scholarly journals Tonsillectomy in IgA Nephropathy - Clinical Case

2021 ◽  
Vol 26 (3) ◽  
pp. 59-61
Author(s):  
Livia Mirela Popa ◽  
Livia Popa ◽  
Cătălin-Bogdan Osalciuc
Keyword(s):  
Antibiotic Therapy ◽  
Iga Nephropathy ◽  
Clinical Case ◽  
Acute Infection ◽  
Acute Onset ◽  
First Episode ◽  
Urinary Volume ◽  
Upper Airways ◽  
Macroscopic Hematuria ◽  
Nephritic Syndrome

Abstract This article presents the clinical case of IgA nephropathy of a patient hospitalized in order to investigate a nephritic syndrome, apparently with acute onset, discovered in the following circumstances: recurrent macroscopic hematuria, decreased urinary volume, the first episode occurring about a month ago in the context of an acute infection of upper airways, remitted under antibiotic therapy, with reappearance every 2 weeks, also accompanied by odynophagia and decreased urinary volume.

Prevalence of IgA Nephropathy: A 10 Years’ Experience from Jinnah Postgraduate Medical Centre, Karachi, Pakistan

2020 ◽  
Keyword(s):  
Body Mass Index ◽  
Iga Nephropathy ◽  
Body Mass ◽  
Immunoglobulin A ◽  
Medical Centre ◽  
Male Dominance ◽  
Clinical Indication ◽  
Glomerular Lesion ◽  
Female Ratio ◽  
Nephritic Syndrome

Background: Immunoglobulin A (IgA) is considered the most frequently dealt primary glomerulonephritis, worldwide. The Berger’s disease or IgA nephropathy is a mesangial proliferative glomerulonephritis characterized by deposition of immunoglobulin A in kidneys. The aim of the study was to report the prevalence of IgA nephropathy and the associated parameters (age, gender, and body mass index) in our population. Methods: This was a retrospective study, accomplished at Jinnah Postgraduate Medical Centre, Karachi, Pakistan, from June 2009-May 2019. The histopathology and immunofluorescence of renal biopsies of 519 patients were studied and the prevalence of biopsy proven IgA nephropathy was determined. The Chi-square test was used for association of biopsy proven IgA nephropathy with age, gender, and body mass index. A p-value of 0.05 or less was considered statistically significant. Results: A total of 519 biopsies were studied, out of those, only 4 (0.8%) had IgA nephropathy with male dominance in the last 10 years at Karachi, Pakistan. Male to female ratio was found to be 3:1. The most common clinical indication for renal biopsy was isolated hematuria in 50% of the cases followed by acute kidney injury and nephritic syndrome with 25% each respectively. Most of the patients suffering from proteinuria (> 3.5gm/24 hours), microscopic hematuria in 80% cases, high blood pressure in 50% cases, with other associated symptoms including edema, gastrointestinal, and skin-related symptoms reported. Conclusion: Immunoglobulin A (IgA) nephropathy is not a commonly diagnosed glomerular lesion. Further large-scale cohorts can aid in determining the other factors associated with a low frequency of IgA nephropathy. Keywords: Biopsy; Glomerulonephritis; Immunoglobulin A; Nephropathy.

Hypoglycemic Hemiparesis Masquerading As Ischemic Stroke: When Guideline Fails

2020 ◽  
Vol 15 (4) ◽  
pp. 420-422
Author(s):  
Dhruvkumar M. Patel ◽  
Mukundkumar V. Patel ◽  
Jayanti K. Gurumukhani ◽  
Maitri M. Patel ◽  
Himal J. Mahadevia ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Neurological Deficit ◽  
Clinical Case ◽  
Complete Recovery ◽  
Acute Onset ◽  
Diabetic Patients ◽  
Focal Neurological Deficit ◽  
Random Blood Sugar ◽  
Resident Doctor

