scholarly journals Sudden Visual Deterioration as the First Symptom of Chronic Kidney Failure

2015 ◽  
Vol 6 (3) ◽  
pp. 394-400 ◽  
Author(s):  
Weronika Pociej-Marciak ◽  
Izabella Karska-Basta ◽  
Marek Kuźniewski ◽  
Agnieszka Kubicka-Trząska ◽  
Bożena Romanowska-Dixon
Keyword(s):  
Systemic Disease ◽  
Hypertensive Crisis ◽  
Clinical Signs ◽  
Diagnostic Procedures ◽  
Chronic Kidney Failure ◽  
Systemic Blood Pressure ◽  
Chronic Glomerulonephritis ◽  
Hypertensive Retinopathy ◽  
Visual Deterioration ◽  
Department Of Ophthalmology

Purpose: We report here a unique case of a sudden loss of vision as the first symptom of an advanced chronic nephropathy. Methods and Results: A 25-year-old man was referred to the Department of Ophthalmology with sudden visual deterioration presumptively diagnosed as bilateral retinitis. The patient had never been under any medical care before and had never had any clinical signs of any chronic disease. He underwent an ophthalmic examination with optical coherence tomography (OCT). Based on the clinical features, OCT scans and systemic blood pressure (BP) assessment (225/145 mm Hg), the patient was definitely diagnosed with hypertensive retinopathy and choroidopathy due to hypertensive crisis. After urgent diagnostic procedures, the patient was diagnosed with a chronic kidney disease at stage 5 in the course of chronic glomerulonephritis. Immediately, a renal replacement therapy was started and the patient was qualified for renal transplantation. Conclusion: Adolescents with an unclear picture of retinal lesions, who have neither a history nor clinical signs of a systemic disease, should undergo careful systemic screening with BP assessment. A sudden deterioration of vision may be the first symptom of a previously undiagnosed severe systemic disease (very rare chronic) that requires immediate treatment.

Blastomyces dermatitidis Prostatic and Testicular Infection in Eight Dogs (1992–2005)

2011 ◽  
Vol 47 (6) ◽  
pp. 413-418 ◽  
Author(s):  
Amy Kaye Totten ◽  
Marcella D. Ridgway ◽  
Debra S. Sauberli
Keyword(s):  
Body Temperature ◽  
Systemic Disease ◽  
Treatment Options ◽  
Treatment Success ◽  
Clinical Signs ◽  
Diagnostic Procedures ◽  
Retrospective Case ◽  
Tb Treatment ◽  
The University ◽  
Retrospective Case Study

This was a retrospective case study of eight dogs diagnosed with prostatic or testicular B. dermatitidis infection. Signalment, clinical presentation, diagnostic procedures, and treatment options were evaluated. Review of medical records of dogs diagnosed with blastomycosis at the University of Illinois Veterinary Teaching Hospital from 1992 to 2005 yielded four dogs with prostatic blastomycosis (PB) and four dogs with testicular blastomycosis (TB). Three of the four dogs with PB and all four dogs with TB had evidence of urogenital disease. Three dogs with PB had an elevated body temperature and all had systemic disease. All dogs with TB had a normal body temperature, and three had systemic disease and one had clinical signs limited to testicular disease. Cytology or histopathology was used to diagnose PB or TB. Treatment included itraconazole or fluconazole with or without nonsteroidal anti-inflammatory drugs. PB and TB are infrequently recognized and may be under diagnosed due to failure to specifically evaluate these tissues. PB or TB should be considered in the evaluation and staging of male dogs with blastomycosis. Male dogs with urogenital signs should be evaluated via prostatic or testicular cytology or histopathology since proper identification and management of PB or TB may improve overall treatment success.

scholarly journals FABRY NEFROPATIJA

2013 ◽  
Vol 23 (6) ◽  
pp. 82-87
Author(s):  
Marius Miglinas ◽  
Pranas Šerpytis ◽  
Urtė Gargalskaitė ◽  
Justė Danieliūtė ◽  
Algirdas Utkus
Keyword(s):  
Blood Pressure ◽  
Kidney Disease ◽  
Cerebrovascular Disorders ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Pressure Control ◽  
Systemic Blood Pressure ◽  
Chronic Glomerulonephritis ◽  
Lysosomal Storage ◽  
Fabry Nephropathy

