seventy-two patients with severe falciparum malaria are described. Twenty-four (33.3%) were complicated by acute renal failure. Comparing patients with renal failure and those without, statistically significant differences occurred regarding presence of cerebral malaria (83% vs 46%), jaundice (92% vs 33%), and death (54% vs 17%). A significantly higher number of patients with renal failure were nonimmune visitors to malaria endemic regions. Renal failure was oliguric in 45% of cases. Dialysis was indicated in 38%, 29% died in early renal failure, and 33% recovered spontaneously. It is concluded that falciparum malaria is frequently complicated by cerebral malaria and renal failure. As nonimmune individuals are prone to develop serious complications, malaria prophylaxis and vigorous treatment of cases is mandatory. PMID:2236718

  8. Unusual renal tumour: multilocular cystic renal cell carcinoma.

    PubMed

    Palmeiro, Marta Morna; Niza, João Luz; Loureiro, Ana Luisa; Conceição e Silva, João Paulo

    2016-01-01

    Multilocular cystic renal cell carcinoma (MCRCC) is a rare presentation of renal cell carcinoma. Most patients are asymptomatic and frequently MCRCCs are detected incidentally. MCRCCs have good prognosis because of their low malignant potential. We report a case of a 39-year-old woman who presented with mild right flank pain and normal laboratory data. On imaging examinations, a Bosniak III cystic lesion was detected in the lower third of the right kidney. She underwent right partial nephrectomy and histopathology showed a multilocular cystic renal cell carcinoma Fuhrman grade 1. In this article, we also present a review of the literature on MCRCC, highlight the correlation of the pathological and imaging characteristics of these low aggressive renal lesions, and underscore the importance of their recognition to prevent unnecessary radical surgery. PMID:26957035

  9. MRI appearance of massive renal replacement lipomatosis in the absence of renal calculus disease

    PubMed Central

    Fitzgerald, E; Melamed, J; Taneja, S S; Rosenkrantz, A B

    2011-01-01

    Renal replacement lipomatosis is a rare benign entity in which extensive fibrofatty proliferation of the renal sinus is associated with marked renal atrophy. In this report, we present a case of massive renal replacement lipomatosis demonstrated on MRI. The presentation was atypical given an absence of associated renal calculus disease, and an initial CT scan was interpreted as suspicious for a liposarcoma. The differential diagnosis and key MRI findings that served to establish this specific diagnosis are reviewed. Histopathological correlation is also presented, as the patient underwent nephroureterectomy. PMID:21257835

  10. Unilateral renal agenesis and other causes of the solitary photopenic renal fossa

    SciTech Connect

    Howard, W.H.; Bunker, S.R.; Karl, R.D. Jr.; Ralston, T.; Hartshorne, M.F.; Cawthon, M.A.; Bauman, J.M.

    1985-04-01

    The differential diagnosis of a solitary photopenic defect in the renal fossa observed at renal scintigraphy is extensive. A case of one of the most unusual causes for this finding, renal agenesis, is presented. Additional cases that illustrate the similarity in the radionuclide appearance of other pathologic entities are also presented. Correlation with clinical findings and other imaging modalities is required to accurately distinguish these conditions.

  11. Endovascular Exclusion of Renal Artery Aneurysm

    SciTech Connect

    Andersen, Poul Erik Rohr, Nils

    2005-06-15

    A patient who was operated for an abdominal aortic aneurysm 7 years earlier presented with recently discovered iliac and renal artery aneurysms. The renal artery had an angulation of 90{sup o}, but the aneurysm was successfully excluded using a covered vascular stent graft placed over an extrastiff guidewire. Even in cases of complex anatomy of a renal aneurysm, endovascular treatment should be considered. With development of more flexible and low-profile endoprosthesis with accurate deployment, these have become more usable.

  12. A nested case-control study of leukocyte mitochondrial DNA copy number and renal cell carcinoma in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial.

    PubMed

    Hofmann, Jonathan N; Hosgood, H Dean; Liu, Chin-San; Chow, Wong-Ho; Shuch, Brian; Cheng, Wen-Ling; Lin, Ta-Tsung; Moore, Lee E; Lan, Qing; Rothman, Nathaniel; Purdue, Mark P

    2014-05-01

    Mitochondrial DNA (mtDNA) is vulnerable to mutations, and the number of copies of mtDNA per cell may increase to compensate for DNA damage. Case-control studies have reported associations between altered mtDNA copy number and risk of renal cell carcinoma (RCC); however, this association has not been investigated prospectively. We conducted a nested case-control study (252 cases and 504 controls) of RCC risk in relation to pre-diagnostic leukocyte mtDNA copy number in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. mtDNA copy number was measured in triplicate using a fluorescence-based quantitative PCR assay; samples from 22 cases and 36 controls could not be assayed, leaving 230 cases and 468 controls for analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression. High mtDNA copy number was associated with an increased risk of RCC, both overall (highest quartile versus lowest: OR = 2.0, 95% CI = 1.2-3.2; P trend = 0.002) and among cases diagnosed ≥6 years after blood collection (OR = 2.6, 95% CI = 1.4-5.0; P trend = 0.003). These findings did not differ significantly by sex, body mass index, history of hypertension or smoking status (P interaction ≥ 0.3). Results of this study suggest that high pre-diagnostic leukocyte mtDNA copy number, a suspected marker of oxidative DNA damage and mitochondrial dysfunction, is associated with increased future RCC risk. PMID:24398668

  13. Renal Fibrosis

    PubMed Central

    Zeisberg, Michael; Maeshima, Yohei; Mosterman, Barbara; Kalluri, Raghu

    2002-01-01

    During progression of chronic renal disease, qualitative and quantitative changes in the composition of tubular basement membranes (TBMs) and interstitial matrix occur. Transforming growth factor (TGF)-β1-mediated activation of tubular epithelial cells (TECs) is speculated to be a key contributor to the progression of tubulointerstitial fibrosis. To further understand the pathogenesis associated with renal fibrosis, we developed an in vitro Boyden chamber system using renal basement membranes that partially mimics in vivo conditions of TECs during health and disease. Direct stimulation of TECs with TGF-β1/epithelial growth factor results in an increased migratory capacity across bovine TBM preparations. This is associated with increased matrix metalloproteinase (MMP) production, namely MMP-2 and MMP-9. Indirect chemotactic stimulation by TGF-β1/EGF or collagen type I was insufficient in inducing migration of untreated TECs across bovine TBM preparation, suggesting that basement membrane integrity and composition play an important role in protecting TECs from interstitial fibrotic stimuli. Additionally, neutralization of MMPs by COL-3 inhibitor dramatically decreases the capacity of TGF-β1-stimulated TECs to migrate through bovine TBM preparation. Collectively, these results demonstrate that basement membrane structure, integrity, and composition play an important role in determining interstitial influences on TECs and subsequent impact on potential aberrant cell-matrix interactions. PMID:12057905

  14. Renal Calculi

    PubMed Central

    Yendt, E. R.

    1970-01-01

    The pathogenesis of renal calculi is reviewed in general terms followed by the results of investigation of 439 patients with renal calculi studied by the author at Toronto General Hospital over a 13-year period. Abnormalities of probable pathogenetic significance were encountered in 76% of patients. Idiopathic hypercalciuria was encountered in 42% of patients, primary hyperparathyroidism in 11%, urinary infection in 8% and miscellaneous disorders in 8%. The incidence of uric acid stones and cystinuria was 5% and 2% respectively. In the remaining 24% of patients in whom no definite abnormalities were encountered the mean urinary magnesium excretion was less than normal. Of 180 patients with idiopathic hypercalciuria, only 24 were females. In the diagnosis of hyperparathyroidism, the importance of detecting minimal degrees of hypercalcemia is stressed; attention is also drawn to the new observation that the upper limit of normal for serum calcium is slightly lower in females than in males. The efficacy of various measures advocated for the prevention of renal calculi is also reviewed. In the author's experience the administration of thiazides has been particularly effective in the prevention of calcium stones. Thiazides cause a sustained reduction in urinary calcium excretion and increase in urinary magnesium excretion. These agents also appear to affect the skeleton by diminishing bone resorption and slowing down bone turnover. PMID:5438766

  15. Survival patterns of patients on maintenance hemodialysis for end stage renal disease in Ethiopia: summary of 91 cases

    PubMed Central

    2013-01-01

    Background The increasing incidence and prevalence of chronic kidney disease is an important challenge for health systems around the world. Access for care of the disease in Ethiopia is extremely limited. The main purpose of the study was to investigate survival pattern and assess risk factors for poor outcome of patients on maintenance hemodialysis for end stage renal disease in Ethiopia. Methods Medical records of patients on maintenance hemodialysis for end stage renal disease at Saint Gabriel General Hospital between 2002 and 2010 were reviewed. The data was collected by complete review of patient’s clinical data. Descriptive statistics was used for most variables and Chi-square test, where necessary, was used to test the association among various variables. Kaplan-Meier survival analysis was done to assess both short and long term survival. P-values of < 0.05 were considered as statistically significant. Results A total of 190 patients were registered for hemodialysis at the hospital 91 of which were included in the final assessment. Mean age at dialysis initiation was 58 ± 15 years. Fifty-five (60.4%) of the patients had prior history of diabetes. Almost all of them had serum creatinine of > 5mg/dl and some degree of anemia at dialysis initiation. Forty-one (45.1%) deaths occurred during dialysis treatment and 21 (23.1%) of patients died within the first 90 days of starting dialysis. Only 42.1% of them survived longer than a year. The frequently registered causes of death were septicemia (34.1%) and cardiovascular diseases (29.3%). Use of catheter as vascular access was associated with decreased short term and long term survival. Conclusion Dialysis as treatment modality is extremely scarce in Ethiopia and affordable to only the rich. Survival pattern in those on the treatment is less satisfactory and short of usual standards in the developed world and needs further investigation. We thus recommend a large scale analysis of national dialysis

  16. Tumor Necrosis Adds Prognostically Significant Information to Grade in Clear Cell Renal Cell Carcinoma: A Study of 842 Consecutive Cases From a Single Institution.

