Primary Ewings sarcoma (EWS) of the kidney is a very rare tumor and very few cases have been reported till date. We present a case of a young girl presenting to us with flank pain. On evaluation, she was found to have a renal mass. She was explored and a nephrectomy was done. Histopathology was reported as EWS. She was then planned for adjuvant chemotherapy. Primary EWS of the kidney is characterized by an aggressive course and poor prognosis. Hence, while dealing with renal masses in young patients, this entity should always be kept in mind. World J Nephrol Urol. 2017;6(1-2):18-20 doi: https://doi.org/10.14740/wjnu304w
{"title":"Ewings Sarcoma of the Kidney: A Rare Entity","authors":"S. Choubey, Gotam Pipara, Anurag Kumar","doi":"10.14740/WJNU304W","DOIUrl":"https://doi.org/10.14740/WJNU304W","url":null,"abstract":"Primary Ewings sarcoma (EWS) of the kidney is a very rare tumor and very few cases have been reported till date. We present a case of a young girl presenting to us with flank pain. On evaluation, she was found to have a renal mass. She was explored and a nephrectomy was done. Histopathology was reported as EWS. She was then planned for adjuvant chemotherapy. Primary EWS of the kidney is characterized by an aggressive course and poor prognosis. Hence, while dealing with renal masses in young patients, this entity should always be kept in mind. World J Nephrol Urol. 2017;6(1-2):18-20 doi: https://doi.org/10.14740/wjnu304w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"6 1","pages":"18-20"},"PeriodicalIF":0.0,"publicationDate":"2017-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48611328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Golli-Bennour, C. Zaied, C. Bouaziz, Y. Guedri, A. Achour, S. Abid, H. Bacha
The major problem associated with hemodialysis (HD) therapy is the choice of dialyzer membrane matters as well as the mode of sterilization required before utilization. In this context, we aimed to determine the effect of two sterilization processes (steam and gamma rays) on genotoxicity of polysulfone dialysis membranes. A 38-year-old man with end-stage renal disease and one age-matched healthy subject were enrolled in our study. We analyzed lipid peroxidation measured by serum malondialdehyde (MDA) formation and DNA fragmentation assessed by agarose gel electrophoresis and diphenylamine quantification. Our results clearly showed that there is a rising generation of MDA and DNA fragmentation in patient sera during HD session when compared to healthy subject data. This increase in MDA and DNA fragmentation amounts followed respectively the sterilization process. As classified from the more biocompatible one, the steam sterilized polysulfone dialyzer is the top ranked, followed by the gamma rays sterilized one. We concluded that using steam instead of gamma rays for sterilization may improve the biocompatibility of polysulfone dialyzer membranes. World J Nephrol Urol. 2017;6(1-2):14-17 doi: https://doi.org/10.14740/wjnu296e
{"title":"Do Sterilization Processes Really Make Difference in Dialysis-Induced Genotoxicity?","authors":"E. Golli-Bennour, C. Zaied, C. Bouaziz, Y. Guedri, A. Achour, S. Abid, H. Bacha","doi":"10.14740/WJNU296E","DOIUrl":"https://doi.org/10.14740/WJNU296E","url":null,"abstract":"The major problem associated with hemodialysis (HD) therapy is the choice of dialyzer membrane matters as well as the mode of sterilization required before utilization. In this context, we aimed to determine the effect of two sterilization processes (steam and gamma rays) on genotoxicity of polysulfone dialysis membranes. A 38-year-old man with end-stage renal disease and one age-matched healthy subject were enrolled in our study. We analyzed lipid peroxidation measured by serum malondialdehyde (MDA) formation and DNA fragmentation assessed by agarose gel electrophoresis and diphenylamine quantification. Our results clearly showed that there is a rising generation of MDA and DNA fragmentation in patient sera during HD session when compared to healthy subject data. This increase in MDA and DNA fragmentation amounts followed respectively the sterilization process. As classified from the more biocompatible one, the steam sterilized polysulfone dialyzer is the top ranked, followed by the gamma rays sterilized one. We concluded that using steam instead of gamma rays for sterilization may improve the biocompatibility of polysulfone dialyzer membranes. World J Nephrol Urol. 2017;6(1-2):14-17 doi: https://doi.org/10.14740/wjnu296e","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"6 1","pages":"14-17"},"PeriodicalIF":0.0,"publicationDate":"2017-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46252219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ryosuke Shibata, N. Takeuchi, M. Takada, Akihito Otsuka