Background: Hypoglycemia may rarely present as hemiparesis and sometimes it is difficult to differentiate from ischemic stroke. When random blood sugar (RBS) value is between 50 and 80 mg % in patients presenting with focal neurological deficit, no guideline exists to consider the possibility of hypoglycemia before initiating thrombolytic therapy. Clinical Case: A 58-year-old male, who was a known case of diabetes and hypertension, was brought to the emergency room with acute onset of right hemiparesis and dysarthria of 90 minutes duration. His NIHSS Score was 9, blood pressure was 150/90 mm of Hg and RBS was 79 mg% on admission. His CT scan brain was normal and was considered for thrombolysis. Resident doctor not aware of previous sugar repeated RBS before thrombolysis which was surprisingly 60 mg% 60 minutes after the first RBS. Even though he was a candidate for thrombolysis, intravenous 25 % dextrose was administered considering the possibility of hypoglycemia. He made a complete recovery within 20 minutes and thrombolytic therapy was withheld. : In Diabetic patients with focal neurological deficit and RBS less than 80 mg% on admission, RBS should be rechecked and in appropriate cases should be challenged with IV dextrose considering the possibility of hypoglycemia before commencing thrombolytic therapy.

Assessing clinicians' management of first episode schizophrenia using clinical case vignettes

2010 ◽  
Vol 4 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Jeff C. Huffman ◽  
Oliver Freudenreich ◽  
Sarah Romeo ◽  
Lee Baer ◽  
Kelly Sutton-Skinner ◽  
...  
Keyword(s):  
Clinical Case ◽  
First Episode ◽  
Case Vignettes ◽  
First Episode Schizophrenia

IgA Nephropathy: Association of a History of Macroscopic Hematuria Episodes with Increased Production of Polymeric IgA

Nephron ◽  
1987 ◽  
Vol 45 (2) ◽  
pp. 98-103 ◽  
Author(s):  
Luz Lozano ◽  
Rosa García-Hoyo ◽  
Jesús Egido
Keyword(s):  
Iga Nephropathy ◽  
Macroscopic Hematuria ◽  
History Of

scholarly journals Recurrent posterior elbow dislocation caused by congenital abnormalities in a 7-year-old child

2021 ◽  
Vol 9 (2) ◽  
pp. 211-219
Author(s):  
Yaroslav N. Proshchenko ◽  
Yulia A. Sigareva
Keyword(s):  
Surgical Treatment ◽  
Elbow Joint ◽  
Clinical Case ◽  
Neonatal Period ◽  
Clinical Manifestations ◽  
Elbow Dislocation ◽  
Primary Diagnosis ◽  
First Episode ◽  
Minor Trauma ◽  
Congenital Origin

BACKGROUND: Congenital posterior elbow dislocation in children is a rare and scarcely reported condition. Owing to the difficulties of an early primary diagnosis and the lack of a standardized management, we present a clinical case of an analysis of surgical treatment according to literature and based on our experience. CLINICAL CASE: We present a case of congenital posterior elbow dislocation in a 7-year-old child. In the absence of a universal algorithm for surgical treatment, we performed an arthrotomy for visual assessment of articular surfaces, intervention on the capsule and tendons of m. brachialis, m. biceps brachii, m. brachioradialis, and modeling of the proximal epiphysis of the right radius. DISCUSSION: We analyzed surgical treatment options and made an overview of the main stabilizers of the elbow joint that prevent elbow dislocations. There are few publications on this condition; to our knowledge, over the past 10 years, only two clinical cases of a similar pathology in children had been published. Not a single case of congenital elbow dislocation in the neonatal period has been described. We analyzed early clinical manifestations and possible causes of delayed primary diagnosis. CONCLUSIONS: Recurrent posterior elbow dislocation of the congenital origin is associated with a functional deficiency of elbow joint stabilizers. In the neonatal period, these abnormalities are usually not detected. The first episode of dislocation may be triggered by a minor trauma without damaging the bone structures. Delayed primary diagnosis may be associated with the paucity of clinical symptoms and compensatory functionality in children. The decision on surgical correction should be based on the analysis of structural anatomical changes in the assessment, of which magnetic resonance imaging plays an important role.

scholarly journals Renal Outcomes of Childhood IgA Nephropathy and Henoch Schönlein Purpura Nephritis

2021 ◽  
Vol 73 (10) ◽  
pp. 687-694
Author(s):  
Thanaporn Chaiyapak ◽  
Anirut Pattaragarn ◽  
Suroj Supavekin ◽  
Nuntawan Piyaphanee ◽  
Kraisoon Lomjansook ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Complete Recovery ◽  
Clinicopathological Characteristics ◽  
Henoch Schonlein Purpura ◽  
Renal Outcomes ◽  
Nephritic Syndrome ◽  
Schonlein Purpura ◽  
Henoch Schönlein Purpura ◽  
Purpura Nephritis

