scholarly journals Plasma exchange for thrombotic microangiopathy secondary to dermatomyositis associated with acute kidney injury and complement activation: a case report with literature review

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Norifumi Hayashi ◽  
Keiichirou Okada ◽  
Yuko Tsuruyama ◽  
Yu Kagaya ◽  
Sho Kumano ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Intensive Care ◽  
Case Report ◽  
Plasma Exchange ◽  
Complement Activation ◽  
Thrombotic Microangiopathy ◽  
Kidney Injury ◽  
Ivig Therapy ◽  
Case Presentation ◽  
Life Threatening

Abstract Background Thrombotic microangiopathy (TMA) in patients with connective tissue disease is rare but life-threatening. In particular, the survival rate of patients with dermatomyositis (DM) that develop TMA is low. The effectiveness of plasma exchange (PEX) therapy is unclear for the treatment of TMA secondary to DM. Case presentation We describe a case of a 28-year-old woman who developed severe DM complicated by aspiration pneumonia from dysphagia and acute kidney injury. The patient was unresponsive to corticosteroids and intravenous immunoglobulin (IVIG) therapy and developed TMA. In this case, immunofluorescence of skin biopsy revealed that complement activation was involved in the pathogenesis of DM. After 6 PEX therapies, thrombocytopenia improved. She was successfully treated by intensive care and PEX therapy. Conclusions PEX therapy was effective to treat TMA secondary to DM associated with complement activation.

scholarly journals Clinical features of acute kidney injury in Coronavirus disease 2019—A case report with review of literature

2020 ◽  
Author(s):  
Hai Yuan ◽  
Xiaohan Lu ◽  
E Guo ◽  
Fengqi Hu ◽  
Zhao Gao
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Kidney Function ◽  
Kidney Injury ◽  
Hubei Province ◽  
Review Of Literature ◽  
Case Presentation ◽  
High Incidence ◽  
Careful Management ◽  
High Incidence Area

Abstract Background: In December 2019, an outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred in Wuhan, Hubei province, China. We surveyed 91 patients who were diagnosis as coronavirus disease 2019 (COVID-19) in Xiangyang, Hubei province. And we found the incident of acute kidney injury (AKI) was 3.29% (3/91), which was higher than in the whole country but similar in Hubei province.Case presentation: We describe a case of 58-year-old man who was diagnosis as AKI stage 3 and non-oliguria AKI in the SARS-CoV-2 infection. After antiviral and other supporting treatment, his kidney function improved and he was transferred to normal ward.Conclusions: This case illustrated that careful management and strict monitoring of kidney function should be employed in COVID-19 patients especially in high incidence area of COVID-19.

When acute kidney injury in the intensive care unit is not acute tubular necrosis: A case report of κ-light chain crystalline tubulopathy

2019 ◽  
Vol 91 (5) ◽  
pp. 311-316
Author(s):  
Neal Shah ◽  
Ivy Rosales ◽  
Rex Neal Smith ◽  
Jacob E. Berchuck ◽  
Andrew J. Yee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Case Report ◽  
Light Chain ◽  
Acute Tubular Necrosis ◽  
Kidney Injury ◽  
Tubular Necrosis

scholarly journals A Case Report on Deliberate Self-poisoning with Imidacloprid in a Young Female - Overview of a Newer Insecticide Poisoning

2021 ◽  
Vol 43 (1) ◽  
pp. 60-62
Author(s):  
Sabin Thapaliya ◽  
Bhupendra K Basnet ◽  
Santa K Das ◽  
Rakshya Thapa
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Case Report ◽  
Organophosphorus Compounds ◽  
East Asian ◽  
Kidney Injury ◽  
Young Female ◽  
Neurological Manifestations ◽  
Asian Countries

Imidacloprid is a newer insecticide of the group Neonicotinoids. It is safer to humans and hence considered a better alternative to organophosphorus compounds, especially in areas like Nepal with higher incidence of deliberate self-poisoning. There has been an increase in the number of reported cases of imidacloprid poisoning from South-East Asian countries, but none from Nepal. We report a case admitted in Intensive Care Unit with neurological manifestations, respiratory failure and development of Acute Kidney Injury following acute imidacloprid poisoning.

scholarly journals An uncommon side effect from the ‘king of fruit’: A case report on life-threatening hyperkalaemia after eating durian fruit

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110631
Author(s):  
Alvin Oliver Payus ◽  
Fatimah Ahmedy ◽  
Syed Sharizman Syed Abdul Rahim ◽  
Doreen Sumpat
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Potassium Level ◽  
Treatment Initiation ◽  
Kidney Injury ◽  
Medical Emergency ◽  
Rare Occurrence ◽  
Severe Condition ◽  
Life Threatening ◽  
Prompt Diagnosis

Hyperkalaemia is a condition of excess potassium level that occurs as a result of increased intake, or reduced renal clearance, or both. In a severe condition, hyperkalaemia is a medical emergency that can be life-threatening especially if recognised late and left untreated. There are many causes of hyperkalaemia. However, eating durian fruit in the background of impaired kidney function is a very rare occurrence. In this article, we report a case of an elderly lady who presented with a life-threatening hyperkalaemia as a result of eating large amount of durian fruit while having multiple diarrhoeal episodes due to acute gastroenteritis that led to acute kidney injury. She was successfully treated and was discharged well. The objective of this case report is to share the rare cause of a life-threatening hyperkalaemia where prompt diagnosis and treatment initiation are crucial to prevent mortality.

scholarly journals Interpretable and Continuous Prediction of Acute Kidney Injury in the Intensive Care

