Renal disease

肾脏疾病
  • 文章类型: Case Reports
    X-连锁无丙种球蛋白血症(XLA)是一种以反复感染为特征的体液免疫缺陷疾病,严重的低丙种球蛋白血症,循环B细胞缺乏.虽然XLA的标志性临床表现通常包括呼吸道,皮肤病学,和胃肠系统,肾脏受累是罕见的。在这篇文章中,我们报告了两例XLA并发肾脏疾病,补充了对记录在案的案例的审查。
    所描述的两个案例涉及孪生兄弟,均表现为呼吸道感染和肾脏表现。随后的基因检测证实了XLA的诊断。弟弟在静脉注射免疫球蛋白(IVIG)治疗和抗感染治疗后表现出改善。由于资金紧张,哥哥只接受了抗感染和对症治疗。出院后七个月,哥哥患上了肾炎。然而,他在IVIG治疗后表现出改善。
    对于复发性感染的男性儿童,应考虑进行免疫分析和基因检测,以促进XLA的有效诊断。定期监测对于检测和治疗XLA患者的免疫介导的肾脏疾病也是必要的。
    UNASSIGNED: X-linked agammaglobulinemia (XLA) is a humoral immunodeficiency disorder characterized by recurrent infections, severe hypogammaglobulinemia, and a deficiency of circulating B cells. While the hallmark clinical manifestations of XLA typically include the respiratory, dermatological, and gastrointestinal systems, renal involvement is infrequent. In this article, we report two cases of XLA with concurrent renal disease, supplemented with a review of documented cases.
    UNASSIGNED: The two cases described involve twin brothers, both presenting with respiratory tract infections and renal manifestations. Subsequent genetic testing confirmed the diagnosis of XLA. The younger brother exhibited improvement following intravenous immunoglobulin (IVIG) therapy and anti-infection treatment. Due to financial constraints, the older brother received only anti-infection and symptomatic treatments. Seven months after discharge, the older brother developed nephritis. However, he showed improvement following IVIG treatment.
    UNASSIGNED: Immune profiling and genetic testing should be considered in male children with recurrent infections to facilitate the effective diagnosis of XLA. Regular monitoring is also imperative to detect and treat immune-mediated renal diseases in patients with XLA.
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  • 文章类型: Case Reports
    我们报告了一例同时诊断为1型糖尿病的患者,Gitelman综合征和Cacci-Ricci病。一名27岁的男性患者在3岁时被诊断出患有Gitelman综合征。十四年后,他患上了自身抗体阴性的1型糖尿病.Cacci-Ricci病由终末血尿显示,并考虑到计算机断层扫描(CT)扫描中发现的外观。手指刺入的血糖水平为6g/dl,无丙酮尿症。肌酐清除率为60ml/min。甲状腺功能检查正常。钙,磷和甲状旁腺激素(PTH)水平正常。讨论:Gitelman综合征是一种罕见的疾病。Gitelman综合征与1型糖尿病之间的关联已在两名患者的文献中报道。作者研究了Gitelman综合征与2型糖尿病之间的关系。已经提出了几种病理生理学解释。Cacci-rcci病是一种罕见的,良性先天性异常。1型糖尿病之间没有关联,Gitelman综合征和Cacci-Ricci病已在文献中报道。据我们所知,这是文献中描述的第一种情况。
    We report the case of a patient who exhibits a concurrent diagnosis of type 1 diabetes mellitus, Gitelman syndrome and Cacci-Ricci disease. A 27-year-old male patient was diagnosed with Gitelman syndrome at the age of 3 years. Fourteen years later, he developed an autoantibody-negative type 1 diabetes mellitus. Cacci-Ricci\'s disease was revealed by terminal hematuria and considered in view of the appearance found on the computed tomography (CT) scan. The finger-prick blood glucose level was 6 g/dl with no acetonuria. Creatinine clearance was 60 ml/min. Thyroid function tests were normal. Calcium, phosphorus and parathormone (PTH) levels were normal. Discussion: Gitelman syndrome is a rare disorder. The association between Gitelman syndrome and type 1 diabetes mellitus has been reported in the literature in two patients. Authors have investigated the association between Gitelman syndrome and type 2 diabetes mellitus. Several pathophysiological explanations have been put forward. Cacci-ricci disease is a rare, benign congenital anomaly. No association between type 1 diabetes mellitus, Gitelman syndrome and Cacci-Ricci disease has been reported in the literature. To our knowledge, this is the first case described in the literature.
