scholarly journals POS-164 PRIMARY CHILDHOOD GLOMERULAR DISEASES IN TUNISIA: A BIOPSY PROVEN CASE SERIES FROM A REFERRAL NEPHROLOGY CENTER

2021 ◽  
Vol 6 (4) ◽  
pp. S67
Author(s):  
M. Tchoupé Djoumbissie ◽  
H. Mani ◽  
K. Kammoun ◽  
N. Dammak ◽  
J. Hachicha
Keyword(s):  
Case Series ◽  
Glomerular Diseases ◽  
Proven Case

scholarly journals Renal Morphology in Coronavirus Disease: A Literature Review

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 258
Author(s):  
Patrick de Oliveira ◽  
Kaile Cunha ◽  
Precil Neves ◽  
Monique Muniz ◽  
Giuseppe Gatto ◽  
...  
Keyword(s):  
Case Reports ◽  
Kidney Tissue ◽  
Adaptive Immune Response ◽  
Case Series ◽  
Vascular Diseases ◽  
Glomerular Diseases ◽  
Morphological Findings ◽  
Renal Morphology ◽  
Long Term Impact

Renal biopsy is useful to better understand the histological pattern of a lesion (glomerular, tubulointerstitial, and vascular) and the pathogenesis that leads to kidney failure. The potential impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the kidneys is still undetermined, and a variety of lesions are seen in the kidney tissue of coronavirus disease patients. This review is based on the morphological findings of patients described in case reports and a series of published cases. A search was conducted on MEDLINE and PubMed of case reports and case series of lesions in the presence of non-critical infection by SARS-CoV-2 published until 15/09/2020. We highlight the potential of the virus directly influencing the damage or the innate and adaptive immune response activating cytokine and procoagulant cascades, in addition to the genetic component triggering glomerular diseases, mainly collapsing focal segmental glomerulosclerosis, tubulointerstitial, and even vascular diseases. Kidney lesions caused by SARS-CoV-2 are frequent and have an impact on morbidity and mortality; thus, studies are needed to assess the morphological kidney changes and their mechanisms and may help define their spectrum and immediate or long-term impact.

scholarly journals Rituximab for Treatment of Membranoproliferative Glomerulonephritis and C3 Glomerulopathies

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Michael Rudnicki
Keyword(s):  
Membranoproliferative Glomerulonephritis ◽  
Case Reports ◽  
Case Series ◽  
Cytotoxic Agents ◽  
Current Evidence ◽  
Retrospective Case ◽  
Glomerular Diseases ◽  
Pattern Of Injury ◽  
Recent Classification ◽  
Anti Cd20

Membranoproliferative glomerulonephritis (MPGN) is a histological pattern of injury resulting from predominantly subendothelial and mesangial deposition of immunoglobulins or complement factors with subsequent inflammation and proliferation particularly of the glomerular basement membrane. Recent classification of MPGN is based on pathogenesis dividing MPGN into immunoglobulin-associated MPGN and complement-mediated C3 glomerulonephritis (C3GN) and dense deposit disease (DDD). Current guidelines suggest treatment with steroids, cytotoxic agents with or without plasmapheresis only for subjects with progressive disease, that is, nephrotic range proteinuria and decline of renal function. Rituximab, a chimeric B-cell depleting anti-CD20 antibody, has emerged in the last decade as a treatment option for patients with primary glomerular diseases such as minimal change disease, focal-segmental glomerulosclerosis, or idiopathic membranous nephropathy. However, data on the use of rituximab in MPGN, C3GN, and DDD are limited to case reports and retrospective case series. Patients with immunoglobulin-associated and idiopathic MPGN who were treated with rituximab showed partial and complete responses in the majorities of cases. However, rituximab was not effective in few cases of C3GN and DDD. Despite promising results in immunoglobulin-associated and idiopathic MPGN, current evidence on this treatment remains weak, and controlled and prospective data are urgently needed.

scholarly journals Synthetic ACTH for Treatment of Glomerular Diseases: A Case Series

2022 ◽  
Vol 9 ◽  
pp. 205435812110669
Author(s):  
Arenn Jauhal ◽  
Bhanu Prasad ◽  
Mathieu Rousseau-Gagnon ◽  
Gabriel Ouellet ◽  
Michelle A Hladunewich
Keyword(s):  
Adverse Events ◽  
Adrenocorticotropic Hormone ◽  
Minimal Change Disease ◽  
Case Series ◽  
Minimal Change ◽  
Lessons Learned ◽  
Focal And Segmental Glomerulosclerosis ◽  
Glomerular Diseases ◽  
Conservative Care ◽  
Segmental Glomerulosclerosis

