scholarly journals Typhoid Fever Presenting With Acute Renal Failure And Hepatitis Simultaneously - A Rare Presentation

2016 ◽  
Vol 22 (2) ◽  
pp. 80-82
Author(s):  
R. Rajput ◽  
D. Jain ◽  
A. Kumar ◽  
A. Mittal
Keyword(s):  
Developing Countries ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Typhoid Fever ◽  
Liver Enzymes ◽  
Renal Involvement ◽  
Rare Presentation ◽  
Hepatic Involvement ◽  
Pain Abdomen ◽  
Important Health

Abstract Typhoid fever is an important health problem worldwide but its incidence is more in developing countries. Hepatic involvement is common, but both hepatic and renal involvement is rare in typhoid fever. We report a case of typhoid fever presenting with hepatitis and acute renal failure. A 17 year old male presenting with fever and pain abdomen was found to have raised blood urea, creatinine, liver enzymes and bilirubin. Widal and typhidot (IgM,IgG) test were positive. His symptoms subsided and deranged parameters resolved with treatment of typhoid fever.

scholarly journals Typhoid fever with multiorgan involvement: pulmonary, hepatic and renal complications with dyselectrolytemia

2018 ◽  
Vol 6 (1) ◽  
pp. 215
Author(s):  
Manish Verma ◽  
Jaisingh Jat ◽  
Khushboo Agarwal
Keyword(s):  
Developing Countries ◽  
Renal Failure ◽  
Young Child ◽  
Typhoid Fever ◽  
Rare Case ◽  
Enteric Fever ◽  
Pulmonary Complication ◽  
Young Female ◽  
Unique Case ◽  
Important Health

Typhoid fever is an important health problem in developing countries like India, especially among young children. It may involve a number of systems and may present with various complications specially if untreated. We report a rare case of typhoid fever with multiple complications in 4 years young female who presented with fever, toxemia, bronchopneumonia, icteric hepatitis and also developed AKI, hyponatremia. Enteric fever with its complications has been reported previously but mostly reported with surgical complications, pulmonary complication, Myocarditis, hepatitis, hepatitis with renal failure etc but this seems to be unique case as presented with multiorgan involvement e.g. bronchopneumonia, icteric hepatitis, AKI and dyselectrolytemia. Previously reported cases were usually adolescents while this case is just 4 years young child. Despite multiple complications, patient responded well to treatment of enteric fever and discharged successfully.

scholarly journals Renal involvement in human rabies: clinical manifestations and autopsy findings of nine cases from northeast of Brazil

2005 ◽  
Vol 47 (6) ◽  
pp. 315-320 ◽  
Author(s):  
Elizabeth De Francesco Daher ◽  
Geraldo Bezerra da Silva Júnior ◽  
Marúsia Thomaz Ferreira ◽  
Fernando Antonio de Sousa Barros ◽  
Tiago Magalhães Gurgel ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Renal Involvement ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Hemodynamic Instability ◽  
Human Rabies ◽  
Tubular Necrosis ◽  
Post Mortem Findings ◽  
Histopathologic Findings

A retrospective study was conducted in nine patients with rabies admitted to a hospital of Fortaleza, Brazil. Autopsy was performed in all cases. The ages ranged from three to 81 years and six were males. They all were bitten by dogs. The time between the accident and the hospital admission ranged from 20 to 120 days (mean 45 ± 34 days). The time until death ranged from one to nine days (mean 3.3 ± 5.5 days). The signs and symptoms presented were fever, hydrophobia, aerophobia, agitation, disorientation, dyspnea, sialorrhea, vomiting, oliguria, sore throat, pain and hypoesthesia in the site of the bite, headache, syncope, cough, hematemesis, mydriasis, hematuria, constipation, cervical pain and priapism. In three out of six patients, there was evidence of acute renal failure, defined as serum creatinine > 1.4 mg/dL. The post-mortem findings in the kidneys were mild to moderate glomerular congestion and mild to intense peritubular capillary congestion. Acute tubular necrosis was seen in only two cases. This study shows some evidence of renal involvement in rabies. Histopathologic findings are nonspecific, so hemodynamic instability, caused by autonomic dysfunction, hydrophobia and dehydration must be responsible for acute renal failure in rabies.

scholarly journals Addison’s Disease Presenting as Acute Renal Failure and Hyperkalemic Paralysis: A Rare Presentation

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Kundan Jana ◽  
Kalyana Janga ◽  
Sheldon Greenberg ◽  
Amit Gulati
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Adrenal Insufficiency ◽  
Delayed Diagnosis ◽  
Kidney Injury ◽  
Addison’S Disease ◽  
Adrenal Crisis ◽  
Addison's Disease ◽  
Medication History ◽  
Rare Presentation

