scholarly journals Transient generalized proximal tubular dysfunction in an infant with a urinary tract infection: the effect of maternal infliximab therapy?

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Michiel F. Schreuder ◽  
Huib de Jong ◽  
Ellen C. van der Kuur ◽  
Elisabeth A.M. Cornelissen
Keyword(s):  
Urinary Tract ◽  
Infliximab Therapy ◽  
Tubular Dysfunction ◽  
Renal Fanconi Syndrome ◽  
Case Presentation ◽  
Proximal Tubular Dysfunction ◽  
First Case ◽  
Proximal Tubular ◽  
Tract Infections ◽  
Amino Aciduria

Abstract Objectives Urinary tract infections (UTIs) are common in childhood. Distal tubular dysfunction during a UTI is relatively common, but proximal tubular involvement is a unique feature in humans. Case presentation We present the first case of transient generalized proximal tubular dysfunction (renal Fanconi syndrome) in an infant with an UTI. During pregnancy, his mother was treated for Crohn’s disease with infliximab (last dose at 28 weeks of gestation). He presented at the age of six weeks with a reduced intake, and was found to have amino-aciduria, glucosuria, and urinary loss of potassium, bicarbonate and low-molecular-weight proteins. Within a few weeks after antibiotic treatment for the UTI, no proximal tubular disorder remained and the boy is doing well. Conclusions We hypothesize that the inflammatory response caused by the UTI was more profoundly present due to the maternal infliximab therapy, and thereby included not only the distal but also the proximal tubules.

Approach to the patient with renal Fanconi syndrome, glycosuria, or aminoaciduria

2018 ◽  
Author(s):  
Detlef Bockenhauer ◽  
Robert Kleta
Keyword(s):  
Fanconi Syndrome ◽  
Tubular Dysfunction ◽  
Renal Fanconi Syndrome ◽  
Renal Glycosuria ◽  
Proximal Tubular Dysfunction ◽  
Wide Range ◽  
Proximal Tubular ◽  
Proximal Tubular Function ◽  
Low Molecular Weight Proteins ◽  
Filtration Capacity

Up to 80% of filtered salt and water is returned back into the circulation in the proximal tubule. Several solutes, such as phosphate, glucose, low-molecular weight proteins, and amino acids are exclusively reabsorbed in this segment, so their appearance in urine is a sign of proximal tubular dysfunction. An entire orchestra of specialized apical and basolateral transporters, as well as paracellular molecules, mediate this reabsorption. Defects in proximal tubular function can be isolated (e.g. isolated renal glycosuria, aminoacidurias, or hypophosphataemic rickets) or generalized. In the latter case it is called the Fanconi–Debre–de Toni syndrome, based on the initial clinical descriptions. However, in clinical practice it is usually referred to as just the ‘renal Fanconi syndrome’. Severity of proximal tubular dysfunction can vary, and may coexist with some degree of loss of glomerular filtration capacity. Causes include a wide range of insults to proximal tubular cells, including a number of genetic conditions, drugs and poisons.

scholarly journals Raoultella ornithinolytica in MALT-type non-Hodgkin Lymphoma

2021 ◽  
Author(s):  
Rui Seixas ◽  
Adelaide Alves ◽  
Aurelia Selaru ◽  
Manuela Vanzeller ◽  
Teresa Shiang ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Hodgkin Lymphoma ◽  
Immunocompromised Patient ◽  
Bloodstream Infections ◽  
Immunocompromised Patients ◽  
Non Hodgkin Lymphoma ◽  
First Case ◽  
Tract Infections

Raoultella ornithinolytica is a bacterium that belongs to the Enterobacteriaceae family. The most frequently reported infections are gastrointestinal and hepatobiliary. Urinary tract infections are very rarely reported and bloodstream infections are usually reported without an identified source. This bacterium is responsible for an increasing number of infections, especially in immunocompromised patients. The authors describe the first case ever reported of an immunocompromised patient due to non-Hodgkin lymphoma MALT type and corticotherapy, who developed urinary tract infection and subsequently bacteriemia due to this pathogen.

The Decline of Autophagy Contributes to Proximal Tubular Dysfunction During Sepsis

Shock ◽  
2012 ◽  
Vol 37 (3) ◽  
pp. 289-296 ◽  
Author(s):  
Hsiu-Wen Hsiao ◽  
Ke-Li Tsai ◽  
Li-Fang Wang ◽  
Yen-Hsu Chen ◽  
Pei-Chi Chiang ◽  
...  
Keyword(s):  
Tubular Dysfunction ◽  
Proximal Tubular Dysfunction ◽  
Proximal Tubular

Tubular function

2015 ◽  
Author(s):  
Marijn Speeckaert ◽  
Joris Delanghe
Keyword(s):  
Fractional Excretion ◽  
Tubular Function ◽  
Tubular Dysfunction ◽  
Renal Fanconi Syndrome ◽  
Glomerular Function ◽  
Diminished Capacity ◽  
Fractional Excretion Of Sodium ◽  
Proximal Tubular ◽  
Pass Through ◽  
Renal Tubular

Assessment of tubular function is more complicated than the measurement of glomerular filtration rate. Different functions may be affecting according to the different segments of tubule involved. Key tests include concentrating and diluting capacity, and fractional excretion of sodium. Tubular proteinuria occurs when glomerular function is normal, but when the proximal tubules have a diminished capacity to reabsorb and to catabolize proteins, causing an increased urinary excretion of the low-molecular-mass proteins that normally pass through the glomerulus. Proximal tubular dysfunction is characterized by hypophosphataemia, and a variety of other abnormalities characteristics of the renal Fanconi syndrome. Distinguishing the location of the lesion in Renal Tubular Acidosis is considered in Chapter 35.

Rare case of pseudohypoaldosteronism in a neonate secondary to congenital hydrometrocolpos

2020 ◽  
Vol 13 (6) ◽  
pp. e234813
Author(s):  
Shruti Kumar ◽  
Helen McDermott ◽  
Sheilah Kamupira ◽  
Juliana Chizo Agwu
Keyword(s):  
Weight Gain ◽  
Urinary Tract ◽  
Rare Case ◽  
Obstructive Uropathy ◽  
Tubular Dysfunction ◽  
Renal Tubular Dysfunction ◽  
Outflow Obstruction ◽  
Renal Tubular ◽  
Tract Infections ◽  
Poor Weight Gain

Pseudohypoaldosteronism (PHA) due to obstructive uropathy, urinary tract infections and congenital urogenital malformations has been reported in the literature; however, there are no reports of PHA associated with hydrometrocolpos due to a common urogenital tract. Hydrometrocolpos is a condition resulting in distension of the vagina and uterus due to accumulation of secretions (other than blood), caused by increased oestrogenic stimulation and vaginal outflow obstruction. We report on a neonatal case of PHA caused by recurrent hydrometrocolpos presenting with vomiting and poor weight gain. There was significant hyponatraemia, hyperkalaemia, and anaemia requiring medical stabilisation prior to surgery. The mechanism by which PHA occurs in obstruction involves renal tubular dysfunction due to pressure from hydronephrosis and the release of intrarenal cytokines. In addition, there is an immature or resistant renal tubular responsiveness to aldosterone during infancy. Clinicians should be aware of this uncommon but serious presentation.

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