Rationale: Synthetic adrenocorticotropic hormone (Tetracosactide) has been used in the treatment of refractory glomerular diseases. Literature surrounding the use of this medication is limited to small case series and there is conflicting data on the rate of adverse events associated with this medication. Presenting concerns of the patient: Glomerulonephritis not in remission after at least 6 months of treatment with conservative care. Stable doses of concurrent immunosuppression were permitted. Diagnoses: Membranous nephropathy, IgA nephropathy, minimal change disease, and focal and segmental glomerulosclerosis. Intervention: Intramuscular synthetic adrenocorticotropic hormone (Tetracosactide, Synacthen Depot) with doses of either 1 mg weekly or 1 mg twice weekly. Outcomes: Five of 12 patients had at least a partial remission with Tetracosactide. Median time to response was 6 months for responders. Five of the 12 patients had adverse events documented, 2 of which led to treatment discontinuation. No patients with focal and segmental glomerulosclerosis responded to treatment. Lessons Learned: Higher rate of adverse events than previously reported with synthetic adrenocorticotropic hormone and uncertain treatment efficacy.

scholarly journals The multiple faces of autoimmune/immune‐mediated myocarditis in children: a biopsy‐proven case series treated with immunosuppressive therapy

2021 ◽  
Author(s):  
Renzo Marcolongo ◽  
Stefania Rizzo ◽  
Alessia Cerutti ◽  
Elena Reffo ◽  
Biagio Castaldi ◽  
...  
Keyword(s):  
Immunosuppressive Therapy ◽  
Case Series ◽  
Immune Mediated ◽  
Proven Case

scholarly journals GLOMERUONEPHRITIS;

2019 ◽  
Vol 26 (05) ◽  
Author(s):  
Sultan Zafar Akhtar ◽  
Humera Adeeb ◽  
Hajira Bibi ◽  
Ihsan Ullah
Keyword(s):  
Lupus Nephritis ◽  
Kidney Diseases ◽  
Case Series ◽  
Membranous Glomerulonephritis ◽  
Immunoglobulin M ◽  
Retrospective Case ◽  
Hypertensive Nephropathy ◽  
Glomerular Diseases ◽  
Male Predominance ◽  
Clinical Records

Background: The histological pattern and frequency of glomerular diseases differs according to the geographic area, race, age and indications for renal biopsy. This study was conducted to evaluate the frequency of different histological patterns of glomerulonephritis during a 10 years period at our institute. Study Design: Retrospective Case series. Period: 1st January 2007 to 31st, December 2017. Study Setting: Institute of kidney diseases, Hayatabad Medical Complex Peshawar, Pakistan. Results and Discussion: Clinical records of 415 native renal biopsies performed in patients with mean age 27.17 ± 14.98 years were included in this study. Males were 266 (64.1%) and females 149 (35.9%). Data was analysed for three age groups separately, Children (<18 years) 147 (35.5%), Adults (18-59 years) 253 (61.0%) and elderly (>60 years) 15 (3.6%). Primary GN (glomerulonephritis) was the most common (74.21%) followed by secondary GN (26.41%). Among primary glomerular diseases, Focal segmental glomerulonephritis (FSGS) was (29.6%), membranoproliferative glomerulonephritis (MPGN) also known as mesangiocapillary glomerulonephritis constituted 19.5% and Membranous glomerulonephritis (MGN) was the third most common (16.6%). Among secondary GN, acute tubular necrosis (ATN) was the most common (25.4%), followed by amyloidosis (14.7%), hypertensive nephropathy (13.7%) and lupus nephritis (12.8%) respectively. There was a slight male predominance in all types of primary GN except for focal necrotizing GN and most of the secondary types except lupus nephritis and chronic tubulointerstitial nephritis (TIN). Below 18 years, MPGN was (58.3%), focal necrotising GN (57.1%) and minimal change disease (MCD) was (52.2%). Crescentic GN (89.5%), MGN (74.5%), immunoglobulin A (IgA) nephropathy (72.7%), chronic sclerosing GN (CSGN) (64.7%) and FSGS (56%) were more common in adults. Frequency of immunoglobulin M (IgM) nephropathy (50%) was equal in children and adults. In elderly patients, the commonest GN reported was hypertensive nephropathy (28.6%), amyloidosis (6.7%) and MGN (5.9%). Conclusion: Among the wide variety of histological patterns, FSGS was the commonest GN in adults followed by MPGN and MGN. Among adults, primary GN was more common. When compared with other studies, FSGS is more common in the present study and some Indian studies, while membranous GN is more common in other regional countries.