    PubMed

    Khor, Li-Yan; Dhakal, Hari P; Jia, Xuefei; Reynolds, Jordan P; McKenney, Jesse K; Rini, Brian I; Magi-Galluzzi, Cristina; Przybycin, Christopher G

    2016-09-01

    Tumor necrosis has been shown to be an independent predictor of adverse outcome in renal cell carcinoma. A modification of the International Society of Urological Pathology (ISUP) grading system for renal cell carcinomas has recently been proposed, which incorporates the presence of tumor necrosis into grade. The investigators proposing this system found that necrosis added significant prognostic information to ISUP grade. We attempted to describe our experience with the effect of tumor necrosis in relationship to nuclear grade by reviewing the slides from a large consecutive series of localized clear cell renal cell carcinomas from our institution and obtaining long-term clinical follow-up information (overall survival). Of the 842 clear cell renal cell carcinomas reviewed, 265 (31.5%) were ISUP grade 1 or 2, 437 (51.9%) were ISUP grade 3, and 140 (16.6%) were ISUP grade 4. Tumor necrosis was present in 177 (21%) cases. Five hundred and forty-seven (64.9%) cases were stage pT1, 83 (9.9%) were stage pT2, 193 (22.9%) were stage pT3a, and 19 (2.3%) were pT3b or higher. Median follow-up was 73.2 months (range 0.12 to 273.6), and 310 (36.8%) patients died. On univariable analysis, there was no significant difference in outcome for tumors of ISUP grades 1 to 3. After adjustment for age, tumor stage, and tumor size, ISUP grade 4 and necrosis were significant predictors of overall survival on multivariable analysis. When the recently proposed modified grading system incorporating tumor necrosis was applied to our data, there was no significant difference in overall survival between patients with modified grade 1 tumors and those with modified grade 2 tumors (P=0.31); however, there was a statistically significant difference between patients with modified grade 1 or 2 tumors and those with modified grade 3 tumors (P=0.04),and a substantial difference in outcome between those with modified grade 3 and modified grade 4 tumors (P<0.001). When a recursive partitioning approach

  17. A familial case of congenital hypothyroidism caused by a homozygous mutation of the thyrotropin receptor gene.

    PubMed

    Bretones, P; Duprez, L; Parma, J; David, M; Vassart, G; Rodien, P

    2001-10-01

    Most of the time congenital hypothyroidism appears as a sporadic disease. In addition to the rare defects in hormonosynthesis associated with goiters, the causes of congenital hypothyroidism include agenesis and ectopy of the thyroid gland. The study of some familial cases has allowed the identification of a few genes responsible for congenital hypothyroidism. We report here a familial case of congenital hypothyroidism, transmitted as a recessive trait, and caused by a homozygous mutation in the thyrotropin receptor (TSH-R). The initial diagnosis of thyroid agenesis, based on the absence of tracer uptake on scintiscan, was incorrect, because ultrasound examination identified severely hypoplastic thyroid tissue in the cervical region. PMID:11716047

  18. Primary renal primitive neuroectodermal tumor

    PubMed Central

    Goel, V; Talwar, V; Dodagoudar, C; Singh, S; Sharma, A; Patnaik, N

    2015-01-01

    Primitive Neuroectodermal Tumor of the kidney is a rare entity. Very few cases of primary renal PNET have been reported to date. Most literature about rPNET is isolated case reports. We report a case of rPNET in a 39-year-old male with a pre-operative diagnosis of renal cell carcinoma with renal vein thrombosis. The patient underwent radical nephrectomy with thrombolectomy, and histopathological examination revealed a highly aggressive tumor composed of monotonous sheets of round cells. Tumor cells were positive for CD 99 and FLI-1, hence confirming the diagnosis of Primitive Neuroectodermal Tumor. Post-surgery, patient was given VAC/IE-based adjuvant chemotherapy. In view of highly aggressive nature of this tumor, prompt diagnosis and imparting effective chemotherapy regimen to the patient is required, and it is important to differentiate PNET from other small round-cell tumors because of different therapeutic approach. PMID:25766349

  19. [A case of acute renal failure in neuroleptic malignant syndrome associated with rhabdomyolysis--possible contributing role of hyperreninemia].

    PubMed

    Fujisawa, K; Maruyama, Y; Nakamura, K; Nagase, M

    1994-10-01

    A schizophrenic woman, aged 45, was admitted complaining of high fever, oliguria, blackish urine, muscle swelling and pain. She had been treated for the past 3 years with haloperidol (8 mg), levomepromazine (150 mg), chlorpromazine (75 mg), lithium carbonate (600 mg), bromocriptine mesilate (7.5 mg), etizolam (1 mg), and flunitrazepam (2 mg), Physical examination revealed her to be an obese and uncommunicatable woman with swelling and weakness of the extremities and abdominal distension without borborygmus. Urine was dark brown and (+) for protein and occult blood. Blood chemistry analysis revealed BUN 71 mg/dl, creatinine 6.8 mg/dl, CPK 143,850 IU and myoglobin 3,980 ng/ml. PRA on the 11th hospital day was 96 ng/ml/hour. This patient fulfilled the Levenson's diagnostic criteria for manifestations of neuroleptic malignant syndrome (NMS). High PRA did not decrease after cessation of the diuretics. After treatment with dantrolene sodium and 10 treatments with hemodialysis, azotemia disappeared with the start of diuresis. The PRA also decreased to the normal level. Characteristic acceleration of the central sympathetic stimuli in NMS seemed to have induced hyperreninemia, which together with rhabdomyolysis, might have contributed to the development of acute renal failure. PMID:7815749

  20. Proximal renal tubular acidosis

    MedlinePlus

    Renal tubular acidosis - proximal; Type II RTA; RTA - proximal; Renal tubular acidosis type II ... by alkaline substances, mainly bicarbonate. Proximal renal tubular acidosis (Type II RTA) occurs when bicarbonate is not ...

  1. Tubulocystic Renal Cell Carcinoma: A Great Imitator

    PubMed Central

    Banerjee, Indraneel; Yadav, Sher Singh; Tomar, Vinay; Yadav, Suresh; Talreja, Shyam

    2016-01-01

    Tubulocystic renal cell carcinoma (TCRC) is a rare renal tumor. Patients are usually asymptomatic; it is usually detected incidentally, during imaging studies for Bosniak type III and type IV renal cysts. These tumors rarely metastasize. The role of targeted therapy in such rare tumors is still controversial. We report a case of TCRC initially presented as a Bosniak type II renal cyst and was discovered ultimately to be a metastatic disease. This type of presentation might broaden our understanding of this rare disease. PMID:27601972

  2. Abnormal patterns of the renal veins

    PubMed Central

    Azari, Hassan; Abedinzadeh, Mehdi

    2012-01-01

    Knowledge of the renal vascular anatomy may greatly contribute to the success of surgical, invasive and radiological procedures of the retroperitoneal region. Here, morphometric and histological studies of a human cadaveric specimen presented a complex, anomalous pattern of renal veins. The left renal vein had an oblique retro-aortic course and received two lumbar veins. It bifurcated near its drainage point into the inferior vena cava. The right renal vein received the right testicular vein. In addition, the left kidney was located at a low position. The spleen was enlarged. The present case is unique and provides information that may help surgeons or angiologists to apply safer interventions. PMID:22536553

  3. A case of growth-hormone staining pituitary adenoma with renal cyst and hepatic cyst: are they related manifestations of a single disease?

    PubMed

    Ma, Jun; Liu, Pinan

    2014-01-01

    Growth-hormone staining pituitary adenoma is a popular disease of the central nervous system. We noticed some patients have accompanying cystic disorders. Several cases of concomitant growth-hormone (GH)-staining pituitary adenoma and other cystic changes have been reported but with no further investigation. We report a case of adult growth-hormone staining pituitary adenoma with accompanying polycystic changes of multiple systems, as well as hypertension and nephrolithiasis. Preoperative clinical assessment revealed intrasellar tumor, multinodular thyroid disorder, renal cysts, and hepatic cysts, with increased serum growth-hormone level and normal thyroid hormone level. The total tumor resection was performed via endoscopic transsphenoidal approach. The pathologic analysis reported growth-hormone staining pituitary adenoma. The postoperative course was uneventful. The endocrine testing was normal soon after the operation and the patient remained well for a follow-up period of eight months. This is the fifth report about simultaneous growth-hormone staining pituitary adenoma and polycystic changes of the kidneys and the liver. With review of the literature we speculate that the abnormal growth hormone secretion of the pituitary adenoma may arouse sequential cystic changes of multiple systems through some IGF-I involved pathways. PMID:25038593

  4. Renal and adrenal tumors: Pathology, radiology, ultrasonography, therapy, immunology

    SciTech Connect

    Lohr, E.; Leder, L.D.

