42 Two Case Reports of Idiopathic Nodular Glomerulosclerosis with Liver Cirrhosis

2020 ◽  
Vol 75 (4) ◽  
pp. 548
2020 ◽  
Vol 8 ◽  
pp. 2050313X2094051
Author(s):  
Ramy Hanna ◽  
Jonathan E Zuckerman ◽  
Antoney Ferrey ◽  
Everado Arias Torres ◽  
Sam Tonthat ◽  
...  

Idiopathic nodular glomerulosclerosis is an unusual histopathological finding that has commonly been observed in male smokers with hypertension. It has remained an enigmatic condition and is best described as a diabetic pattern of glomerular injury seen in non-diabetic patients. It is also one of the few nicotine (smoking)-associated/smoking-associated patterns of renal injury. We present an even more unusual manifestation of this pathological finding in a 59-year-old Hispanic female who presented with chronic kidney disease approaching need for renal replacement therapy. The patient had idiopathic nodular glomerulosclerosis on kidney biopsy, despite no prior history of diabetes, nor smoking history, including no secondhand smoking exposure. The patient did have hypertension. The renal biopsy also showed evidence of chronic thrombotic-microangiopathic changes within arteries and arterioles. Genetic testing of the alternative pathway revealed an unusual and likely pathological variant of thrombomodulin supporting complement dysfunction as having a role in the presentation.


2019 ◽  
Vol 64 (4) ◽  
pp. 148-153 ◽  
Author(s):  
Nicholas J Hadfield ◽  
Subothini Selvendran ◽  
Michael P Johnston

This report presents the fatal case of a 63-year-old man with a new presentation of liver cirrhosis, presumed concurrent acute alcoholic hepatitis and development of Pneumocystis jirovecii pneumonia. The patient had none of the traditional immunosuppressing risk factors associated with Pneumocystis jirovecii pneumonia such as corticosteroid use, haematological malignancy or HIV infection. In the literature, there are two case reports and a case series of two patients which describe the development of Pneumocystis jirovecii pneumonia in acute alcoholic hepatitis. However, all of these previously described cases include identifiable risk factors – namely corticosteroid use and HIV infection. This case suggests that special consideration should be given to Pneumocystis jirovecii pneumonia as a cause of opportunistic infection in acute alcoholic hepatitis.


2002 ◽  
Vol 33 (8) ◽  
pp. 826-835 ◽  
Author(s):  
Glen S. Markowitz ◽  
Julie Lin ◽  
Anthony M. Valeri ◽  
Cecilia Avila ◽  
Samih H. Nasr ◽  
...  

2017 ◽  
Vol 7 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Nao Nakamura ◽  
Kensei Taguchi ◽  
Yoshihiro Miyazono ◽  
Keiichiro Uemura ◽  
Kiyomi Koike ◽  
...  

Nephrology ◽  
2016 ◽  
Vol 21 (12) ◽  
pp. 1074-1075
Author(s):  
Atsushi Tanaka ◽  
Tsukasa Nakamura ◽  
Eiichi Sato ◽  
Yoshihiko Ueda ◽  
Koichi Node

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