RESUMEN
Thrombotic microangiopathies represent a group of particularly serious pathologies that can cause a rapid worsening of renal function, especially in young subjects. Through the clinical case described, we will focus our attention on the clinical and laboratory manifestations of the pathology, on the diagnostics and on the therapies to be used. Recent therapeutic innovations for the treatment of this pathology will also be analysed.
Asunto(s)
Síndrome Hemolítico Urémico Atípico , Cefalea , Hipertensión , Humanos , Síndrome Hemolítico Urémico Atípico/complicaciones , Síndrome Hemolítico Urémico Atípico/diagnóstico , Cefalea/etiología , Hipertensión/complicaciones , Hipertensión/etiología , Masculino , FemeninoRESUMEN
Through a clinical case, we will describe the difficulties associated with providing transplantation opportunities to highly immunized patients. We will therefore focus on new desensitization therapies and their pharmacological effects with the consequent improvement in clinical outcomes. The main desensitization strategies in use and the main future therapeutic prospects will also be discussed.
Asunto(s)
Trasplante de Riñón , Humanos , Desensibilización Inmunológica , Antígenos HLA , Rechazo de Injerto/prevención & controlRESUMEN
Mushroom poisoning can represent an acute event which the clinical nephrologist must deal with and which often leads to the need for emergency dialysis treatment. Through the exposed clinical case, we describe the secondary clinical manifestations of an acute intoxication sustained by Amanita Echinocephalae, and we will provide an overview of the main fungal intoxications of renal interest, the clinical presentation, the diagnostic strategies, and the subsequent treatment.
Asunto(s)
Lesión Renal Aguda , Intoxicación por Setas , Humanos , Amanita , Intoxicación por Setas/complicaciones , Intoxicación por Setas/terapia , Intoxicación por Setas/diagnóstico , Lesión Renal Aguda/inducido químicamente , Lesión Renal Aguda/terapia , Diálisis Renal/efectos adversos , Ingestión de AlimentosRESUMEN
IgG4 related renal disease represents a frequent manifestation of the wider IgG4 related disease, a fibroinflammatory disorder with a not fully understood etiology that affects several organs. Through the clinical case presented, we will focus attention on this pathology and on the diagnostic difficulties that may arise, and on the investigations necessary for the diagnosis. Finally, the main therapeutic options will be discussed.
Asunto(s)
Inmunoglobulina G , Enfermedades Renales , Humanos , Riñón/patología , Enfermedades Renales/patologíaRESUMEN
Alport syndrome is a hereditary clinical condition characterized by multisystemic changes (sensorineural and ocular deafness) associated with hematuria and proteinuria. Due to its genetic variability and multiple symptoms, it is often diagnosed by chance and too late. The present work focuses on this pathology through a clinical case report. It also mentions the new therapeutic possibilities relating to this disease.
Asunto(s)
Nefritis Hereditaria , Femenino , Hematuria/etiología , Humanos , Nefritis Hereditaria/complicaciones , Nefritis Hereditaria/diagnóstico , Nefritis Hereditaria/genética , Proteinuria/etiologíaRESUMEN
Multiple myeloma represents one of the main universal oncological diseases. Due to its clinical characteristics, it is often diagnosed only too late, when it has already determined systemic effects; this results in greater therapeutic difficulty and worse prognostic results. Through the clinical case discussed in this article, we want to focus on the often aspecific manifestations of this pathology and on the need for a correct clinical and diagnostic framework. The main renal manifestations secondary to the deposition of immunoglobulins in both the glomerular and tubular areas will also be examined.
Asunto(s)
Enfermedades Renales , Mieloma Múltiple , Paraproteinemias , Humanos , Riñón , Enfermedades Renales/etiología , Glomérulos Renales , Mieloma Múltiple/complicaciones , Mieloma Múltiple/diagnóstico , Paraproteinemias/complicacionesRESUMEN
We describe here the case of a young patient, employed in agriculture, who entered the emergency room with fever, headache, hematuria and a worsening of renal function; we diagnosed leptospirosis with renal involvement. As the patient lamented very generic symptoms, the anamnesis was fundamental in leading us to suspect an infection, execute the right laboratory analysis, and correctly diagnose a pathology which is currently very rare in Italy.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas , Enfermedades Renales/parasitología , Leptospirosis/complicaciones , Adulto , Enfermedades de los Trabajadores Agrícolas/diagnóstico , Humanos , Enfermedades Renales/diagnóstico , Leptospirosis/diagnóstico , MasculinoRESUMEN
We describe the clinical case of a patient who developed mixed cryoglobulinemia syndrome after hemodialysis treatment with dialysate temperature lower than 36°C despite the negativization of the viral genome for HCV after eradication therapy.
Asunto(s)
Crioglobulinemia/etiología , Púrpura/etiología , Diálisis Renal/efectos adversos , Anemia/etiología , Anemia/terapia , Transfusión Sanguínea , Femenino , Glomerulonefritis por IGA/complicaciones , Hepatitis C Crónica/complicaciones , Humanos , Fallo Renal Crónico/etiología , Fallo Renal Crónico/terapia , Trasplante de Riñón , Persona de Mediana Edad , Complicaciones Posoperatorias , Trombocitopenia/etiologíaRESUMEN
BACKGROUND: Cushing syndrome (CS) has been described as a killing disease due its cardiovascular complications. In fact, chronic cortisol excess leads to a constellation of complications, including hypertension, hyperglycemia, adiposity, and thromboembolism. The main vascular alteration associated with CS is atherosclerosis. METHODS: Aim of this study was to analyze carotid intima-media thickness (cIMT) and ankle-brachial index (ABI), two surrogate markers of subclinical atherosclerosis in a consecutive series of CS patients, compared to patients with essential hypertension (EH) and health subjects (HS). RESULTS: Patients with CS showed a significant increase (P<0.05) of cIMT (0.89+/-0.17 mm) compared to EH (0.81+/-0.16 mm) and HS (0.75+/-0.4 mm), with a high prevalence of plaque (23%; P<0.03). Moreover, CS patients showed a mean ABI values (1.07+/-0.02) significantly lower respect to HS (1.12+/-0.11; P<0.05), and a higher percentage (20%) of pathological values of ABI (< or =0.9; P<0.03). CONCLUSION: In conclusion, we confirmed and extended the data of cIMT in CS, and showed that the ABI represent another surrogate marker of subclinical atherosclerosis in this disease.