    1987-01-01

    Aspects as diverse as radiology, pathology, urology, pediatrics and immunology have been brought together in one book. The most up-do-date methods of tumor diagnosis by CT, NMR, and ultrasound are covered, as are methods of catheter embolization and radiation techniques in case of primarily inoperable tumors. Contents: Pathology of Renal and Adrenal Neoplasms; Ultrasound Diagnosis of Renal and Pararenal Tumors; Computed-Body-Tomography of Renal Carcinoma and Perirenal Masses; Magnetic Resonance Imaging of Renal Mass Lesions; I-125 Embolotherapy of Renal Tumors; Adrenal Mass Lesions in Infants and Children; Computed Tomography of the Adrenal Glands; Scintigraphic Studies of Renal and Adrenal Function; Surgical Management of Renal Cell Carcinoma; Operative Therapy of Nephroblastoma; Nonoperative Treatment of Renal Cell Carcinoma; Prenatal Wilms' Tumor; Congenital Neuroblastoma; Nonsurgical Management of Wilms' Tumor; Immunologic Aspects of Malignant Renal Disease.

  5. Dyschromatosis Universalis Hereditaria with Renal Failure

    PubMed Central

    Rojhirunsakool, Salinee; Vachiramon, Vasanop

    2015-01-01

    Dyschromatosis universalis hereditaria (DUH) is a rare autosomal dominant inherited dermatosis which usually appears during childhood and is characterized by dyspigmentation, with both hypopigmented and hyperpigmented macules. We report a case of DUH with unexplained childhood-onset renal failure. The association between DUH and renal failure is yet to be proven by further studies. PMID:25969678

  6. [Relationship of renal cell carcinoma and hypertension].

    PubMed

    Masanauskiene, Edita; Naudziūnas, Albinas; Jankauskiene, Laima; Unikauskas, Alvydas

    2009-01-01

    The morbidity and mortality due to renal cell carcinoma has increased worldwide over the last 30 years. Renal cell carcinoma accounts for about 90-95% of all renal tumors. The mean age of patients with this type of tumor ranges between 50 and 70 years. It is important to note that primary arterial hypertension as well as obesity and smoking are considered as independent risk factors for renal cell carcinoma. The increase in both systolic and diastolic blood pressure as well as the severity of arterial hypertension may have an impact on development of renal cell carcinoma. We describe the case of a 45-year-old male patient with hypertensive crisis. Computed tomography scan revealed renal cell carcinoma, which was confirmed histologically after surgical treatment. PMID:20173406

  7. [Current management of renal artery stenosis].

    PubMed

    Lenz, T

    2013-12-01

    Severe renal artery stenosis may cause renovascular hypertension; in case of bilateral narrowing or in a stenotic solitary kidney, renal insufficiency (ischemic kidney disease) or rarely pulmonary flush edema may occur. Renal artery stenosis may be treated by revascularization, using either percutaneous (balloon angioplasty, stenting) or less common open surgical procedures, both with excellent primary patency rates. However, randomized trials of renal artery angioplasty or stenting have failed to demonstrate a longer-term benefit with regard to blood pressure control and renal function over medical management alone (except for fibromuscular disease). Furthermore, endovascular procedures are associated with substantial risks. It has not yet been demonstrated that renal revascularization leads to a prolongation of event-free survival. Careful patient selection is essential to maximize the potential benefit. PMID:24217529

  8. Renal Denervation

    PubMed Central

    Persu, Alexandre; Renkin, Jean; Thijs, Lutgarde; Staessen, Jan A.

    2013-01-01

    The term “ultima ratio” has multiple, though related, meanings. The motto “ultima ratio regum,” cast on the cannons of the French army of King Louis XIV, meant that war is the last argument of kings, that is, the one to be used after all diplomatic arguments have failed. Along similar lines, we propose that, given the current evidence, renal denervation should be used as a last resort, after state-of-the-art drug treatment optimized at expert centers failed to control blood pressure. PMID:22851728

  9. Retroperitoneoscopic renal biopsy: still a good indication!

    PubMed

    Micali, Salvatore; Dandrea, Matteo; De Carne, Cosimo; Martorana, Eugenio; De Stefani, Stefano; Cappelli, Gianni; Bianchi, Giampaolo

    2014-01-01

    The histological evaluation of the renal parenchyma is often essential in cases of several renal diseases and provides useful information in determining the prognosis and guiding treatment. In patients with contraindications to percutaneous kidney biopsy, retroperitoneal laparoendoscopic single-site surgery (LESS) is to be preferred as a minimally invasive technique. However, there are cases in which the LESS technique is difficult to perform, especially given that the learning curve is not optimal. We present a case of a Jehovah's Witness patient with severe obesity, in whom conventional retroperitoneal laparoscopic renal biopsy was preferred to the LESS technique. PMID:25198939

  10. 42 CFR 415.176 - Renal dialysis services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Renal dialysis services. 415.176 Section 415.176 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Renal dialysis services. In the case of renal dialysis services, physicians who are not paid under...

  11. 42 CFR 415.176 - Renal dialysis services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Renal dialysis services. 415.176 Section 415.176 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... § 415.176 Renal dialysis services. In the case of renal dialysis services, physicians who are not...

  12. 42 CFR 415.176 - Renal dialysis services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Renal dialysis services. 415.176 Section 415.176 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... § 415.176 Renal dialysis services. In the case of renal dialysis services, physicians who are not...

  13. 42 CFR 415.176 - Renal dialysis services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Renal dialysis services. 415.176 Section 415.176 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... § 415.176 Renal dialysis services. In the case of renal dialysis services, physicians who are not...

  14. 42 CFR 415.176 - Renal dialysis services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Renal dialysis services. 415.176 Section 415.176 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Renal dialysis services. In the case of renal dialysis services, physicians who are not paid under...

  15. Evaluation of renal vascular anatomy in live renal donors: Role of multi detector computed tomography

    PubMed Central

    Pandya, Vaidehi Kumudchandra; Patel, Alpeshkumar Shakerlal; Sutariya, Harsh Chandrakant; Gandhi, Shruti Pradipkumar

    2016-01-01

    Background: Evaluation of renal vascular variations is important in renal donors to avoid vascular complications during surgery. Venous variations, mainly resulting from the errors of the embryological development, are frequently observed. Aim: This retrospective cross-sectional study aimed to investigate the renal vascular variants with multidetector computed tomography (MDCT) angiography to provide valuable information for surgery and its correlations with surgical findings. Materials and Methods: A total of 200 patients underwent MDCT angiography as a routine work up for live renal donors. The number, course, and drainage patterns of the renal veins were retrospectively observed from the scans. Anomalies of renal veins and inferior vena cava (IVC) were recorded and classified. Multiplanar reformations (MPRs), maximum intensity projections, and volume rendering were used for analysis. The results obtained were correlated surgically. Results: In the present study, out of 200 healthy donors, the standard pattern of drainage of renal veins was observed in only 67% of donors on the right side and 92% of donors on the left side. Supernumerary renal veins in the form of dual and triple renal veins were seen on the right side in about 32.5% of donors (dual right renal veins in 30.5% cases and triple right renal veins in 2.5% cases). Variations on the left side were classified into four groups: supernumerary, retro-aortic, circumaortic, and plexiform left renal veins in 1%, 2.5%, 4%, 0.5%, cases respectively. Conclusions: Developmental variations in renal veins can be easily detected on computed tomography scan, which can go unnoticed and can pose a fatal threat during major surgeries such as donor nephrectomies in otherwise healthy donors if undiagnosed. PMID:27453646

  16. Post-renal Transplantation de novo Renal Cell Carcinoma in a Middle-aged Man.

    PubMed

    Pandya, V K; Sutariya, H C

    2016-01-01

    Renal cell carcinoma is usually seen in the native kidney but may be seen in the renal allograft. We report a rare case of renal cell carcinoma in a 56-year-old renal allograft recipient who was transplanted for end-stage renal disease induced by analgesic nephropathy. This complication developed after 13 years of renal transplantation. Patient was investigated for hematuria and abdominal pain with a normal renal function. Computed tomography depicted a mass sized 9.0×7.3×6.8 cm that involved the upper pole of the transplant. There was no metastasis. The patient underwent radical allograft nephrectomy for the carcinoma that had extended up to the renal hilum. Histopathological examination revealed Furhman grade-1, clear cell variant, stage pT2 N0 M0. In the last visit, the patient was on maintenance hemodialysis via arterio-venous fistula and planned for cadaveric renal transplantation. Computed tomography could facilitate early diagnosis and proper management of patients with post-renal allograft renal cell carcinoma. PMID:26889374

  17. Post-renal Transplantation de novo Renal Cell Carcinoma in a Middle-aged Man

    PubMed Central

    Pandya, V. K.; Sutariya, H. C.