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  • 文章类型: Published Erratum
    [这更正了文章DOI:10.3389/fgene.2023.1122893。].
    [This corrects the article DOI: 10.3389/fgene.2023.1122893.].
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  • 文章类型: Case Reports
    本病例报告描述了常用的皮肤防护屏障乳膏与尿液收集袋一起使用对苄索氯铵方法测量6个月女婴尿蛋白的积极干扰,导致错误的结果。通过将尿液样品与该乳膏人工混合并将使用苄索氯铵方法获得的结果与使用邻苯三酚红法获得的结果进行比较来鉴定干扰。
    This case report describes the positive interference of the commonly used skin protective barrier cream used together with urine collection bags on the benzethonium chloride method for urine protein measurements in a 6-month-old female baby, leading to falsely elevated results. The interference was identified by both artificially mixing urine samples with this cream and comparing the results obtained using the benzethonium chloride method with those obtained using the pyrogallol red method.
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  • 文章类型: Case Reports
    背景:Anderson-Fabry病(AFD)是一种X连锁疾病,由酶半乳糖苷酶α(GLA)的活性降低引起。当GLA基因序列被改变正常DNA序列的突变改变时,产生α-半乳糖苷酶A酶的变体,它可能起作用,也可能不起作用。这些突变导致了法布里病,到目前为止,已经在Anderson-Fabry病患者中描述了800多种不同的基因突变。在这种情况下,我们报告了一个女性的病例,她是这种突变的唯一家庭成员。病例介绍:我们报告了一例52岁女性,患有终末期慢性肾脏病,接受透析治疗。患者全血中α-半乳糖苷酶活性为6.6nmol/ml/h,lyso-GB3水平为11.45nmol/L(正常范围<2.3nmol/L)。α-半乳糖苷酶A基因序列分析揭示了外显子6中c.947dupT的致病变体,导致p。I317NfsTer16氨基酸取代。遗传分析在任何其他筛选的家族成员中均未检测到相同的突变。结论:国际法布里病基因型-表型数据库(dbFGP)报道了外显子6中的致病性变异c.947dupT,这可能与法布里病的经典表型有关。在这个案例报告中,我们报告了一个女性的病例,她是这种致病变异的唯一家庭成员。类似的情况没有在文献中描述这种致病变异,它代表了法布里病患者家族间和家族内变异性的重要情况。文献表明,在法布里病的背景下经常发现从头致病变体。
    Background: Anderson-Fabry disease (AFD) is an X-linked disease that results from reduced activity of the enzyme galactosidase alpha (GLA). When the GLA gene sequence is altered by mutations that alter the normal DNA sequence, variants of the alpha-galactosidase A enzyme are produced, which may or may not function. These mutations are responsible for Fabry disease, and to date, over 800 different mutations of the gene have been described in patients with Anderson-Fabry disease. In this case, we report the case of a woman who is the sole family member with this type of mutation. Case presentation: We report a case of a 52-year-old woman with end-stage chronic kidney disease in dialysis treatment. The patient\'s alpha-galactosidase activity was 6.6 nmol/ml/h in whole blood, and lyso-GB3 levels were 11.45 nmol/L (normal range < 2.3 nmol/L). Alpha-galactosidase A gene sequence analysis revealed a pathogenic variant of c.947dupT in exon 6, leading to the p. I317NfsTer16 amino acid substitution. The genetic analysis did not detect the same mutation in any of the other screened family members. Conclusion: The international Fabry disease genotype-phenotype database (dbFGP) reports a pathogenic variant c.947dupT in exon 6 that is probably associated with a classical phenotype of Fabry disease. In this case report, we report the case of a woman who is the sole family member with this type of pathogenic variant. Similar situations have not been described in the literature for this pathogenic variant, and it represents an important case of inter- and intrafamilial variability in patients with Fabry disease. The literature shows that de novo pathogenic variants are frequently found in the context of Fabry disease.