Acute focal bacterial nephritis (AFBN) is a bacterial infection of the renal parenchyma without abscess formation and is classified as a subtype of acute renal pyelitis. There are many reports of AFBN in pediatrics; however, urinary tract infection, cystitis, or pyelitis developed into AFBN in few adult cases. AFBN symptoms include fever, shivering, back pain, and/or costovertebral angle tenderness. Here, we report two adult cases of AFBN in which its diagnosis using contrast-enhanced computed tomography was helpful. World J Nephrol Urol. 2016;5(3):63-66 doi: http://dx.doi.org/10.14740/wjnu280w
{"title":"Two Cases of Acute Focal Bacterial Nephritis","authors":"Ryosuke Shibata, N. Takeuchi, M. Takada, Akihito Otsuka","doi":"10.14740/WJNU280W","DOIUrl":"https://doi.org/10.14740/WJNU280W","url":null,"abstract":"Acute focal bacterial nephritis (AFBN) is a bacterial infection of the renal parenchyma without abscess formation and is classified as a subtype of acute renal pyelitis. There are many reports of AFBN in pediatrics; however, urinary tract infection, cystitis, or pyelitis developed into AFBN in few adult cases. AFBN symptoms include fever, shivering, back pain, and/or costovertebral angle tenderness. Here, we report two adult cases of AFBN in which its diagnosis using contrast-enhanced computed tomography was helpful. World J Nephrol Urol. 2016;5(3):63-66 doi: http://dx.doi.org/10.14740/wjnu280w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"5 1","pages":"63-66"},"PeriodicalIF":0.0,"publicationDate":"2016-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67239960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. El-shazly, Mohamed Aziz, M. Selim, A. Badawi, M. Gawish, A. Al-Amiri, A. Allam, O. Ragab, Marwa Elbedwihy
Background: Acute unilateral ureteric obstruction, with normal contralateral kidney, is occasionally accompanied by a rise of serum creatinine. Urgent drainage is usually performed to restore normal renal function. However, there is a growing evidence in literature that this rise of serum creatinine is false (pseudo renal failure) due to absorption of urine with its high creatinine. This is possibly through back flow into venous and lymphatic vessels. This hypothesis can render urgent intervention in these circumstances unnecessary. Our aim was to measure global renal function by measuring estimated renographic glomerular filtration rate (GFR) to determine if there is a real impairment of renal function or not in this clinical scenario. Methods: It is a prospective study over 3 years (2012 - 2015). All patients with acute unilateral ureteric obstruction due to ureteric stones with normal contralateral kidney and high serum creatinine > 140 mmol/L were included in our study. All patients were diagnosed by abdominal ultrasonography and non-contrast computed tomography (CT). Estimated GFR (eGFR) was measured using DTPA isotope renography on admission. Serum creatinine measurement and DTPA were repeated 2 weeks after intervention or after spontaneous passage of stones. Results: Fifty-three patients (all males) were enrolled in the study. The mean age was 36.43 ± 9.2 years. The mean serum creatinine on admission was 178.7 ± 14.83 µmol/L (normal range for males: 70 - 120 µmol/L). The mean eGFR on admission was 95.04 ± 15.41 mL/min (normal range for males: 75 - 125 mL/min). Thirteen patients passed stones on medical expulsive therapy without intervention. Thirty-one patients underwent double J insertion and nine patients underwent ureteroscopy with stones removal or disintegration. The mean serum creatinine after treatment was 107.5 ± 6.5 µmol/L. The mean eGFR after drainage or after passage of stones was 94.45 ± 6.37 mL/min. The difference between eGFR on admission and eGFR after passage of stones or after intervention was statistically insignificant (P > 0.05). Conclusions: Rise of serum creatinine in patients with acute unilateral ureteric obstruction is not associated with decreased renographic eGFR. Renal impairment in these circumstances is not a true impairment. World J Nephrol Urol. 2016;5(3):51-53 doi: http://dx.doi.org/10.14740/wjnu276w