    2016-01-01

    Renal cell carcinoma is usually seen in the native kidney but may be seen in the renal allograft. We report a rare case of renal cell carcinoma in a 56-year-old renal allograft recipient who was transplanted for end-stage renal disease induced by analgesic nephropathy. This complication developed after 13 years of renal transplantation. Patient was investigated for hematuria and abdominal pain with a normal renal function. Computed tomography depicted a mass sized 9.0×7.3×6.8 cm that involved the upper pole of the transplant. There was no metastasis. The patient underwent radical allograft nephrectomy for the carcinoma that had extended up to the renal hilum. Histopathological examination revealed Furhman grade-1, clear cell variant, stage pT2 N0 M0. In the last visit, the patient was on maintenance hemodialysis via arterio-venous fistula and planned for cadaveric renal transplantation. Computed tomography could facilitate early diagnosis and proper management of patients with post-renal allograft renal cell carcinoma. PMID:26889374

  18. A Giant Intra Abdominal Mass Mimicking Renal Cell Carcinoma: A Rare Presentation of Renal Angiomyolipoma.

    PubMed

    Haque, M E; Rahman, M A; Kaisar, I; Islam, M F; Salam, M A

    2016-07-01

    Angiomyolipoma (AML) is a benign tumor commonly found in kidney than extra renal sites. Most of the small renal angiomyolipomas are diagnosed incidentally on ultrasound and other imaging studies. Some renal AMLs present clinically when become very big, giant renal angiomyolipoma. Although almost all cases are benign, a relatively rare variant of epitheloid angiomyolipoma has got malignant potential and can even metastasize. Ultrasonography, CT and MRI scan are usually used for diagnosis of angiomyolipoma with high level of accuracy; even though some lesions may be confused as renal cell carcinoma on imaging studies. Here, a 48 year old man presented with a large intra-abdominal mass preoperatively diagnosed as a case of right renal cell carcinoma and radical nephrectomy was performed. Histopathology revealed epitheloid angiomyolipoma (EAML). PMID:27612907

  19. A case of upper gastrointestinal acute bleeding as a complication of renal carcinoma metastases to the papilla Vateri

    PubMed Central

    Piskorz, Łukasz; Wawrzycki, Marcin; Jabłoński, Sławomir; Brocki, Marian

    2013-01-01

    Acute bleeding from metastatic tumour of the papilla Vateri is an extremely rare case. In this report the case of a woman who suffered from complications after a metastatic tumour of the papilla is described. Seventeen years following resection of the kidney due to clear cell carcinoma the patient was admitted to the clinic because of massive bleeding (Forrest IB) to the upper digestive tract in the form of sanguineous vomiting. The conducted diagnostics revealed a bleeding tumour of the papilla Vateri. Endoscopic treatment could not effectively stop the bleeding. A surgical procedure was performed by Whipple's method. A histopathological examination showed a metastatic clear cell tumour of the kidney. The patient was discharged from hospital on the 8th day following her admission and was also referred for further oncological treatment. The discussion is based on other cases of rare bleeding from the digestive tract within tumours of the bile duct and papilla Vateri. PMID:24596540

  20. Acute Cardiac Tamponade: An Unusual Cause of Acute Renal Failure

    PubMed Central

    Phadke, Gautam; Whaley-Connell, Adam; Dalal, Pranavkumar; Markley, John; Rich, Andrew

    2012-01-01

    We are reporting a case of acute renal failure after cardiac surgery due to acute pericardial effusion. The patient had normal baseline renal function but developed acute oliguric renal failure with a significant increase in serum creatinine postoperatively. Pericardiotomy led to an improvement in blood pressure, immediate diuresis and quick recovery of renal function back to baseline. Pericardial tamponade should be included in the consideration of causes of the cardiorenal syndrome. PMID:22619656

  1. Percutaneous Renal Cyst Ablation and Review of the Current Literature.

    PubMed

    Desai, Devang; Modi, Sunny; Pavicic, Matthew; Thompson, Melissa; Pisko, John

    2016-01-01

    Renal cysts are common and most often are discovered incidentally, but may require intervention if associated with pain, hypertension, or hematuria. Minimally invasive treatment options are preferred with numerous modalities available, including renal cyst ablation. This case report of a 61-year-old female describes the effective percutaneous drainage and endoscopic ablation of a simple parapelvic renal cyst for management of symptomatic renal calculus. Current literature regarding this surgical intervention and alternative methods is discussed. PMID:27579403

  2. Percutaneous Renal Cyst Ablation and Review of the Current Literature

    PubMed Central

    Desai, Devang; Pavicic, Matthew; Thompson, Melissa; Pisko, John

    2016-01-01

    Abstract Renal cysts are common and most often are discovered incidentally, but may require intervention if associated with pain, hypertension, or hematuria. Minimally invasive treatment options are preferred with numerous modalities available, including renal cyst ablation. This case report of a 61-year-old female describes the effective percutaneous drainage and endoscopic ablation of a simple parapelvic renal cyst for management of symptomatic renal calculus. Current literature regarding this surgical intervention and alternative methods is discussed.

  3. Diffuse elevated MIBG activity in the renal parenchyma caused by compromised renal blood flow.

    PubMed

    Liu, Bin; Codreanu, Ion; Yang, Jigang; Servaes, Sabah; Zhuang, Hongming

    2014-11-01

    Increased metaiodobenzylguanidine (MIBG) activity in the kidneys is usually focal and commonly attributed to radioactive urine accumulation in the renal pelvis. Hereby, we present 2 cases of abnormal diffuse MIBG activity in the kidneys caused by compromised renal blood flow. The patterns should be differentiated from physiologic renal MIBG activity, especially when the uptake is relatively symmetric as well as from regional MIBG-avid disease. PMID:24999702

  4. Endovascular Coil Embolization in a Postnephrostomy Renal Vein to Renal Pelvis Fistula

    SciTech Connect

    Anil, Gopinathan Taneja, Manish

    2011-02-15

    We report the case of a 74-year-old man with post-percutaneous-nephrostomy venous hemorrhage from an iatrogenic fistula between the renal pelvis and a large tributary of the renal vein. Conservative management failed to contain the hemorrhage. Hence the fistula was occluded by coil embolization through the renal vein. This endovascular approach enabled rapid and effective stoppage of the venous bleed.There was no recurrence of the bleed or any pertinent complication at 3-month follow-up.

  5. A case of Staphylococcus aureus meningitis associated with cryoglobulin-related renal failure and clinically mild encephalitis/encephalopathy with a reversible splenial lesion.

    PubMed

    Shimozono, Koji; Korenaga, Hideki; Mawatari, Reiko; Tsukishima, Naoki

    2016-05-31

    A 59-years old man, having untreated hypertension and diabetes, was admitted to our hospital because of lumbago and fever. A T2-weighted image of spine showed increased signal intensity of vertebra at L3 and L4. Methicillin-susceptible staphylococcus aureus (MSSA) infection was confirmed by blood culturing. Cerebrospinal fluid (CSF) analysis showed pleocytosis. Diagsosis of pyogenic spondylitis with bacterial meningitis was made. Diffusion-weighted magnetic imaging of the brain disclosed a focal hyperintense lesion in the corpus callosum which showed a low coefficient in the apparent diffusion coefficient mapping. This finding suggests a clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS). His symptoms temporarily ameliorated by antibiotic therapy. Two weeks later, however, his conscious level rapidly worsened to comatose state. Concomitantly he developed acute renal failure with severe proteinuria. Serum serology showed a positive cryoglobulin test. Mechanical ventilation, hemodialysis and steroid pulse therapy improved his consciousness with a resultant complete recovery of all symptoms. We emphasize the possible complications in some cases of MERS. PMID:27151224

  6. Three Synchronous Atypical Metastases of Clear Cell Renal Carcinoma to the Maxillary Gingiva, Scalp and the Distal Phalanx of the Fifth Digit: A Case Report.

    PubMed

    Selvi, Firat; Faquin, William C; Michaelson, Marc Dror; August, Meredith

    2016-06-01

    Oral cavity metastasis of malignant tumors is extremely rare and accounts for only 1% of all malignant oral tumors. Renal cell carcinoma (RCC) can metastasize to any part of the body, with a 15% risk of metastasis to the head and neck region when the disease is disseminated and a 1% risk when it is not. RCC also is the third most common infraclavicular neoplasm that metastasizes to the oral cavity, after lung carcinoma in men and breast carcinoma in women. In the maxillofacial region, the nasal cavity and paranasal sinuses are the most commonly affected sites, followed by the oral cavity. This report describes the case of a 51-year-old man with a history of clear RCC presenting with 3 synchronous atypical metastases of this tumor to the maxillary gingiva, scalp, and distal phalanx of the fifth digit. Clinical findings, diagnosis, pathology, and treatment of these lesions are discussed. Metastasis of RCC should always be included in the differential diagnosis when a new oral and maxillofacial lesion appears in a patient with a history of RCC because the metastatic lesions can often present in a broad spectrum of forms. The rapid growth of these lesions should alert clinicians to avoid any delays in biopsy examination and subsequent treatment, which is usually palliative, because prognosis is usually poor. PMID:26954558

  7. Simultaneous metastases of clear cell renal cell carcinoma to the urinary bladder and left retroperitoneal space: A case report and review of the literature

    PubMed Central

    LI, HENGPING; WANG, JIANZHONG; WEI, QIANG; WANG, HUAN

    2016-01-01

    The present study describes an extremely rare case of simultaneous metastases of clear cell renal cell carcinoma (ccRCC) to the urinary bladder and left retroperitoneal space, occurring subsequent to an open radical nephrectomy. A review of the literature is also considered. A 70-year-old man presenting with diabetes mellitus and hypertension was referred to West China Hospital (Chengdu, China) with constant left flank pain that had been apparent for 2 months. Ultrasonography identified a heterogeneous tumor with a solid component measuring 4.4×3.4×5.0 cm, and computed tomography (CT) revealed a circumscribed and contrast-enhanced tumor in the left kidney. Subsequent pathological analysis of the specimen, obtained from an open radical nephrectomy, confirmed the presence of ccRCC. At 1 month after the radical nephrectomy, an abdominopelvic CT scan identified tumors located on the posterior bladder wall and also in the left retroperitoneal space, forming due to hematuria and acute urinary clot retention. There was no evidence of metastasis to the lungs, bones or other organs. A transurethral resection of the bladder tumor was performed and pathological analysis of the bladder specimen demonstrated metastatic ccRCC. Extensive hydrothorax and general anasarca presented half a month after the transurethral resection, with the patient subsequently succumbing 15 days later. PMID:27347119

  8. A novel mutation of the HNF1B gene associated with hypoplastic glomerulocystic kidney disease and neonatal renal failure: a case report and mutation update.