Anderson-Fabry disease (AFD) is a X-linked lysosomal storage disorder caused by mutations of the GLA gene that encodes α-galactosidase A, what causes intracellular accumulation of globotriaosylceramide. The main manifestations of AFD are pain attacks, acroparasthesias, cutaneous angiokeratomas, hypohydrosis, kidney, heart and cerebrovascular disorders. Late life-threatening complications include cardiomyopathy, cerebrovascular disease and renal injury. Fabry nephropathy may not appear with clinical signs and symptoms in childhood, but in the older adulthood occurs with significant proteinuria which leads to terminal kidney disease. Proteinuria, hypertension, high level of serum creatinine and low glomerular filtration rate are the main symptoms of progressive kidney disease. Adequate blood pressure control is recommended as proteinuria appears to be correlated with systemic blood pressure in both sexes. Fabry nephropathy treatment focus on control of hypertension, lipids and proteinuria and the main method of patients with terminal kidney disease treatment is kidney transplantation. When there are lack of the other classical manifestations for patients with renal disease, most of these cases are initially diagnosed as chronic glomerulonephritis. In this clinical case chronic glomerulonephropathy was also stated as preliminary diagnosis. AFD was verified by kidney biopsy and genetic testing.

scholarly journals Predictors of mortality in children with lupus nephritis

2014 ◽  
Vol 54 (6) ◽  
pp. 338
Author(s):  
Lukman Oktadianto ◽  
Risky Vitria Prasetyo ◽  
Ninik Asmaningsih Soemyarso ◽  
Mohammad Sjaifullah Noer
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Renal Involvement ◽  
Hypertensive Crisis ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Predictors Of Mortality ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Mean Time

Background Renal involvement during the clinical course ofsystemic lupus erythematosus (SLE) is generally considered to bethe most important factor influencing disease prognosis in termsof morbidity and mortality. Various factors have been reported toinfluence the prognosis of lupus nephritis (LN).Objective To analyze clinical signs and laboratory parameters thatmight serve as predictors associated with mortality in pediatricLN.Methods Retrospectively, medical records of children with LNat Soetomo Hospital from 1998 to 2011 were studied. Diagnosisof SLE was based on Revised American Rheumatism Associationcritera, while patients with clinical manifestations of hypertension,abnormal urinalysis, and serum creatinin > 1 mg/dL wereconsidered as lupus nephritis. Cox proportional hazard modelingwas used to assess for associations of clinical signs and laboratoryparameters with mortality. Kaplan-Meier survival analysis wasused to assess the cumulative survival from the time of diagnosisto the outcome.Results There were 57 children with LN of whom 43 (75%) weregirls. The female-to-male ratio was 3:1. Subjects’ mean age was 10.6(SD 6.87) years. The mean time of observation was 51 (SD 74.54)months and 23 (40%) children died. Age, gender, hypertension,hematuria, proteinuria, and anemia were not significant aspredictors for mortality. However, hypertensive crisis (HR=2.79;95%CI 1.16 to 6.75; P=0.02) and initial glomerular filtration rate(GFR) of <75 mL/min/1.73m2 (HR=3.01; 95%CI 1.23 to 7.34;P=0.01) were significant predictors of mortality in children with LN.The mean survival time of LN with hypertensive crisis and initialGFR <75 mL/min/1.73m2 was 36.9 (SD 12.17) months.Conclusion Hypertensive crisis and GFR <75 mL/min/1.73m2 aresignificant predictors of mortality in children with LN.

scholarly journals ГІСТОЛОГІЧНА ДІАГНОСТИКА ХРОНІЧНОЇ НИРКОВОЇ НЕДОСТАТНОСТІ В КОТІВ

2016 ◽  
Vol 18 (3(70)) ◽  
pp. 17-21
Author(s):  
B.V. Borysevich ◽  
V. Sviridenko ◽  
V.V. Hunich
Keyword(s):  
Renal Failure ◽  
Kidney Failure ◽  
Clinical Signs ◽  
Chronic Kidney Failure ◽  
Glomerular Sclerosis ◽  
Kidney Cells ◽  
Paraffin Sections ◽  
Blood Capillaries ◽  
Histological Studies ◽  
Laboratory Results

