Bilateral Xanthogranulomatous Pyelonephritis due to Staphylococcus Schleiferi: An Uncommon Presentation

Light chain deposition disease (LCDD) is a rare multisystemic disorder associated with plasma cell proliferation. It mainly affects the kidney, but liver and heart involvement may occur, sometimes mimicking the picture of systemic amyloidosis. Liver disease in LCDD is usually asymptomatic and exceptionally manifests with severe cholestatic hepatitis. We report the case of a 66-year-old female with κ-LCDD and cast nephropathy in the setting of symptomatic multiple myeloma who, after a first cycle of bortezomib-dexamethasone chemotherapy, developed severe and rapidly worsening intrahepatic cholestasis secondary to liver κ-light chain deposition. Intrahepatic cholestasis was attributed to LCDD on the basis of the liver histology and exclusion of possible diagnoses. Chemotherapy was maintained and resulted in progressive resolution of cholestasis. We report here an uncommon presentation of LCDD, with prominent liver involvement that fully recovered with bortezomib-based chemotherapy, and briefly review the relevant literature. Abbreviations: AKI: Acute kidney injury; ALP: alkaline phosphatase; ALT: alanine aminotransferase; AST: aspartate aminotransferase; CMV: Cytomegalovirus; EBV: Epstein–Barr virus; GGT: gamma-glutamyl transferase; HSV: Herpes simplex virus; LC: light chain; LCDD: Light chain deposition disease; MIDD: Monoclonal immunoglobulin deposition disease; MM: Multiple myeloma.

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Chronic Constipation due to Hypercalcemia Associated with Parathyroid Adenoma: An Uncommon Presentation - A Brief Report

Journal of Advanced Research in Medicine ◽

10.24321/2349.7181.201908 ◽

2019 ◽

Vol 06 (02) ◽

pp. 13-15

Author(s):

Naresh Kumar ◽

Keyword(s):

Parathyroid Adenoma ◽

Chronic Constipation ◽

Uncommon Presentation

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Lupus cystitis: unusual cause of renal failure in systemic lupus erythematosus

BMJ Case Reports ◽

10.1136/bcr-2019-233446 ◽

2019 ◽

Vol 12 (12) ◽

pp. e233446

Author(s):

Kevin John ◽

Krupa Varughese ◽

Ranil Johann Boaz ◽

Tarun George

Keyword(s):

Systemic Lupus Erythematosus ◽

Acute Kidney Injury ◽

Renal Failure ◽

Renal Function ◽

Lupus Erythematosus ◽

Kidney Injury ◽

Systemic Lupus ◽

Uncommon Presentation ◽

Acute Dyspnoea ◽

Chronic Fever

A 42-year-old woman presented with chronic fever, abdominal pain, intermittent loose stools and dysuria for 3 months. She had recently developed acute dyspnoea with acute kidney injury. She was found to have a contracted, thick-walled bladder with bilateral hydroureteronephrosis. She underwent bilateral percutaneous nephrostomies, following which her renal function recovered. She satisfied the clinical and immunological features of the Systemic Lupus International Collaborating Clinics criteria for systemic lupus erythematosus (SLE). She was initiated on immunosuppression. Lupus cystitis with a contracted bladder is an uncommon presentation of SLE.

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