    PubMed

    Alvelos, Maria Inês; Rodrigues, Magda; Lobo, Luísa; Medeira, Ana; Sousa, Ana Berta; Simão, Carla; Lemos, Manuel Carlos

    2015-02-01

    Hepatocyte nuclear factor 1 beta (HNF1B) plays an important role in embryonic development, namely in the kidney, pancreas, liver, genital tract, and gut. Heterozygous germline mutations of HNF1B are associated with the renal cysts and diabetes syndrome (RCAD). Affected individuals may present a variety of renal developmental abnormalities and/or maturity-onset diabetes of the young (MODY). A Portuguese 19-month-old male infant was evaluated due to hypoplastic glomerulocystic kidney disease and renal dysfunction diagnosed in the neonatal period that progressed to stage 5 chronic renal disease during the first year of life. His mother was diagnosed with a solitary hypoplastic microcystic left kidney at age 20, with stage 2 chronic renal disease established at age 35, and presented bicornuate uterus, pancreatic atrophy, and gestational diabetes. DNA sequence analysis of HNF1B revealed a novel germline frameshift insertion (c.110_111insC or c.110dupC) in both the child and the mother. A review of the literature revealed a total of 106 different HNF1B mutations, in 236 mutation-positive families, comprising gross deletions (34%), missense mutations (31%), frameshift deletions or insertions (15%), nonsense mutations (11%), and splice-site mutations (8%). The study of this family with an unusual presentation of hypoplastic glomerulocystic kidney disease with neonatal renal dysfunction identified a previously unreported mutation of the HNF1B gene, thereby expanding the spectrum of known mutations associated with renal developmental disorders. PMID:25700310

  9. [Renal physiology].

    PubMed

    Gueutin, Victor; Deray, Gilbert; Isnard-Bagnis, Corinne

    2012-03-01

    The kidneys are responsible for the urinary excretion of uremic toxins and the regulation of several body systems such as intra and extracellular volume status, acid-base status, calcium and phosphate metabolism or erythropoiesis. They adapt quantitative and qualitative composition of the urine to keep these systems in balance. The flow of plasma is filtered in the range of 120 mL/min, and depends on the systemic and renal hemodynamics which is subject to self-regulation. The original urine will then be modified in successive segments of the nephron. The proximal nephron is to lead the massive reabsorption of water and essential elements such as sodium, bicarbonates, amino-acids and glucose. The distal nephron includes the distal convoluted tubule, the connector tube and the collecting duct. Its role is to adapt the quality composition of urine to the needs of the body. PMID:22157516

  10. Acute Kidney Injury Associated with Renal Cell Carcinoma Complicated by Renal Vein and Inferior Vena Cava Involvement.

    PubMed

    Sugase, Taro; Akimoto, Tetsu; Kubo, Taro; Imai, Toshimi; Otani-Takei, Naoko; Miki, Takuya; Takeda, Shin-Ichi; Nukui, Akinori; Muto, Shigeaki; Morita, Tatsuo; Nagata, Daisuke

    2016-01-01

    Acute kidney injury (AKI) is caused by diverse pathologies, although it may occasionally result from concurrent renal efflux disturbances. We herein describe a case of AKI in a patient complicated by renal cell carcinoma (RCC) with renal vein and inferior vena cava (IVC) involvement. A neoplastic thrombus which disrupted the blood flow in the renal vein appeared to play a role in the rapid decline in the renal function. Such a scenario has rarely been mentioned in the previous literature describing the cases of RCC complicated by AKI. Concerns regarding the diagnostic and therapeutic strategies for RCC are also discussed. PMID:27580548

  11. Double left renal veins and multiple right renal veins found in Japanese adults.

    PubMed

    Yahiro, J; Miyoshi, S

    1993-12-01

    A case of circumaortic renal venous collar, the first such collar to be observed in a Japanese female cadaver, is presented, and its anatomical organization is compared with that in another case in which four right renal veins accompanied four right and three left renal arteries in a Japanese male cadaver. Double left renal veins are formed by persistence of a more central retroaortic venous anastomosis, in contrast to multiple right renal veins, which are formed by persistence of some embryonic renal veins arranged in ladder-like patterns. In our case, the dorsal limb of the renal collar communicated with the azygos system veins and lumbar veins. The azygos system veins were considered to have atrophied as a result of some persisting retroaortic venous anastomoses located in the thorax. Therefore, we believe that the renal collar was related to the atrophy of the azygos system veins. To determine whether there are racial differences in incidence of renal collar, further studies in Asians are required. PMID:8202308

  12. Gallbladder bleeding-related severe gastrointestinal bleeding and shock in a case with end-stage renal disease

    PubMed Central

    Tsai, Jun-Li; Tsai, Shang-Feng

    2016-01-01

    Abstract Gallbladder (GB) bleeding is very rare and it is caused by cystic artery aneurysm and rupture, or GB wall rupture. For GB rupture, the typical findings are positive Murphy's sign and jaundice. GB bleeding mostly presented as hemobilia. This is the first case presented with severe GI bleeding because of GB rupture-related GB bleeding. After comparing computed tomography, one gallstone spillage was noticed. In addition to gallstones, uremic coagulopathy also worsens the bleeding condition. This is also the first case that patients with GB spillage-related rupture and bleeding were successfully treated by nonsurgical management. Clinicians should bear in mind the rare causes of GI bleeding. Embolization of the bleeding artery should be attempted as soon as possible. PMID:27281100

  13. Renal artery injury during robot-assisted renal surgery.

    PubMed

    Lee, Jae Won; Yoon, Young Eun; Kim, Dae Keun; Park, Sung Yul; Moon, Hong Sang; Lee, Tchun Yong

    2010-07-01

    Laparoscopic partial nephrectomy (LPN) is becoming the standard of care for incidentally diagnosed, small renal tumors. With its seven degrees of freedom and three-dimensional vision, the DaVinci robotic surgical system has been used to assist in LPNs. The main disadvantage of robot-assisted surgery, however, is the lack of tactile feedback. We present a case of renal artery injury during robot-assisted renal surgery. Robot-assisted partial nephrectomy (RPN) was planned for 47-year-old man with a 3.5-cm right renal mass. After standard bowel mobilization, renal hilar dissection was performed. In the attempt to complete the dissection posteriorly, however, there was sudden profuse bleeding. The intraperitoneal pressure immediately increased to 20 mm Hg, and an additional suction device was inserted through the 5-mm liver retractor port. On inspection, there was an injury at the takeoff of the posterior segmental artery. A decision was made to convert to robot-assisted laparoscopic radical nephrectomy. The main renal artery and renal vein were controlled with Hem-o-Lok clips. The estimated blood loss was 2,000 mL. Four units of packed red blood cells were transfused intraoperatively. The post-transfusion hemoglobin level was 12.6 g/dL. There were no other perioperative complications. The surgeon should keep in mind that the robotic arms are very powerful and can easily injure major vessels because of lack of tactile feedback. A competent and experienced tableside surgeon is very important in robot-assisted surgery because the unsterile console surgeon cannot immediately react to intraoperative complications. PMID:20590468

  14. A suspected case of plasma cell-rich acute renal transplant rejection associated with de novo donor-specific antibody.

    PubMed

    Yoshikawa, Mikiko; Kitamura, Ken; Ishimura, Takeshi; Hara, Shigeo; Fujisawa, Masato; Nishi, Shinichi

    2015-07-01

    A kidney transplant case with de novo donor-specific antibody showed monoclonal plasma cell infiltration into the graft with ABO incompatibility. Three years after transplantation, the patient's graft function suddenly deteriorated. Interstitial edema and the predominant infiltration of inflammatory plasma cells with kappa chain monoclonality were observed in biopsy specimens. The in situ hybridization of Epstein-Barr virus was negative and post-transplant lymphoproliferative disorder was not evident from radiological examinations. On laboratory examination, the patient had de novo donor-specific antibody for HLA-DQ. We suspected plasma cell-rich acute rejection for which methylprednisolone pulse therapy, plasma exchange, rituximab, and 15-deoxyspergualin were given. In the ensuing biopsy, the degree of plasma cell infiltration was similar to the first biopsy; however, kappa chain monoclonality relatively weakened. Owing to resistance to these treatments, intravenous immunoglobulin (IVIG) (0.5 g/kg/day) was added. The serum creatinine level gradually declined to 3.1 mg/dL; however, it increased up to 3.6 mg/dL again. In the final biopsy, the infiltrated plasma cells disappeared but severe interstitial fibrosis developed. This case showed difficulty in the diagnosis and treatment of plasma cell-rich acute rejection. A detailed consideration of this case may be helpful in understanding the clinical features and pathogenesis of this condition. PMID:26031590

  15. 99mtechnetium-dimercapto-succinic acid renal scanning and excretory urography in diagnosis of renal scars in children

    SciTech Connect

    McLorie, G.A.; Aliabadi, H.; Churchill, B.M.; Ash, J.M.; Gilday, D.L. )

    1989-09-01

    We compared the ability of excretory urography (without tomography) and 99mtechnetium-dimercapto-succinic acid renal scanning to detect renal scars in 32 children with primary vesicoureteral reflux. These children did not have hydronephrosis, renal failure or urinary tract obstruction. In all cases both studies were conducted within a 10-month period. The findings from both modalities were in agreement for 51 of the 64 renal units evaluated (80%). Evaluation of the excretory urogram indicated 6 cases of diffuse and 2 of focal scarring that were not detected by evaluation of the renal scan. The sensitivity of excretory urography to detect renal scars was 84% and the specificity was 83%. The 99mtechnetium-dimercapto-succinic acid renal scan showed 5 cases of focal renal scarring not detected by excretory urography. The sensitivity of the renal scan to detect renal scars was 77% and the specificity was 75%. We conclude that neither study alone could effectively replace the other for the detection of renal scars, and recommend that both be included in the initial evaluation and followup of patients with renal scars.