The objective of the study is to set the criteria of histological diagnosis of chronic renal insufficiency in cats. Lifetime diagnosis of chronic renal failure in a complex was set in complex, basing on anamnesis, clinical signs and laboratory results of blood and urine. For histological studies 29 cats corpses of different breeds and ages were used, who died from chronic kidney failure. Paraffin sections of 7 – 10 mm thickness from the different segments of kidney were stained with Carazzi's hematoxylin and eosin.It was established that during the histological studies in the kidney of cats who died from chronic kidney failure the microscopic changes diversity is characteristic. A characteristic feature of chronic kidney failure cats is complex of changes, which includes: 1) expand and overflow of blood capillaries of the glomeruli; 2) sludge–phenomenon in the capillaries of the glomerulus; 3) lack of blood in the capillaries of the glomerulus; 4) an increased amount of leachate in the cavity of Boumen–Shumlyanskiy capsule; 5) thickening (in some casescrescent–like) of parietal layer of Boumen–Shumlyanskiy capsule due to the hypertrophy and hyperplasia of its cells in the part of kidney cells; 6) glomerular sclerosis of the renal corpuscles and total necrosis of the renal corpuscles; 7) microcysts formation, mainly in the cortex. Other microscopic changes in different animals vary. 

scholarly journals Potential Role of Hepatozoon canis in a Fatal Systemic Disease in a Puppy

Pathogens ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1193
Author(s):  
Andrea De Bonis ◽  
Mariasole Colombo ◽  
Rossella Terragni ◽  
Barbara Bacci ◽  
Simone Morelli ◽  
...  
Keyword(s):  
Potential Role ◽  
Complete Blood Count ◽  
Systemic Disease ◽  
Clinical Signs ◽  
Whole Body ◽  
Hepatozoon Canis ◽  
Veterinary Clinic ◽  
Imidocarb Dipropionate ◽  
Thoracolumbar Region

Canine hepatozoonosis caused by Hepatozoon canis is an emerging disease in Europe. Clinical pictures vary from subclinical to life-threatening and non-specific clinical signs are predominantly reported. A 2-month-old female puppy originating from Southern Italy was adopted and moved to Northern Italy. Then, the dog was brought to a local veterinary practice for gastrointestinal signs, migrating lameness and pruritic dermatitis, and then tested positive for Hepatozoon spp. gamonts at the blood smear. After treatment with imidocarb dipropionate and doxycycline, the dog showed an initial clinical improvement. However, gastrointestinal signs recurred, and diffuse superficial pyoderma appeared on the thoracolumbar region, along with fever, lethargy, and weight loss. Eight months from the first onset of clinical signs, the dog was referred to a veterinary clinic and subjected to complete blood count, urine and fecal analysis, along with abdominal ultrasonography, whole-body CT and gastroduodenal endoscopy. Skin biopsies and blood samples were subjected to a PCR-coupled sequencing protocol, which scored both positive for H. canis. Alterations were consistent with a pre-existing cholangiohepatitis and multiple acquired extrahepatic shunts secondary to portal hypertension. The dog was euthanatized due to a clinical worsening two months later. The potential role of H. canis in the systemic disease observed, clinic-pathological findings and epizootiological implications are discussed.

scholarly journals Isolated jejunal perforation - hidden danger in blunt abdominal trauma

2021 ◽  
pp. 75-75
Author(s):  
Krstina Doklestic ◽  
Dragan Vasin ◽  
Bojan Jovanovic ◽  
Dzemail Detanac ◽  
Ivana Lesevic
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Road Traffic ◽  
Bowel Perforation ◽  
Clinical Signs ◽  
Diagnostic Procedures ◽  
Initial Examination ◽  
Adequate Treatment ◽  
Short Period

Introduction. Isolated jejunal perforation (IJP) without any associated injuries is rare in blunt abdominal trauma (BAT). It most commonly occurs in decelerating trauma. Diagnosis of traumatic intestinal perforation may be difficult in the first hours after injury so unrecognized ?missing? intestinal injuries incidences are as high as 24%. Unrecognized traumatic bowel perforation without adequate treatment leads to the intestinal leakage into the peritoneal cavity, making progress in secondary peritonitis and potentially lethal complications. Case outline. We presented the case of 43 years old women injured in road traffic accident. She was admitted to emergency surgery after diagnostic procedures according to the protocol for trauma. Initial examination, and body computed tomography (CT) revealed orthopedic injuries. Daily monitoring and follow-up examinations were done, she did not complain of any discomfort nor pain in the abdomen and there were no signs of abdominal injury. Two days after trauma, follow-up abdominal CT revealed highly suspected jejunum perforation, still with no signs of pneumoperitoneum. Laparotomy was performed and diagnosis of IJP was confirmed. Bowel perforation was surgically closed in two layers, followed by drainage of septic collections, abdominal saline lavage and primary abdominal closure. The patient was discharged on the seventh postoperative day without complications. Conclusion. In the case of BAT due to severe traumatic force in patient with nonspecific clinical signs of abdominal trauma on initial clinical and radiological examination, follow-up in a short period is necessary, to detect hidden jejunal perforation. Surgery is a life-saving for those patients and treatment of these injuries usually require simple operative procedures.