Hyperkalemic paralysis in the setting of acute renal failure can lead to a missed or delayed diagnosis of adrenal insufficiency as the raised potassium can be attributed to the renal failure. Acute kidney injury as the presenting manifestation in an adrenal crisis due to Addison’s disease has been rarely reported in the literature. Here, we present the case of a young 37-year-old male who came with hyperkalemic paralysis and acute renal failure needing emergent hemodialysis. He had no past medical history and no medication history. His hyponatremia, hypotension, and hyperkalemia pointed to a picture of adrenal insufficiency confirmed by undetectable serum cortisol, elevated ACTH, renin, and low aldosterone levels and imaging. Replacement steroid therapy was given, and the patient made a steady recovery. He was advised on the importance of compliance to treatment at discharge to prevent another crisis event. Acute renal failure with hyperkalemia as a presenting manifestation of Addison’s disease can be very misleading. It is especially important to be vigilant of adrenal insufficiency in such patients as the hyperkalemia is resistant to standard therapy of insulin dextrose and can precipitate fatal arrhythmia if treatment is delayed.

scholarly journals Granulomatous nephritis: A rare presentation of juvenile-onset sarcoidosis

2021 ◽  
Author(s):  
Prashant Chotalia ◽  
Sapan Pandya ◽  
Puja Srivastava
Keyword(s):  
Renal Failure ◽  
Renal Involvement ◽  
Cervical Lymphadenopathy ◽  
Unknown Origin ◽  
Oral Prednisolone ◽  
Pulmonary Involvement ◽  
Juvenile Onset ◽  
Rare Presentation ◽  
Pyrexia Of Unknown Origin ◽  
Renal Functions

ABSTRACT Sarcoidosis is rare in children. Incidence and prevalence of sarcoidosis in India are not known. Renal involvement in childhood sarcoidosis is further rare with no clear data about prevalence. Here we report a case of a 13-year-old girl who presented with sarcoidosis with multi-system involvement including renal sarcoidosis. She initially presented with pyrexia of unknown origin and cervical lymphadenopathy – evaluation of which led to diagnosis of sarcoidosis. Later, after development of pulmonary involvement, she was treated with oral prednisolone and azathioprine. She again defaulted on medicines and later presented with renal failure and was diagnosed with a renal sarcoidosis. She was treated with oral prednisolone and mycophenolate mofetil with which she gradually improved with normal renal functions.

scholarly journals Design and Production of a Recombinant Hybrid Toxin to Raise Protective Antibodies against Loxosceles Spider Venom

Toxins ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 108 ◽  
Author(s):  
Paula Calabria ◽  
Lhiri Shimokawa-Falcão ◽  
Monica Colombini ◽  
Ana Moura-da-Silva ◽  
Katia Barbaro ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Platelet Aggregation ◽  
Health Problem ◽  
Neutralizing Antibodies ◽  
Inclusion Bodies ◽  
Recombinant Antigen ◽  
Important Health ◽  
Protective Antibodies

Human accidents with spiders of the genus Loxosceles are an important health problem affecting thousands of people worldwide. Patients evolve to severe local injuries and, in many cases, to systemic disturbances as acute renal failure, in which cases antivenoms are considered to be the most effective treatment. However, for antivenom production, the extraction of the venom used in the immunization process is laborious and the yield is very low. Thus, many groups have been exploring the use of recombinant Loxosceles toxins, particularly phospholipases D (PLDs), to produce the antivenom. Nonetheless, some important venom activities are not neutralized by anti-PLD antibodies. Astacin-like metalloproteases (ALMPs) are the second most expressed toxin acting on the extracellular matrix, indicating the importance of its inclusion in the antigen’s formulation to provide a better antivenom. Here we show the construction of a hybrid recombinant immunogen, called LgRec1ALP1, composed of hydrophilic regions of the PLD and the ALMP toxins from Loxosceles gaucho. Although the LgRec1ALP1 was expressed as inclusion bodies, it resulted in good yields and it was effective to produce neutralizing antibodies in mice. The antiserum neutralized fibrinogenolytic, platelet aggregation and dermonecrotic activities elicited by L. gaucho, L. laeta, and L. intermedia venoms, indicating that the hybrid recombinant antigen may be a valuable source for the production of protective antibodies against Loxosceles ssp. venoms. In addition, the hybrid recombinant toxin approach may enrich and expand the alternative antigens for antisera production for other venoms.