  16. [Multicystic renal dysplasia and Wilms tumor].

    PubMed

    Muguerza, R; Martínez-Urrutia, M J; López Pereira, P; Picazo, L; Blesa, E; Jaureguizar, E

    1996-10-01

    We review a case of multicystic right dysplasia containing nodular renal blastema in a 3-year-old girl with left Wilms tumor. In relation to this finding the management of the asymptomatic multicystic dysplastic kidney in discussed. PMID:9131988

  17. Hereditary renal adysplasia: new observations and hypotheses.

    PubMed

    Moerman, P; Fryns, J P; Sastrowijoto, S H; Vandenberghe, K; Lauweryns, J M

    1994-01-01

    Renal agenesis and dysplasia are frequently regarded by pathologists, even pediatric pathologists, as sporadic malformations. We report six fetal autopsy cases of hereditary renal adysplasia (HRA): two pairs of siblings, one case with paternal unilateral renal agenesis, and one case with an autosomal balanced 6p/19q translocation. The main purpose of this paper is to emphasize that nonsyndromal renal agenesis and dysplasia are pathogenetically related and often inherited as an autosomal dominant trait with incomplete penetrance and variable expression. A subsidiary purpose is to present a case of bilateral multicystic dysplasia with a balanced 6p/19q translocation. This observation further supports the assignment of one of the loci for HRA to chromosome 6p. PMID:8065999

  18. Effect of different breathing patterns in the same patient on stereotactic ablative body radiotherapy dosimetry for primary renal cell carcinoma: A case study

    SciTech Connect

    Pham, Daniel; Kron, Tomas; Foroudi, Farshad; Siva, Shankar

    2013-10-01

    Stereotactic ablative body radiotherapy (SABR) for primary renal cell carcinoma (RCC) targets requires motion management strategies to verify dose delivery. This case study highlights the effect of a change in patient breathing amplitude on the dosimetry to organs at risk and target structures. A 73-year-old male patient was planned for receiving 26 Gy of radiation in 1 fraction of SABR for a left primary RCC. The patient was simulated with four-dimensional computed tomography (4DCT) and the tumor internal target volume (ITV) was delineated using the 4DCT maximum intensity projection. However, the initially planned treatment was abandoned at the radiation oncologist's discretion after pretreatment cone-beam CT (CBCT) motion verification identified a greater than 50% reduction in superior to inferior diaphragm motion as compared with the planning 4DCT. This patient was resimulated with respiratory coaching instructions. To assess the effect of the change in breathing on the dosimetry to the target, each plan was recalculated on the data set representing the change in breathing condition. A change from smaller to larger breathing showed a 46% loss in planning target volume (PTV) coverage, whereas a change from larger breathing to smaller breathing resulted in an 8% decrease in PTV coverage. ITV coverage was similarly reduced by 8% in both scenarios. This case study highlights the importance of tools to verify breathing motion prior to treatment delivery. 4D image guided radiation therapy verification strategies should focus on not only verifying ITV margin coverage but also the effect on the surrounding organs at risk.

  19. Hyperdense renal masses: a CT manifestation of hemorrhagic renal cysts

    SciTech Connect

    Sussman, S.; Cochran, S.T.; Pagani, J.J.; McArdle, C.; Wong, W.; Austin, R.; Curry, N.; Kelly, K.M.

    1984-01-01

    Eleven patients with sharply circumscribed round to ovoid renal cysts measuring 70-90 H on CT are reported. The cysts were hyperdense on unenhanced scans, measuring 30-60 H greater than the adjacent parenchyma, and either hypodense, isodense, or hyperdense on enhanced scans. Four patients had polycystic kidney disease; of the other 7 patients, the cysts were cortical in 6 and parapelvic in 1. Eight patients had a solitary cyst and 3 had multiple cysts. Sonography demonstrated internal echoes and/or lack of increased through-transmission in 6 patients. Pathological analysis was available in 6 cases and indicated a benign, hemorrhagic renal cyst. This hyperdense CT appearance is characteristic of some hemorrhagic renal cysts, though differentiation between benign and malignant cysts requires cyst puncture and/or surgery.

  20. The role of renal biopsy in small renal masses

    PubMed Central

    Burruni, Rodolfo; Lhermitte, Benoit; Cerantola, Yannick; Tawadros, Thomas; Meuwly, Jean-Yves; Berthold, Dominik; Jichlinski, Patrice; Valerio, Massimo

    2016-01-01

    Renal biopsy is being increasingly proposed as a diagnostic tool to characterize small renal masses (SRM). Indeed, the wide adoption of imaging in the diagnostic workup of many diseases had led to a substantial increased incidence of SRM (diameter ≤4 cm). While modern ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) techniques have high sensitivity for detecting SRM, none is able to accurately and reliably characterize them in terms of histological features. This is currently of key importance in guiding clinical decision-making in some situations, and in these cases renal biopsy should be considered. In this review, we aim to summarize the technique, diagnostic performance, and predicting factors of nondiagnostic biopsy, as well as the future perspectives. PMID:26858784

  1. Segmental Renal Infarction due to Blunt Trauma

    PubMed Central

    Alevizopoulos, Aristeidis; Hamilton, Lauren; Stratu, Natalia; Rix, Gerald

    2016-01-01

    Segmental renal infarction is a rare situation which has been reported so far in the form of case reports. It's caused usually by cardiac conditions, such as atrial fibrillation, and systemic diseases (e.g. systemic lupus erythematous). We are presenting a case of a 31 year old healthy male, who sustained a left segmental renal infarction, following a motorbike accident. We report his presentation, management and outcome. We also review the literature in search of the optimal diagnostic and treatment pathway. To our knowledge, this is the first report of segmental renal infarction due to blunt trauma. PMID:27175338

  2. Fibromuscular Dysplasia Presenting with Bilateral Renal Infarction

    SciTech Connect

    Doody, O.; Adam, W. R.; Foley, P. T.; Lyon, S. M.

    2009-03-15

    Fibromuscular dysplasia (FMD) describes a group of conditions which cause nonatheromatous arterial stenoses, most commonly of the renal and carotid arteries, typically in young women. We report a rare case of bilateral segmental renal infarction secondary to FMD in a young male patient. His initial presentation with loin pain and pyrexia resulted in a delay in the definitive diagnosis of FMD. He was successfully treated with bilateral balloon angioplasty. The delayed diagnosis in this patient until the condition had progressed to bilateral renal infarcts highlights the need for prompt investigation and diagnosis of suspected cases of FMD.

  3. Transcatheter stent implantation for the treatment of abdominal aortic coarctation and right renal artery stenosis in takayasu's arteritis: a case with a 4-year follow up.

    PubMed

    Ghazi, Payam; Haji-Zeinali, Ali-Mohammad; Ghasemi, Masuood; Pour, Manijeh Zargham

    2011-01-01

    We describe a Takayasu arteritis patient who was admitted because of an abdominal aortic stenosis, further complicated by the presence of a stenotic right renal artery located in the area of the aortic stenosis. After treatment of the renal stenosis with a 4 × 15 mm Driver stent, a 16 × 60 self-expandable nitinol stent (OptiMed) was deployed through the stenosis of the abdominal aorta. Even though the right renal artery was initially compromised after stent deployment through the aortic stenosis, the patient was successfully treated with renal artery re-dilation by a balloon passed through open cells of the aortic stent. During follow up, the patient suffered no procedure-related complications. PMID:21478132

  4. Zygomycosis in a renal allograft recipient

    PubMed Central

    Lakshminarayana, G.; Rajesh, R.; Kurian, G.; Unni, V. N.

    2009-01-01

    Invasive fungal infections can cause considerable morbidity and mortality in immunocompromised patients. Zygomycosis is a type of invasive fungal infection with a rapid course and grave prognosis. Renal transplant recipients with concomitant diabetes mellitus are most susceptible to this infection. We report here a case of disseminated zygomycosis (Rhizopus sp.) in a renal allograft recipient with posttransplant diabetes mellitus (PTDM). This is the first reported case of zygomycosis caused by Rhizopus species. PMID:20352010

  5. Renal Presentation in Pediatric Acute Leukemia

    PubMed Central

    Sherief, Laila M.; Azab, Seham F.; Zakaria, Marwa M.; Kamal, M.; Elbasset Aly, Maha Abd; Ali, Adel; Alhady, Mohamed Abd

    2015-01-01

    Abstract Renal enlargement at time of diagnosis of acute leukemia is very unusual. We here in report 2 pediatric cases of acute leukemia who had their renal affection as the first presenting symptom with no evidences of blast cells in blood smear and none of classical presentation of acute leukemia. The first case is a 4-year-old girl who presented with pallor and abdominal enlargement. Magnetic resonance imaging showed bilateral symmetrical homogenous enlarged kidneys suggestive of infiltration. Complete blood picture (CBC) revealed white blood count 11 × 109/L, hemoglobin 8.7 g/dL and platelet count 197 × 109/L. Bone marrow aspiration was performed, and diagnosed precursor B-cell ALL was made. The child had an excellent response to modified CCG 1991 standard risk protocol of chemotherapy with sustained remission, but unfortunately relapsed 11 month after the end of therapy. The second child was 13-month old, presented with pallor, vomiting, abdominal enlargement, and oliguria 2 days before admission. Initial CBC showed bicytopenia, elevated blood urea, creatinine, and serum uric acid, while abdominal ultrasonography revealed bilateral renal enlargement. Bone marrow examination was done and showed 92% blast of biphenotypic nature. So, biphynotypic leukemia with bilateral renal enlargement and acute renal failure was subsequently diagnosed. The patients admitted to ICU and received supportive care and prednisolone. Renal function normalized and chemotherapy was started. The child achieved complete remission with marked reduction of kidney size but, unfortunately she died from sepsis in consolidation phase of therapy. This case demonstrates an unusual early renal enlargement in childhood acute leukemia. Renal involvement of acute leukemia should be considered in child presenting with unexplained bilateral renal enlargement with or without renal function abnormalities and bone marrow examination should be included in the workup. PMID:26376384

