, Youn Kyung Kee, Eunyoung Lee, Choong-kun Lee, Seung Gyu Han, Su Jin Heo, Tae-Hyun Yoo Malakoplakia is an uncommon chronic granulomatous inflammatory disease which is associated with immunocompromised conditions such as malignancy, autoimmune disease, chronic alcohol intake, poorly controlled diabetes and long-term steroid use. Malakoplakia can occur at various sites, most commonly in the genitourinary tract including urinary bladder and the ureter. Renal parenchymal involvement is relatively uncommon, accounting for 15% of all malakoplakia. A few cases of renal malakoplakia have been reported in Korea, and only one case was accompanied by acute kidney injury. Here we report an 80-year-old female patient with renal parenchymal malakoplakia and acute interstitial nephritis presented as acute kidney injury with literature review.
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, Chang-Yun Yoon, Seung Gyu Han, Eunyoung Lee, In Mee Han, Moon Sung Woo, Se Hee Park, Tae-Hyun Yoo A 54-year-old man was diagnosed as syndrome of inappropriate secretion of antidiuretic hormone (SIADH) 7 days after lung transplantation, whereas the preoperative serum sodium level was normal. Hypertonic saline infusion with furosemide did not improve hyponatremia, however, tolvaptan corrected his serum sodium levels from 123 mEq/L to 131 mEq/L. Seven days after maintenance of tolvaptan, this drug was discontinued and hyponatremia did not occur. Herein, we report a case of SIADH after lung transplantation treated with tolvaptan.
, Yon Hee Kim, Young Eun Kwon, Yung Ly Kim, Ki Heon Nam, Heun Choi, Young Ju Kim, Kyoung Sook Park, Hyeon Joo Jeong, Hyung Jung Oh, Jung Tak Park, Seung Hyeok Han, Shin-Wook Kang, Tae-Hyun Yoo Primary amyloidosis has unfavorable prognosis, particularly with organ involvement. Here, we report a case of clinical remission of renal amyloidosis after autologous hematopoietic cell transplantation. A 51-year-old female patient visited our hospital due to generalized edema. Initial evaluation showed hyperlipidemia, hypoalbuminemia, and heavy proteinuria, which were consistent with nephrotic syndrome. However, IgM lamda type monoclonal gammopathy was detected in serum and urine electrophoresis studies. Renal biopsy showed Congo red-positive amyloid deposition in mesangial area, glomerular capillary walls, and arterioles and amyloid fibers were confirmed by electron microscopy. Immunohistochemial study of the biopsy tissue demonstrated systemic light-chain amyloidosis (AL amyloidosis). Multiple myeloma was not evident on bone marrow examination. She received autologous hematopoietic cell transplantation after high dose melphalan treatment. Complete remissions were achieved after the treatment, respectively. Our findings suggest the potential role of autologous peripheral blood stem cell transplantation in treatment of AL amyloidosis.
, Yoon Jin Cha, Young Eun Kwon, Yung Ly Kim, Kyoung Sook Park, Seong Yeong An, Beom Jin Lim, Hyeon Joo Jeong, Hyung Jung Oh, Tae-Hyun Yoo, Shin-Wook Kang, Kyu Hun Choi, Seung Hyeok Han Nephrotic syndrome is most commonly observed in membranous lupus nephritis in patients with systemic lupus erythematosus (SLE). However, other forms of idiopathic nephrotic syndrome rarely occur in these patients. Here, we report a case of SLE complicated by minimal change disease (MCD). A 24-year-old woman with SLE visited our hospital for generalized edema and heavy proteinuria. Laboratory tests did not support immunological exacerbation of lupus, while renal biopsy revealed diffusely effaced foot processes without electron-dense deposits that were consistent with MCD. Administration of high-dose corticosteroids and 6 subsequent cycles of monthly intravenous cyclophosphamide resulted in complete remission. Although nephrotic-range proteinuria recurred 1 month after switching to maintenance therapy with mycophenolate mofetil, complete remission was reestablished after a 6-month treatment with corticosteroids and cyclosporine. Physicians should be cautious in assessment and management of such a rare renal manifestation.
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