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  • 文章类型: Case Reports
    寻常型天疱疮和肾病综合征之间可能有联系,我们的寻常型天疱疮患者发生局灶节段肾小球硬化并回顾相关文献证明了这一点。因此,如果寻常型天疱疮患者在尿液分析期间发现双侧下肢水肿或蛋白尿,这可能表明肾脏受累。
    寻常型天疱疮是一种自身免疫性水疱性疾病,其特征是存在针对桥粒蛋白3和1的IgG自身抗体。重要的是评估寻常型天疱疮患者的潜在自身免疫关联,以便可以进行适当的实验室和体格检查以监测其他自身免疫性疾病的任何增加的风险。该病例报告描述了一名55岁的女性,她出现了口腔和腋窝糜烂,根据皮肤组织病理学和免疫荧光诊断为寻常型天疱疮。随访期间,病人被发现有蛋白尿,结果转诊到肾病科医生那里.活检后,患者被诊断为肾病综合征和微小病变。尽管治疗,患者的蛋白尿持续存在,血清肌酐水平升高,导致第二次活检,证实诊断为局灶性节段肾小球硬化。本研究报告了第一例寻常型天疱疮合并局灶节段性肾小球硬化,并回顾了有关获得性免疫球性疾病和任何类型的肾病综合征并存的文献。
    UNASSIGNED: There may be a connection between pemphigus vulgaris and nephrotic syndrome, as evidenced by the occurrence of focal segmental glomerulosclerosis in our pemphigus vulgaris patient and reviewing relevant literature. Therefore, if a patient with pemphigus vulgaris presents with bilateral lower extremity edema or proteinuria detected during urinalysis, it could indicate involvement of the kidneys.
    UNASSIGNED: Pemphigus vulgaris is a type of autoimmune blistering disease characterized by the presence of IgG autoantibodies against desmogleins 3 and 1. It is important to evaluate potential autoimmune associations in patients with pemphigus vulgaris so that appropriate laboratory and physical examinations can be performed to monitor for any increased risk of other autoimmune disorders. This case report describes a 55-year-old woman who presented with oral and axillary erosions, which were diagnosed as pemphigus vulgaris based on skin histopathology and immunofluorescence. During follow-up, the patient was found to have proteinuria, which led to referral to a nephrologist. The patient was diagnosed with nephrotic syndrome and minimal change disease after a biopsy. Despite treatment, the patient\'s proteinuria persisted and serum creatinine levels increased, leading to a second biopsy which confirmed the diagnosis of focal segmental glomerulosclerosis. This study reports on the first case of pemphigus vulgaris with focal segmental glomerulosclerosis and reviews the literature on the co-occurrence of acquired immunobullous diseases and nephrotic syndrome of any kind.
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  • 文章类型: Journal Article
    未经证实:气候变化正在增加受伤的风险,疾病,全球死亡。然而,环境温度与肾脏疾病之间的关联尚未得到充分表征。这项研究旨在量化与环境温度相关的肾脏疾病住院的风险和可归因负担。
    UNASSIGNED:在2000年和2015年期间收集了来自巴西1816个城市的每日入院数据。采用时间分层的病例交叉设计来评估温度与肾脏疾病之间的关联。相对风险(RR),可归因分数(AF),并计算其置信区间(CI)来估计关联和归因负担。
    UNASSIGNED:在研究期间共记录了2,726,886例肾脏疾病住院治疗。每日平均温度每升高1°C,在全国范围内,延迟0-7天的肾脏疾病住院估计风险增加了0.9%(RR=1·009,95%CI:1·008-1·010).温度与肾脏疾病之间的关联在滞后0天时最大,但在滞后1-2天时仍然存在。女性的风险更为突出,0-4岁儿童,老年人≥80岁。7·4%(95%CI:5·2-9·6%)的肾脏疾病住院率可能归因于温度升高,相当于202,093例(95%CI:141,554-260,594例)。
    UNASSIGNED:这项全国性的研究提供了强有力的证据,表明应该制定更多的政策来防止与热有关的住院和缓解气候变化。
    UASSIGNED:中国国家奖学金委员会,澳大利亚国家健康和医学研究委员会。
    UNASSIGNED: Climate change is increasing the risks of injuries, diseases, and deaths globally. However, the association between ambient temperature and renal diseases has not been fully characterized. This study aimed to quantify the risk and attributable burden for hospitalizations of renal diseases related to ambient temperature.
    UNASSIGNED: Daily hospital admission data from 1816 cities in Brazil were collected during 2000 and 2015. A time-stratified case-crossover design was applied to evaluate the association between temperature and renal diseases. Relative risks (RRs), attributable fractions (AFs), and their confidence intervals (CIs) were calculated to estimate the associations and attributable burden.
    UNASSIGNED: A total of 2,726,886 hospitalizations for renal diseases were recorded during the study period. For every 1°C increase in daily mean temperature, the estimated risk of hospitalization for renal diseases over lag 0-7 days increased by 0·9% (RR = 1·009, 95% CI: 1·008-1·010) at the national level. The associations between temperature and renal diseases were largest at lag 0 days but remained for lag 1-2 days. The risk was more prominent in females, children aged 0-4 years, and the elderly ≥ 80 years. 7·4% (95% CI: 5·2-9·6%) of hospitalizations for renal diseases could be attributable to the increase of temperature, equating to 202,093 (95% CI: 141,554-260,594) cases.