  6. Hepatocyte Growth Factor Prevents Acute Renal Failure of Accelerates Renal Regeneration in mice

    NASA Astrophysics Data System (ADS)

    Kawaida, Kouichi; Matsumoto, Kunio; Shimazu, Hisaaki; Nakamura, Toshikazu

    1994-05-01

    Although acute renal failure is encountered with administration of nephrotoxic drugs, ischemia, or unilateral nephrectomy, there has been no effective drug which can be used in case of acute renal failure. Hepatocyte growth factor (HGF) is a potent hepatotropic factor for liver regeneration and is known to have mitogenic, motogenic, and morphogenic activities for various epithelial cells, including renal tubular cells. Intravenous injection of recombinant human HGF into mice remarkably suppressed increases in blood urea nitrogen and serum creatinine caused by administration of cisplatin, a widely used antitumor drug, or HgCl_2, thereby indicating that HGF strongly prevented the onset of acute renal dysfunction. Moreover, exogenous HGF stimulated DNA synthesis of renal tubular cells after renal injuries caused by HgCl_2 administration and unilateral nephrectomy and induced reconstruction of the normal renal tissue structure in vivo. Taken together with our previous finding that expression of HGF was rapidly induced after renal injuries, these results allow us to conclude that HGF may be the long-sought renotropic factor for renal regeneration and may prove to be effective treatment for patients with renal dysfunction, especially that caused by cisplatin.

  7. Primary Renal Hydatid Cyst: Mis-Interpretation as a Renal Malignancy

    PubMed Central

    Choi, Hoon; Park, Jae Young; Kim, Jae-Heon; Moon, Du Geon; Lee, Jeong-Gu

    2014-01-01

    Primary renal echinococcosis, a rare disease involving the kidney, accounts for 2-3% of human echinococcosis. A 64-year-old female patient from Uzbekistan presented with complaints of left flank pain. A CT scan revealed a cystic mass in the upper to midpole of the left kidney. We regarded this lesion as a renal malignancy and hand-assisted laparoscopic radical nephrectomy was performed to remove the renal mass. The mass consisted of a large unilocular cyst and multiple smaller cysts without any grossly visible renal tissue. The final pathologic diagnosis was a renal hydatid cyst. For patients from endemic areas, hydatid cyst should be included in the differential diagnosis. Here, we present a case of renal hydatid cyst in a female patient who relocated from Uzbekistan to Korea. PMID:25031471

  8. Isolated renal hydatid presenting as a complex renal lesion followed by spontaneous hydatiduria.

    PubMed

    Bhaya, Anil; Shinde, Archana P

    2015-07-28

    Echinococcosis is a zoonotic disease. Liver is the most common site of involvement. Renal involvement is seen in 2% to 3% of patients. Computed tomography findings in renal hydatid typically include: a cyst with thick or calcified wall, unilocular cyst with detached membrane, a multiloculated cyst with mixed internal density and daughter cysts with lower density than maternal matrix. Rarely type IV hydatid cysts may mimic hypovascular renal cell carcinoma. We report a case of previously asymptomatic middle aged female who presented with mild intermittent pain and a complex renal lesion on imaging which was considered to be a hypovascular renal carcinoma or urothelial neoplasm. However, by serendipity, the patient had spontaneous hydatiduria and later was definitively diagnosed and stented. Hydatid disease should always be considered amongst the top differential diagnosis of an isolated "complex" renal lesion which remains indeterminate on imaging. PMID:26217457

  9. Isolated renal hydatid presenting as a complex renal lesion followed by spontaneous hydatiduria

    PubMed Central

    Bhaya, Anil; Shinde, Archana P

    2015-01-01

    Echinococcosis is a zoonotic disease. Liver is the most common site of involvement. Renal involvement is seen in 2% to 3% of patients. Computed tomography findings in renal hydatid typically include: a cyst with thick or calcified wall, unilocular cyst with detached membrane, a multiloculated cyst with mixed internal density and daughter cysts with lower density than maternal matrix. Rarely type IV hydatid cysts may mimic hypovascular renal cell carcinoma. We report a case of previously asymptomatic middle aged female who presented with mild intermittent pain and a complex renal lesion on imaging which was considered to be a hypovascular renal carcinoma or urothelial neoplasm. However, by serendipity, the patient had spontaneous hydatiduria and later was definitively diagnosed and stented. Hydatid disease should always be considered amongst the top differential diagnosis of an isolated “complex” renal lesion which remains indeterminate on imaging. PMID:26217457

  10. Familial renal cancer as an indicator of hereditary leiomyomatosis and renal cell cancer syndrome.

    PubMed

    Raymond, Victoria M; Herron, Casey M; Giordano, Thomas J; Gruber, Stephen B

    2012-03-01

    Hereditary Leiomyomatosis and Renal Cell Carcinoma (HLRCC) is a hereditary condition which typically presents with cutaneous and uterine leiomyomata. Papillary type II renal cell carcinoma and other less common histologic subtypes of renal cancer have been reported in HLRCC. We describe the case of a 31-year-old man in which the pathology review of his renal carcinoma and a positive family history of renal carcinoma allowed for the identification of a pathogenic mutation in the FH gene (c.698G>A;p.R233H) confirming the diagnosis of HLRCC. Recognition of this syndrome allowed for appropriate surveillance as well as identification of at-risk family members. Pathology review is essential for accurate diagnosis of a hereditary cancer syndrome in the setting of familial renal cancer. PMID:22127509

  11. [Post-denervation renal artery stenosis - a matter of concern?].

    PubMed

    Cordeanu, M; Gaertner, S; Prinz, É; Bronner, F; Jahn, C; Hannedouche, T; Stephan, D

    2015-06-01

    Renal denervation, an invasive technique indicated in resistant hypertension patients insufficiently controlled by antihypertensive drugs, has a good safety profile. However, an increasing number of post-denervation renal artery stenosis cases has recently been reported. We describe the case of a 49-year-old woman with resistant hypertension who was referred to our university hypertension center for renal sympathetic denervation. Her daily treatment included six antihypertensive drugs. CT angiography prior to denervation showed no renal artery stenosis or vessel wall lesions. A standard renal denervation procedure using the St Jude protocol was performed. After an initial improvement in blood pressure profile, she presented with a blood pressure impairment at 3 months after renal denervation leading to the diagnosis of a severe right renal artery stenosis. PMID:26047879

  12. Renal Biopsy in Type 2 Diabetic Patients

    PubMed Central

    Espinel, Eugenia; Agraz, Irene; Ibernon, Meritxell; Ramos, Natalia; Fort, Joan; Serón, Daniel

    2015-01-01

    The majority of diabetic patients with renal involvement are not biopsied. Studies evaluating histological findings in renal biopsies performed in diabetic patients have shown that approximately one third of the cases will show pure diabetic nephropathy, one third a non-diabetic condition and another third will show diabetic nephropathy with a superimposed disease. Early diagnosis of treatable non-diabetic diseases in diabetic patients is important to ameliorate renal prognosis. The publication of the International Consensus Document for the classification of type 1 and type 2 diabetes has provided common criteria for the classification of diabetic nephropathy and its utility to stratify risk for renal failure has already been demonstrated in different retrospective studies. The availability of new drugs with the potential to modify the natural history of diabetic nephropathy has raised the question whether renal biopsies may allow a better design of clinical trials aimed to delay the progression of chronic kidney disease in diabetic patients. PMID:26239461

  13. Colchicine myoneuropathy in a renal transplant patient.

    PubMed

    Dupont, Peter; Hunt, Ian; Goldberg, Lawrence; Warrens, Anthony

    2002-07-01

    Colchicine is widely employed for the treatment of gout in renal transplant patients where NSAIDs are contra-indicated and allopurinol prophylaxis is often avoided due to concomitant azathioprine immunosuppression. We report here a case of colchicine-induced myoneuropathy in a renal transplant recipient. Our patient had myalgia, muscle weakness, elevated creatine kinase levels, myopathic changes on electromyography and peripheral neuropathy. Withdrawal of colchicine resulted in recovery within 4 weeks. Renal transplant recipients are likely to be at greater risk of colchicine-induced myoneuropathy due to the unique concurrence of risk factors predisposing to toxicity in such patients. These risk factors include the high incidence of gout in this population, widespread use of colchicine as first-line therapy, impaired renal function and concomitant cyclosporin treatment. The diagnosis should be considered in any renal transplant recipient receiving the drug who develops myopathy. Prompt withdrawal of colchicine therapy should result in rapid clinical and biochemical improvement. PMID:12122515

  14. Analysis of Renal Anomalies in VACTERL Association

    PubMed Central

    Cunningham, Bridget K.; Khromykh, Alina; Martinez, Ariel F.; Carney, Tyler; Hadley, Donald W.; Solomon, Benjamin D.