2021 ◽  
Author(s):  
Iacopo Vagliano ◽  
Oleksandra Lvova ◽  
Martijn C. Schut
Keyword(s):  
Machine Learning ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Recurrent Neural Networks ◽  
Kidney Injury ◽  
Predictive Performance ◽  
Continuous Model ◽  
Machine Learning Model ◽  
Threatening Condition ◽  
Life Threatening

Acute kidney injury (AKI) is a common and potentially life-threatening condition, which often occurs in the intensive care unit. We propose a machine learning model based on recurrent neural networks to continuously predict AKI. We internally validated its predictive performance, both in terms of discrimination and calibration, and assessed its interpretability. Our model achieved good discrimination (AUC 0.80-0.94). Such a continuous model can support clinicians to promptly recognize and treat AKI patients and may improve their outcomes.

scholarly journals PENATALAKSANAAN SEPSIS AKI PADA PASIEN MULTIPLE MYELOMA DENGAN HIPERKALSEMIA BERAT

2018 ◽  
Vol 1 (1) ◽  
pp. 54-65
Author(s):  
Agus Sumedi
Keyword(s):  
Intensive Care Unit ◽  
Multiple Myeloma ◽  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Case Report ◽  
Light Chain ◽  
Bone Lesion ◽  
Kidney Injury ◽  
Vasoactive Agents

This case report talking about a female 56 yo with Multiple Myeloma (MM) suffer from Pneumonia and Acute Kidney Injury (AKI). MM is haematology cancer produce free light chain that impair renal tubulus, cause anemia, bone lesion and hypercalcemia. This patient came to hospital withsevere pneumonia, acute kidney injury andsevere hypercalcemia. In intensive care unit supported by mechanical ventilation, diuretic, antibiotics administration,haemodialysis,vasoactive agents, bisphosphonat and others.The acitenobacter baumanni was identified from sputum culture and then developed become multidrugs resistant leading to septic syock and multi organs dysfunction and death in two weeks.

scholarly journals Pneumomediastinum as a Manifestation of Granulomatosis with Polyangiitis

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Ahmed Alhazmi ◽  
Mohamed Moulaye Cheikh ◽  
Rola Yousef Hassan
Keyword(s):  
Computed Tomography ◽  
Acute Kidney Injury ◽  
Case Report ◽  
Emergency Room ◽  
Plasma Exchange ◽  
Granulomatosis With Polyangiitis ◽  
Kidney Injury ◽  
Smoking History ◽  
Pulse Steroids ◽  
Purpuric Rash

A 38-year-old hypertensive male with a smoking history presented to the emergency room with significant hemoptysis, arthritis, and a purpuric rash. Other findings included a dropping hemoglobin and acute kidney injury with microscopic hematuria. The pulmonary computed tomography was significant for alveolar hemorrhage and a rarely reported pneumomediastinum. Along with this constellation of findings, a positive antiproteinase 3 helped to confirm this patient’s diagnosis of granulomatosis with polyangiitis. Treatment commenced with sessions of plasma exchange and pulse steroids along with cyclophosphamide infusions. The patient had since improved and made a full recovery. This case report highlights the rarely described pneumomediastinum in association with vasculitides.

scholarly journals Potassium wasting nephropathy in the setting of tizanidine overdose: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Michael J. Brucculeri ◽  
Juan Garcia
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Kidney Injury ◽  
Cardiac Conduction ◽  
Electrolyte Disorders ◽  
Case Presentation ◽  
Arrhythmogenic Potential ◽  
Electrolyte Abnormalities ◽  
Biochemical Abnormalities

Abstract Background Hypokalemia has been rarely attributed to tizanidine, although the precise mechanism is unclear. Severe hypokalemia is a well-established cause of abnormalities involving cardiac conduction. Given this agent’s well-known cardiac arrhythmogenic potential, awareness of potential concomitant electrolyte abnormalities is important. Case presentation Electrolyte disorders, including hypokalemia, are rare complications of the antispasmodic medicine tizanidine when taken in doses as outlined by the manufacturer’s prescribing instructions. Although cases of severe hypokalemia have also been described in the literature in association with this agent, such reports are few. We report a Caucasian case of an intentional overdose involving a very large ingestion of tizanidine. In addition to the characteristic abnormalities on the electrocardiogram, our patient developed electrolyte derangements as well as self-limited acute kidney injury. These biochemical abnormalities included profound hypokalemia that was refractory to aggressive replacement over the ensuing several days, before eventually dissipating. A thorough assessment of the etiology of this hypokalemia was consistent with a defect in renal potassium handling. Conclusion In our patient with intentional tizanidine overdose, severe and refractory hypokalemia appears to have been due to a transient potassium wasting nephropathy.

scholarly journals Prostate cancer-associated thrombotic microangiopathy: A case report and review of the literature

2021 ◽  
Vol 5 (1) ◽  
pp. 017-022
Author(s):  
Kharagjitsing HHS ◽  
te Boekhorst PAW ◽  
Durdu-Rayman Nazik
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Case Report ◽  
Plasma Exchange ◽  
Prostate Carcinoma ◽  
Thrombotic Microangiopathy ◽  
Current Data ◽  
Review Of The Literature ◽  
Life Threatening ◽  
Metastatic Prostate Carcinoma

Background: Thrombotic microangiopathy (TMA) is a rare and life-threatening complication of prostate carcinoma. Whether plasma exchange has a role in treatment remains a subject of debate. Here we present a case followed by a systematic review of the literature on this subject. Case report: We describe a 69-year old patient presenting with TMA, which was associated with an underlying metastatic prostate carcinoma. We conducted a search of similar cases in literature. Results: Our patient was treated and responded well on plasma exchange. Systematic review of the literature showed 17 additional cases of TMA associated with prostate carcinoma of which eleven were treated with plasma exchange with mostly good response. Conclusion: Based on current data we cannot exclude a potential role for plasma exchange in prostate cancer associated TMA.

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