scholarly journals Rituximab in glomerular diseases: a case series and narrative review

2021 ◽  
Author(s):  
Inês Duarte ◽  
João Oliveira ◽  
Cristina Outerelo ◽  
Iolanda Godinho ◽  
Marta Pereira ◽  
...  
Keyword(s):  
Case Series ◽  
Infectious Complications ◽  
Second Line ◽  
Second Line Therapy ◽  
Glomerular Diseases ◽  
Renal Deterioration ◽  
First Line Therapy ◽  
Line Therapy ◽  
Immune Mediated ◽  
Different Response

Abstract Introduction: The use of Rituximab (RTX) in glomerular diseases (GD) has increased in the past years, although it is still only used in a small fraction of patients. Methods: A single center retrospective study of adult patients with membranous nephropathy (MN), focal segmental glomerulosclerosis (FSGS), lupus nephritis (LN), and vasculitis treated with RTX as first or second-line therapy was conducted at our center from 2010 to 2020. Results: We identified 19 patients; 36.8% had MN and 25.0% each had FSGS, LN, and vasculitis. RTX was first-line therapy in 26.3% of patients and in 73.7% it was second-line therapy. Mean follow-up time was 7.7 ± 7.2 years. In MN, 2 patients (28.6%) had complete remission (CR), 2 patients (28.6%) had partial remission (PR), and 3 patients (42.9%) had no response (NR). In FSGS, 2 patients (50.0%) presented CR, 1 patient (25.0%) had no response, and 1 patient had renal deterioration. Two patients (50.0%) had a LN class IV with a CR after RTX, 1 patient with LN class IIIC/V had no response, and 1 patient with LN class II had renal deterioration. In vasculitis, 3 patients (75.0%) presented CR and 1 patient had PR. Infusion reactions were present in 2 patients (10.5%) and one patient had multiple infectious complications. Conclusions: The efficacy of RTX in treating different types of immune-mediated GD has been demonstrated with different response rates, but an overall safe profile. In our case series, the results are also encouraging. Longitudinal studies are needed to better understand the effect of RTX in GD.

scholarly journals Late Relapses of Membranous Nephropathy: A Case Series

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0007712020
Author(s):  
Yonatan Peleg ◽  
Andrew S. Bomback ◽  
Pietro A. Canetta ◽  
Jai Radhakrishnan ◽  
Gerald B. Appel ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Membranous Nephropathy ◽  
Clinical Symptoms ◽  
Case Series ◽  
Renal Outcome ◽  
Late Relapse ◽  
Sustained Remission ◽  
Glomerular Diseases ◽  
Disease Remission

Background: Relapse of the nephrotic syndrome is common among primary membranous nephropathy (MN) patients. Relapses of MN typically occur within a few years of achieving disease remission. There is limited description to date regarding MN patients who have late relapse of MN, i.e. after more than five years of sustained disease remission. The objective of this case series was to report the clinical course of MN patients with late relapse. Methods: We analyzed the patient database of the Center for Glomerular Diseases at Columbia University to identify patients seen at our center who had relapse of biopsy-proven MN at least five years after achieving sustained disease remission. Results: We identified 16 patients with late MN relapse. The median time in sustained remission prior to relapse was 10.2 (range 7-29.0) years. Ten (62.5%) patients were diagnosed with late relapse based on laboratory monitoring alone without clinical symptoms of the nephrotic syndrome. Fourteen (87.5%) patients received immunosuppression during their initial presentation and late relapse. Patients had favorable long term renal outcomes over a median 21 (range 12-56) year follow-up period with 14 (87.5%) patients in remission at study conclusion and median decline in eGFR per year -0.63 (range -6.3 - 17.5) ml/min/1.73m2/year. Conclusions: This case series highlights a previously under-appreciated and likely rare outcome of MN, namely late relapse. Late relapse patients, having a longer time in sustained remission, may have a more favorable long-term renal outcome.

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