    2014-01-01

    VACTERL association refers to a combination of congenital anomalies that can include: Vertebral anomalies, Anal atresia, Cardiac malformations, Tracheo-Esophageal fistula with esophageal atresia, Renal anomalies (typically structural renal anomalies), and Limb anomalies. We conducted a description of a case series to characterize renal findings in a cohort of patients with VACTERL association. Out of the overall cohort, 48 patients (with at least 3 component features of VACTERL and who had abdominal ultrasound performed) met criteria for analysis. Four other patients were additionally analyzed separately, with the hypothesis that subtle renal system anomalies may occur in patients who would not otherwise meet criteria for VACTERL association. Thirty-three (69%) of the 48 patients had a clinical manifestation affecting the renal system. The most common renal manifestation (RM) was vesicoureteral reflux (VUR) in addition to a structural defect (present in 27%), followed by unilateral renal agenesis (24%), and then dysplastic/multicystic kidneys or duplicated collected system (18% for each). Twenty-two (88%) of the 25 patients with a structural RM had an associated anorectal malformation. Individuals with either isolated lower anatomic anomalies, or both upper and lower anatomic anomalies were not statistically more likely to have a structural renal defect than those with isolated upper anatomic anomalies (p=0.22, p=0.284 respectively). Given the high prevalence of isolated VUR in our cohort, we recommend a screening VCUG or other imaging modality be obtained to evaluate for VUR if initial renal US shows evidence of obstruction or renal scarring, as well as ongoing evaluation of renal health. PMID:25196458

  15. Interpreting overall survival results when progression-free survival benefits exist in today’s oncology landscape: a metastatic renal cell carcinoma case study

    PubMed Central

    Tang, Yiyun; Bycott, Paul; Åkerborg, Örjan; Jönsson, Linus; Negrier, Sylvie; Chen, Connie

    2014-01-01

    Background The debate surrounding the acceptance of progression-free survival (PFS) as an intermediate endpoint to overall survival (OS) has grown in recent years, due to the challenges in demonstrating an OS benefit within clinical trials today. PFS is generally a good predictor of OS for cases where survival post-progression (SPP) is short, and less so when SPP is long. SPP depends on multiple factors, including residual effect from experimental treatment and effect from crossover or other subsequent therapies, posing unique challenges into the translation of PFS benefit into OS. Methods The objective of this analysis was to conduct simulations investigating how increasing SPP impacts PFS translation to OS, utilizing data from the AXIS (axitinib versus sorafenib in advanced metastatic renal cell carcinoma) trial. The underlying assumption was a treatment benefit in PFS (the PFS distribution parameters were chosen to be equal to median PFS in the AXIS trial) but no treatment effect on SPP, implying that PFS improvement is directly reflected in OS improvement. Results The probability of a statistically significant difference between arms for OS decreased from 54.7% to 6.1% when median SPP was increased from one to 20 months. The probability of the hazard ratio of OS being ≥0.9 was similarly increased from 24.3% to 72.6%, even though the hazard ratio for PFS was 0.69. Conclusion The present study shows that when simulated SPP is added to trial PFS data, the existing PFS benefit is diluted. Knowing that the AXIS treatment arms are well balanced with respect to post-trial treatments, we conclude that the PFS to OS benefit translation is primarily obscured by random variability largely unrelated to the true outcomes. The implications for drug development are not insignificant, as there would be a need to include more patients in studies or utilize a longer follow-up time to overcome the SPP variability issue. PMID:25278784

  16. Methylene blue treatment for cytokine release syndrome-associated vasoplegia following a renal transplant with rATG infusion: A case report and literature review

    PubMed Central

    DENNY, JOHN T.; BURR, ANDREW T.; BALZER, FRED; TSE, JAMES T.; DENNY, JULIA E.; CHYU, DARRICK

    2015-01-01

    Rabbit anti-thymocyte globulin (rATG) is an infusion of polyclonal rabbit-derived antibodies against human thymocyte markers, which can be used to prevent and treat acute rejection following organ transplantation. However, the product monograph issued by the manufacturer (Sanofi Canada) reports that serious immune-mediated reactions have been observed following the use of rATG, consisting of anaphylaxis or severe cytokine release syndrome (CRS), which is a form of vasoplegic syndrome (VS), in which distributive shock occurs refractory to norepinephrine (NE) and vasopressin (VP). Severe infusion-associated reactions are consistent with CRS and can cause serious cardiac or respiratory problems, or in certain cases, mortality. CRS is a form of systemic inflammatory response syndrome (SIRS). In SIRS, the substantial activation of endothelial inducible nitric oxide synthase (iNOS) and smooth muscle guanylate cyclase (GC) is observed, which can produce severe hypotension that is unresponsive to conventional vasopressors. Methylene blue (MB) is a direct inhibitor of iNOS and GC and has been used as an effective treatment for VS following cardiothoracic surgery. In the present study, the successful use of MB as a rescue therapy for CRS in a patient receiving rATG following a renal transplant was reported. Following an uneventful cadaveric kidney transplant involving the intravenous (IV) administration of rATG for the induction of immunological tolerance, the patient became markedly hypotensive and tachycardic. The patient required high doses of VP and NE infusions. Following the protocol described for treating refractory VS in post-cardiac surgery patients, the decision was made to initiate the patient on an IV MB infusion. This treatment protocol was shown to improve the hemodynamic status of the patient, which enabled the withdrawal of vasopressors and suggests an important role for methylene blue in the management of refractory VS. PMID:26136914

  17. A primary Sjögren's syndrome patient with distal renal tubular acidosis, who presented with symptoms of hypokalemic periodic paralysis: Report of a case study and review of the literature.

    PubMed

    Soy, Mehmet; Pamuk, Omer Nuri; Gerenli, Murat; Celik, Yahya

    2005-11-01

    Although renal tubular acidosis (RTA), secondary to autoimmune interstitial nephritis, develops in a large proportion of patients with Sjögren's syndrome (SS), most of the subjects are asymptomatic. Here, we shall present a 39-year-old female patient who came to us with hypokalemic periodic paralysis (HPP), and who was later diagnosed with distal RTA. The patient, who had xerostomia and xerophthalmia for a long period of time, was diagnosed with primary SS from serologic and histologic findings. The patient recovered by being prescribed potassium replacement therapy. Although renal biopsy was not performed, corticosteroids were administered because HPP indicated severe interstitial nephritis. HPP did not reoccur during a 2-year follow-up period. We also review cases with SS-related distal RTA and HPP. PMID:15690142

  18. Renal infarct: a rare disease due to a rare etiology

    PubMed Central

    Akshintala, Divya; Bansal, Saurabh K.; Emani, Vamsi Krishna; Yadav, Manajyoti

    2015-01-01

    Renal infarction is caused by profound hypoperfusion secondary to embolic/thrombotic occlusion of the renal artery or vasospasm of the renal artery. We present a case of a 54-year-old patient who presented with nausea, vomiting, and vague abdominal pain. He had frequent episodes of migraine headaches and he treated himself with as needed rizatriptan. CT scan of the abdomen showed renal cortical infarction. After extensive investigations, etiology of his renal infarct was deemed to be due to rizatriptan. PMID:26091657

  19. Transition of organizational category on renal cancer.

    PubMed

    Nagashima, Yoji; Kuroda, Naoto; Yao, Masahiro

    2013-03-01

    The incidence of kidney cancer is gradually increasing, with a rate of 2-3% per decade. The kidney develops various kinds of neoplasms, some of which are associated with familial cancer syndromes. Such cases have provided clues to identify the cancer-responsible genes. In 2004, the World Health Organization published a new classification system of renal neoplasms, incorporating recent knowledge obtained in the cytogenetic and molecular biological fields, i.e. genes responsible for each histologic subtype (von Hippel-Lindau for clear cell renal cell carcinoma, c-met for papillary renal cell carcinoma type 1, etc.). Subsequently, the Japanese classification system in 'the General Rule for Clinicopathological Study of Renal Cell Carcinoma' has been revised as the 4th edition, according to the World Health Organization system. Several novel subtypes have been introduced, i.e. mucinous tubular and spindle cell carcinoma, and Xp11.2/TFE3 translocation-associated renal cell carcinoma. Even after the publication of the classification, other novel subtypes have emerged, i.e. acquired cystic disease-associated renal cell carcinoma and tubulocystic renal cell carcinoma. Additionally, some of the subtypes seem to form families based on morphological transition, immunohistochemical features and gene expression profile. In future, the classification of renal cell carcinoma should be reorganized on the basis of molecular biological characteristics to establish personalized therapeutic strategies. PMID:23390307

  20. Renal leiomyosarcoma in a cat.

    PubMed

    Evans, Dawn; Fowlkes, Natalie

    2016-05-01

    Renal leiomyosarcoma was diagnosed in a 10-year-old Domestic Shorthair cat with a 3-year history of clinically managed, chronic renal disease. Sudden death was preceded by a brief episode of mental dullness and confusion. At postmortem examination, the gross appearance of the left kidney was suggestive of hydronephrosis, and a nephrolith was present in the contralateral kidney. However, histology revealed an infiltrative, poorly differentiated, spindle cell sarcoma bordering the grossly cavitated area. Neoplastic cells were immunoreactive for vimentin and smooth muscle actin, which led to a diagnosis of renal leiomyosarcoma; neoplastic cells were not immunoreactive for desmin. Leiomyosarcoma arising in the kidney is a rare occurrence in humans and an even rarer occurrence in veterinary medicine with no prior cases being reported in cats in the English literature. The macroscopic appearance of the tumor at postmortem examination was misleadingly suggestive of hydronephrosis as a result of the large cavitation and may be similar to particularly unusual cases of renal leiomyosarcomas in humans that have a cystic or cavitated appearance. PMID:26975352