Background: Henoch-Schönlein purpura nephritis (HSPN) is considered the systemic form of IgA nephropathy (IgAN). However, differing clinicopathological features and renal outcomes of children with IgAN and HSPN have been reported in some studies. Methods: This study retrospectively reviewed children with IgAN and HSPN younger than 18 years, between January 2004 and December 2015. The clinicopathological characteristics at diagnosis and the renal outcomes after at least 1 year of follow-up were compared between the two groups. Results: A total of 54 children, comprising 21 with IgAN and 33 with HSPN, were recruited. The children with HSPN were younger than the children with IgAN. Gross hematuria and nephritic syndrome at the initial presentation were more common in children with IgAN. Regarding the pathological findings, IgAN had greater chronicity than HSPN. After a median follow-up period from first presentation to renal outcomes measurement of 4.0 years (1.3-12.2) in children with IgAN and 4.2 years (1.1-11.4) in children with HSPN, the renal outcomes were better in the latter group. The incidence of chronic kidney disease (CKD) was 28.6% in children with IgAN and 6.1% in children with HSPN (p = 0.02). Complete recovery was observed more frequently in children with HSPN than in children with IgAN (57.1% in IgAN vs. 87.9% in HSPN, p = 0.01). Conclusions: Childhood IgAN has greater chronicity and worse renal outcomes than childhood HSPN, with a lower rate of complete recovery and a higher frequency of CKD. We recommend long-term follow-up for CKD in children with IgAN.

scholarly journals Wilson–Konovalov disease: acute onset, course, diagnosis and treatment (clinical case)

2021 ◽  
pp. 76-81
Author(s):  
Yu.I. Alekseeva ◽  
◽  
Ji. V. Turkin ◽  
О.B. Synoverskaya ◽  
L.Ya. Ivanyshyn ◽  
...  
Keyword(s):  
Clinical Picture ◽  
Clinical Case ◽  
Local Level ◽  
Acute Onset ◽  
Left Lobe ◽  
Diagnostic Methods ◽  
Laboratory Research ◽  
Disease Etiology ◽  
Research Institution ◽  
Body Tissues

The article presents information on the main etiology and pathogenesis of Wilson–Konovalov disease, as hepato-lenticular degeneration associated with excessive accumulation of copper in body tissues due to an inherited autosomal recessive defect of a protein that transports copper. A rare case of the onset and course of the disease in a patient who was examined and treated at the Ivano-Frankivsk Regional Children's Clinical Hospital is described. The main focus is on the acute, atypical onset of the disease, in particular the signs of severe intoxication syndrome caused by manifestations of hepatic encephalopathy, steroid-induced diabetes, anemia of complex genesis, coronavirus disease, pyoderma. The difficulties of diagnosing the disease against the background of delayed manifestation of the main pathognomonic manifestations and the absence of reliable signs of the disease are shown. The clinical picture of this clinical case, features of the course are described, the indicators of the main clinical and laboratory research methods are given, the results of instrumental diagnostic methods and genetic examination methods are shown, both in laboratories of Ukraine and abroad, which confirmed the diagnosis of Wilson–Konovalov disease. The treatment of this clinical case is described in detail not only at the local level but also in the main leading research institution of Ukraine «OHMATDYT» and «National Institute of Surgery and Transplantology named after O.O. Shalimov». Recommendations for further observation and treatment of the child at the place of residence after orthotopic transplantation of the left lobe of the liver from a living family donor. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: Wilson-Konovalov disease, etiology, pathogenesis, clinical picture, diagnosis, examination, treatment.

scholarly journals Indian scenario of IgA nephropathy: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
pp. 159-65
Author(s):  
Anju Khairwa
Keyword(s):  
Systematic Review ◽  
Iga Nephropathy ◽  
Clinical Features ◽  
Meta Analysis ◽  
Microscopic Hematuria ◽  
Macroscopic Hematuria ◽  
Female Ratio ◽  
Cochrane Database ◽  
Male Female Ratio ◽  
Indian Scenario