scholarly journals A review of the classification of nonstrabismic binocular vision anomalies

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Charles Darko-Takyi ◽  
Naimah Ebrahim Khan ◽  
Urvashni Nirghin
Keyword(s):  
Binocular Vision ◽  
Systemic Disease ◽  
Clinical Signs ◽  
Review Literature ◽  
Test Procedures ◽  
Convergence Insufficiency ◽  
Different Types ◽  
Proper Diagnosis ◽  
Divergence Insufficiency

There are conflicting and confusing ideas in literature on the different types of accommodative and vergence anomalies as different authors turn to classify them differently. This paper sought to review literature on the different classifications and types of nonstrabismic binocular vision anomalies and harmonize these classifications. Search engines, namely Google scholar, Medline, Cinahl and Francis databases, were used to review literature on the classification of accommodative and vergence dysfunctions using keywords like <em>binocular vision dysfunctions</em>, <em>classification of nonstrabismic binocular vision disorders or anomalies</em>, <em>accommodative disorders/anomalies classification</em> and <em>vergence disorders/anomalies classifications</em>, and included works that described these anomalies. Nonstrabismic binocular vision anomalies are classified as accommodative and vergence anomalies. There are three different major types of accommodative anomalies, namely accommodative insufficiency, accommodative infacility (accommodative inertia), and accommodative excess (accommodative spasm), and seven different types of vergence anomalies (convergence insufficiency, convergence excess, divergence insufficiency, divergence excess, basic esophoria, basic exophoria and fusional vergence dysfunctions), which are functional in origin. Functionally, there is a commonly reported interaction between accommodative and convergence insufficiency referred to as pseudoconvergence insufficiency. Accommodative paralysis (subtype of accommodative insufficiency) and vergence anomalies – <em>i.e.</em>, convergence paralysis, convergence spasm and divergence paralysis – are non-functional in origin with underlying systemic disease etiologies. Systemic convergence insufficiency, associated with subnormal accommodation, is a non-functional interaction between the accommodative and convergence insufficiency. The classification of nonstrabismic binocular vision anomalies is based on the description of the clinical signs and the underlying etiology either functional or non-functional in origin. Proper diagnosis and management involves investigation of the underlying etiology in addition to the battery of binocular vision test procedures.

Clinical features of ANCA-associated vasculitis

2013 ◽  
pp. 1090-1102
Author(s):  
Wolfgang L. Gross ◽  
Julia U. Holle
Keyword(s):  
Respiratory Tract ◽  
Clinical Features ◽  
Lower Respiratory Tract ◽  
Granulomatosis With Polyangiitis ◽  
Systemic Vasculitis ◽  
Systemic Disease ◽  
Clinical Signs ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Granulomatous Lesions ◽  
Organ Manifestations

The primary ANCA-associated vasculitides are granulomatosis with polyangiitis (Wegener’s, GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss syndrome, CSS). They predominantly affect small (and medium-sized) vessels and share a variable association with ANCA (anti-neutrophil cytoplasm antibody) directed against neutrophil proteinase 3 (PR3, mainly in GPA) and myeloperoxidase (MPO, mainly in MPA and CSS). Crescentic necrotizing glomerulonephritis and alveolar haemorrhage due to pulmonary capillaritis represent classical (vasculitic) organ manifestations of the ANCA-associated vasculitides (AAV). MPA occurs as a ’pure’ small (to medium-size) vessel vasculitis, whereas GPA and CSS are characterized by additional distinct clinical and pathological features. In GPA, granulomatous lesions of the upper and/or lower respiratory tract are a hallmark of the disease. Granulomatous lesions may be large in appearance and occur as space-consuming, infiltrating, and destructive inflammatory masses. GPA is believed to follow a stagewise course with an initial localized form, restricted granulomatous lesions of the upper and/or lower respiratory tract without clinical signs of vasculitis, and a consecutive generalization to systemic vasculitis which may be either non-organ-threatening (early systemic) or organ- and life- threatening (generalized GPA). Rarely, patients arrest in the localized stage and do not progress to systemic disease. In EGPA asthma, hypereosinophilia and eosinophilic organ infiltration (e.g. eosinophilic myocarditis) are typical features of the disease apart from vasculitis. Similarly to GPA, EGPA follows a stagewise course: asthma and eosinophilia may precede full-blown disease for several months or years. Recent cohort studies suggest different phenotypes in EGPA (predominantly vasculitic and MPO-ANCA-positive and predominantly with eosinophilic organ infiltration, usually ANCA-negative). This chapter focuses on the clinical features of the primary AAV and their outcome.