Efficacy of Eculizumab in Gemcitabine-Induced Thrombotic Microangiopathy: Experience of the French Thrombotic Microangiopathies Reference Centre

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 136-136 ◽  
Author(s):  
Maximilien Grall ◽  
Francois Provôt ◽  
Jean-Philippe Coindre ◽  
Claire Pouteil-Noble ◽  
Dominique Guerrot ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Thrombotic Microangiopathy ◽  
Conflicts Of Interest ◽  
Early Stage ◽  
Renal Involvement ◽  
Cancer Evolution ◽  
Multicentric Study ◽  
Packed Red Blood Cells

Abstract Background: Gemcitabine is a broadly prescribed chemotherapy, the use of which can be limited by renal adverse events, including hypertension, proteinuria, oedema, acute renal failure and thrombotic microangiopathy (TMA). As opposed to thrombotic thrombocytopenic purpura, gemcitabine-induced TMA generally responds poorly to therapeutic plasma exchange and prognosis is dismal. The usual severe renal involvement and the normal activity of the von Willebrand factor-cleaving protease ADAMTS13 relate gemcitabine-induced TMA to atypical haemolytic syndrome, in which complement blockage is remarkably efficient. In this regard, this study evaluated the efficacy of eculizumab, a monoclonal antibody targeting the terminal complement pathway, in patients with gemcitabine-induced TMA. Methods: We conducted an observational, retrospective, multicentric study including all patients with gemcitabine-induced TMA treated by eculizumab in 4 French centres, between 2011 and 2014. Patients with a TMA considered to be directly attributed to an uncontrolled cancer were excluded. Results: 8 patients with a gemcitabine-induced TMA treated by eculizumab were included (6 women, 2 men). Gemcitabine was prescribed for pancreatic (n=3, 37.5%), ovarian (n=3, 37.5%) and pulmonary (n=2, 25%) cancer. TMA occurred after a median of 5.5 months (range 1.7-13) and a median cumulative dose of 22.8g (range 9.0-48.0). The main characteristics were microangiopathic hemolytic anemia (100%), thrombocytopenia (87.5%), normal ADAMTS13 activity (100%), acute renal failure (100%, including 62% stage 3 acute kidney injury (AKI) and 25% renal replacement therapy), hypertension (75%) and diffuse oedema (62.5%). Eculizumab was started after a median of 19.5 days (range 6-44) following TMA diagnosis. A median of 4.5 injections of eculizumab was performed (range 3-22). Complete haematological remission was achieved in 6 patients (75%) and blood transfusion significantly decreased after only one injection of eculizumab (median of 2 packed red blood cells (range 0-10) before treatment vs 0 (range 0-1) after one injection, p=.015). Two patients recovered completely renal function (25%), and 4 achieved a partial remission (50%), with a median estimated glomerular filtration rate (GFR) improvement of 15 ml/min/1.73m2 (range 7-16). Five patients (62.5%) died during follow-up, from a septic and hemorrhagic shock on early stage (1 case), and from cancer evolution after a median of 6 months (range 2-13) following eculizumab initiation (4 cases). Conclusion: These encouraging results suggest that eculizumab is efficient on hemolysis and reduces transfusion requirement in gemcitabine-induced TMA. Moreover, eculizumab may improve renal function. Prospective trials are now required to further investigate this issue. Disclosures No relevant conflicts of interest to declare.

scholarly journals Acute Renal Failure Secondary to Tuberculosis: A Diagnostic Challenge

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Saeed I. Khilji ◽  
Hong Kuan Kok ◽  
Limy Wong ◽  
Anthony M. Dorman ◽  
J. Joseph Walshe
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Renal Biopsy ◽  
Diagnostic Challenge ◽  
Rare Presentation ◽  
Antituberculosis Treatment ◽  
Clinical Presentations ◽  
Renal Tuberculosis ◽  
Repeat Renal Biopsy ◽  
Multiorgan Disease

Tuberculosis is a multiorgan disease with varied clinical presentations and is reemerging due to increasing immigration and globalization. We present the case of an immigrant female patient who developed acute renal failure with clinical and biochemical features suggestive of lupus nephritis but with a timely renal biopsy showing caseating granulomata in the renal parenchyma consistent with renal tuberculosis. Despite treatment with antituberculosis treatment and resolution of TB on repeat renal biopsy, she remained haemodialysis dependent. We discuss the diagnostic challenges faced in this presentation and also explore possible differential diagnoses. This rare presentation highlights the importance of renal biopsy in the diagnosis and treatment of acute renal failure and the atypical presentation of tuberculosis.

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