Background: IgA nephropathy (IgAN) is most common primary glomerulopathy. There are variations in prevalence of IgAN and its clinical features in different studies from India. Aim: To summarize overall scenario of IgAN in India. Methods: In this systematic review, studies related to IgAN and related renal disease were included. Data searched were PubMed, EMBASE, Google scholar, and Cochrane Database from inception to 31st January 2019. Results: Total 49 studies (N=2480) were included: 21studies (N=2309) of primary IgAN; 19 studies (N=21) of Secondary IgAN; four studies (N=133) of IgA vasculitis nephropathy (IgAVN); and five studies (N=17) of IgA dominant nephropathy (IgADN). Prevalence of IgAN was 16.5% in India. Age of affected persons was ranging from 27.2±16.7 to 48.6±21.3 years . Male female ratio was 1.8:1. Clinical features of Primary IgAN, IgAVN, IgADN & Secondary IgAN were microscopic hematuria (49.6%, 44.4%, 15.6% & 59.5%), macroscopic hematuria (5.1%, 0.4%,40.9%,& 35.7%), Subnephrotic proteinuria (42.1%, 29.4%, 23.2%, & 52.3%), nephrotic proteinuria (16.0%, 4.4%, 76.8%,& 47.6%), and hypertension (25.8%,18.3%, 35.5%,& 47.6%).. The 24 hours proteinuria was ranging from 2.6±1.5 to 4.7±2.3 gm/day and serum creatinine (mg/dl) was ranging from 0.9±0 to 3.5±3.9 mg/dl. Histolomorphologically, all type of IgAN showed mesangial hypercellularity and Immunofluorescence revealed IgA deposition. Conclusion: The overall prevalence of primary IgAN in India was 16.5%. The subnephrotic proteinuria and microscopic hematuria were common clinical features. Keywords: IgA Nephropathy; histomorphology; prevalence; India.

scholarly journals Cervical Necrotizing Fasciitis Caused by Dental Extraction

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
José Alcides Arruda ◽  
Eugênia Figueiredo ◽  
Pâmella Álvares ◽  
Luciano Silva ◽  
Leorik Silva ◽  
...  
Keyword(s):  
Necrotizing Fasciitis ◽  
Chronic Renal Disease ◽  
Subcutaneous Tissue ◽  
Clinical Manifestations ◽  
Acute Onset ◽  
Dental Extraction ◽  
Upper Airways ◽  
Irreversible Damage ◽  
Cervical Area ◽  
Ischemic Ulcers

Cervical necrotizing fasciitis is an unusual infection characterized by necrosis of the subcutaneous tissue and fascial layers. Risk factors for the development of necrotizing fasciitis include diabetes mellitus, chronic renal disease, peripheral vascular disease, malnutrition, advanced age, obesity, alcohol abuse, intravenous drug use, surgery, and ischemic ulcers. This report presents a case of necrotizing fasciitis in the cervical area caused by dental extraction in a 73-year-old woman. Cervical necrotizing fasciitis in geriatric patient is rare, and even when establishing the diagnosis and having it timely treated, the patient can suffer irreversible damage or even death. Clinical manifestations in the head and neck usually have an acute onset characterized by severe pain, swelling, redness, erythema, presence of necrotic tissue, and in severe cases obstruction of the upper airways. Therefore, the presentation of this clinical case can serve as guidance to dentists as a precaution to maintain an aseptic chain and be aware of the clinical condition of older patients and the systemic conditions that may increase the risk of infections.

Comparison of 8 versus 15 Days of Antibiotic Therapy for Ventilator-Associated Pneumonia in Adults

2018 ◽  
pp. 257-262
Author(s):  
Laurie O. Mark ◽  
Jean Kwo
Keyword(s):  
Antibiotic Therapy ◽  
Randomized Trial ◽  
Study Design ◽  
Clinical Case ◽  
Pulmonary Infection ◽  
Ventilator Associated Pneumonia ◽  
Icu Patients ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of the landmark study “Comparison of 8 versus 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial.” In adult patients with ventilator-associated pneumonia (VAP), is treatment with an 8-day course of antimicrobials as effective as a 15-day course? Starting with that question, the chapter describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. In ICU patients who develop microbiologically proven VAP, an 8-day antimicrobial course is not inferior to a 15-day course with respect to all-cause mortality or recurrence of pulmonary infection. However, these findings may not apply to patients who are immunocompromised, and shorter or longer duration of antibiotics may sometimes be indicated.

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