    UNASSIGNED: This nationwide study provides robust evidence that more policies should be developed to prevent heat-related hospitalizations and mitigate climate change.
    UNASSIGNED: China Scholarship Council, and the Australian National Health and Medical Research Council.
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  • 文章类型: Review
    全身性草酸盐病是草酸钙晶体沉积到各种身体组织中的病症。尽管这可能是由于一种罕见的原发性综合症引起的,在这种综合症中,乙醛酸代谢的错误导致草酸盐的过量产生,它更常被视为以增加的肠草酸盐吸收为特征的第二过程。这里,我们描述了一名长期肠外营养支持的短肠综合征患者,他出现了全身性氧化中毒的独特表现,导致骨髓内草酸盐晶体沉积,导致全血细胞减少。在这份报告中,除了回顾关于这种可能罕见的草藻病表现的文献外,我们还讨论了短肠综合征的发病机制及其管理,包括预防。
    Systemic oxalosis is a condition in which calcium oxalate crystals deposit into various bodily tissues. Although this may occur as the result of a rare primary syndrome in which an error of glyoxylate metabolism causes an overproduction of oxalate, it is more often seen as a secondary process characterized by increased enteric oxalate absorption. Here, we describe a patient with short bowel syndrome on long-term parenteral nutrition support who developed a unique manifestation of systemic oxalosis, leading to deposition of oxalate crystals within the bone marrow contributing to pancytopenia. In this report, in addition to reviewing the literature on this presumably rare manifestation of oxalosis, we also discuss its pathogenesis in the setting of short bowel syndrome and its management, including prevention.
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  • 文章类型: Case Reports
    难治性高血压是一个挑战,在终末期肾病(ESRD)患者谁是定期血液透析,尽管使用了新型降压药和量身定制的透析处方。双侧肾切除术似乎是一个被遗忘的选择。我们介绍了16岁男孩的病史,该男孩接受了开放性双侧肾切除术作为难治性高血压的抢救治疗。这种血压的手术治疗选择可令人满意地控制迄今为止的难治性高血压,并伴有多次危及生命的高血压危机。
    Refractory hypertension is a challenge in End Stage Renal Disease (ESRD) patients who are on regular hemodialysis, despite the use of novel antihypertensive agents and tailor-made dialysis prescriptions. Bilateral nephrectomy seems to be a forgotten option. We present a case history of 16 year old boy who underwent open bilateral nephrectomy as a rescue therapy for refractory hypertension. This surgical treatment option of blood pressure led to satisfactory control of hitherto refractory hypertension complicated with multiple life-threatening episodes of hypertensive crises.
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  • 文章类型: Case Reports
    快速进展性肾小球肾炎(RPGN)是一种罕见的综合征,其特征是血清肌酐突然升高和肾活检上存在新月。如果没有适当和及时的治疗,多达90%的受影响患者可能发展为终末期肾病(ESRD).在许多资源匮乏的国家,获得肾脏替代疗法的机会有限,因此,提高对这个实体的认识是很重要的。我们讲述了两名血清肌酐升高的儿童的临床过程,高血压和血尿,随后在活检中被诊断为新月体性肾小球肾炎。尽管接受过免疫抑制治疗,两个孩子的肾脏结局都很差,也许是由于适当治疗机构的延误。必须使所有管理儿童的临床医生都意识到这种临床综合征,以便及时转诊到肾脏病学。这将有助于改善肾脏预后。
    Rapidly progressive glomerulonephritis (RPGN) is a rare syndrome which is marked by a sudden rise in serum creatinine and the presence of crescents on renal biopsy. If appropriate and timely treatment is not instituted, as many as 90% of affected patients may develop End Stage Renal Disease (ESRD). There is only limited access to renal replacement therapy in many low resource countries, thus it is important that awareness of this entity is raised. We narrate the clinical course of two children who were admitted with rising serum creatinine, hypertension and haematuria and who were subsequently diagnosed with crescentic glomerulonephritis on biopsy. Despite having received immunosuppressive therapy, both children had a poor renal outcome, perhaps due to delays in institution of appropriate treatment. It is imperative that all clinicians who manage children are made aware of this clinical syndrome so that timely referrals to nephrology are done. This will help to improve renal outcomes.
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