scholarly journals Association of Hypertensive Retinopathy with different serum lipid parameters in patients of Essential Hypertension: A Hospital Based Study

2018 ◽  
Vol 7 (2) ◽  
pp. 50-57
Author(s):  
Bishwa Nath Adhikari ◽  
Pramod Sharma Gautam ◽  
Binod Bekoju ◽  
Sadhana Basnet ◽  
Himlal Bhandari
Keyword(s):  
Essential Hypertension ◽  
Lipid Profile ◽  
Serum Lipid ◽  
Cross Sectional Study ◽  
Serum Lipid Profile ◽  
Hypertensive Retinopathy ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Medical College ◽  
Department Of Ophthalmology

Introduction: Abnormalities in serum lipid and lipoprotein levels are recognized as major modifiable risk factors for cardiovascular disease and essential hypertension and retinopathy. So this study was conducted to evaluate the role of dyslipidemia on development of retinopathy in hypertensive patients and to establish the association of parameters of serum lipid profile with hypertensive retinopathy. Materials and Methods: A cross-sectional study was conducted in Ophthalmology Department among 135 patients in Nobel Medical College and Teaching Hospital (NoMCTH), Biratnagar who were diagnosed with essential hypertension. Patients having diabetes mellitus, myopia, hazy ocular media and other posterior segment disorders were excluded from the study. The detailed ophthalmic examination was carried out in department of ophthalmology, NoMCTH, Biratnagar and all the study population were investigated for fasting serum lipid profile. Result: Out of 135 patients with essential hypertension, 65.44% had retinopathy and remaining had no signs of retinopathy. Mean age of patients were 60.24 (±15.14) years. Although no gender preponderance was found with retinopathy but this study showed that hypertensive retinopathy increases significantly with increase in age and its incidence increases after the age of 60 years. Conclusion: The duration of hypertension was found to be strongly associated with development of hypertensive retinopathy. The increase in all the lipid profile parameters (Serum TG, TC, and LDL and LDL:HDL) and the obesity were found to be strongly associated with retinopathy in hypertensive patients.

scholarly journals Endothelial lesion and complement activation in patients with Scleroderma Renal Crisis

2019 ◽  
Vol 41 (4) ◽  
pp. 580-584
Author(s):  
Ney Arencibia Pérez ◽  
María Luisa Agüera Morales ◽  
Rafael Sánchez Sánchez ◽  
Rosa María Ortega Salas ◽  
Rafael Ángel Fernández de la Puebla ◽  
...  
Keyword(s):  
Complement Activation ◽  
Analytical Data ◽  
Clinical Signs ◽  
Endothelial Damage ◽  
Hypertensive Retinopathy ◽  
Scleroderma Renal Crisis ◽  
Acute Type ◽  
Vascular Endothelial ◽  
Acute Injuries ◽  
Renal Crisis

Abstract In kidney biopsies reviews, scleroderma renal crisis (SRC) is characterized by vascular endothelial injuries, C4d deposits on peritubular vessels, and acute and chronic injuries coexisting on the same biopsy. The clinical signs of thrombotic microangiopathy (TMA) are described in systemic sclerosis (SSc), nevertheless, it has not been related to acute injuries described on kidney biopsies. We report a case of SRC in a patient with scleroderma-dermatomyositis overlap syndrome, which also showed clinical and histopathological data of TMA. On fundus examination, a severe acute hypertensive retinopathy was found. The kidney biopsy showed severe endothelial damage with widening of mucoid cells at the level of the intima, focal concentric proliferation on most small arterioles, and C3, C4d, and IgM deposits along the capillary walls. The genetic study of complement only showed the presence of membrane cofactor protein (MCP) risk haplotypes, without other genetic complement disorders. We understand that in a patient with TMA and SSc, the kidney damage would be fundamentally endothelial and of an acute type; moreover, we would observe clear evidence of complement activation. Once further studies correlate clinical-analytical data with anatomopathological studies, it is likely that we will be forced to redefine the SRC concept, focusing on the relationship between acute endothelial damage and complement activation.

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