{"title":"Acute Unilateral Ureteric Obstruction in Young Men With High Serum Creatinine: Is It True or False Renal Impairment?","authors":"M. El-shazly, Mohamed Aziz, M. Selim, A. Badawi, M. Gawish, A. Al-Amiri, A. Allam, O. Ragab, Marwa Elbedwihy","doi":"10.14740/WJNU276W","DOIUrl":"https://doi.org/10.14740/WJNU276W","url":null,"abstract":"Background: Acute unilateral ureteric obstruction, with normal contralateral kidney, is occasionally accompanied by a rise of serum creatinine. Urgent drainage is usually performed to restore normal renal function. However, there is a growing evidence in literature that this rise of serum creatinine is false (pseudo renal failure) due to absorption of urine with its high creatinine. This is possibly through back flow into venous and lymphatic vessels. This hypothesis can render urgent intervention in these circumstances unnecessary. Our aim was to measure global renal function by measuring estimated renographic glomerular filtration rate (GFR) to determine if there is a real impairment of renal function or not in this clinical scenario. Methods: It is a prospective study over 3 years (2012 - 2015). All patients with acute unilateral ureteric obstruction due to ureteric stones with normal contralateral kidney and high serum creatinine > 140 mmol/L were included in our study. All patients were diagnosed by abdominal ultrasonography and non-contrast computed tomography (CT). Estimated GFR (eGFR) was measured using DTPA isotope renography on admission. Serum creatinine measurement and DTPA were repeated 2 weeks after intervention or after spontaneous passage of stones. Results: Fifty-three patients (all males) were enrolled in the study. The mean age was 36.43 ± 9.2 years. The mean serum creatinine on admission was 178.7 ± 14.83 µmol/L (normal range for males: 70 - 120 µmol/L). The mean eGFR on admission was 95.04 ± 15.41 mL/min (normal range for males: 75 - 125 mL/min). Thirteen patients passed stones on medical expulsive therapy without intervention. Thirty-one patients underwent double J insertion and nine patients underwent ureteroscopy with stones removal or disintegration. The mean serum creatinine after treatment was 107.5 ± 6.5 µmol/L. The mean eGFR after drainage or after passage of stones was 94.45 ± 6.37 mL/min. The difference between eGFR on admission and eGFR after passage of stones or after intervention was statistically insignificant (P > 0.05). Conclusions: Rise of serum creatinine in patients with acute unilateral ureteric obstruction is not associated with decreased renographic eGFR. Renal impairment in these circumstances is not a true impairment. World J Nephrol Urol. 2016;5(3):51-53 doi: http://dx.doi.org/10.14740/wjnu276w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"5 1","pages":"51-53"},"PeriodicalIF":0.0,"publicationDate":"2016-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67239295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatocyte nuclear factor-1beta (HNF-1beta) is a transcription factor that is responsible for the development of kidney, pancreas, liver and genitourinary tract. Affected individuals may present a variety of renal developmental abnormalities and/or maturity-onset diabetes of the young type 5 (MODY 5). Here we report a boy with autosomal recessive polycystic kidney disease (ARPKD) diagnosed in neonatal period who developed insulin-dependent diabetes at the age of 11. He presented with poliuria and polydipsia. The diagnosis of ARPKD was made in neonatal period based on the findings of large hyperechogenic kidneys in antenatal ultrasound and no history of renal disease in parents. Laboratory investigations revealed hyperglycemia, glycosuria, and a reduced glomerular filtration rate (GFR). Based on autoantibody-negative diabetes and low-dose insulin requirement in addition to renal anomalies, he was suspected to have MODY 5. Genetic studies identified a known heterozygous HNF1B gene mutation (S148L) compatible with an MODY 5 phenotype. As a result, MODY 5 should be considered in children with developmental kidney disease and hyperglycemia. Also HNF-1beta mutations should be suspected in patients with undefined cystic kidney disease especially when associated with other systemic findings as in our case. World J Nephrol Urol. 2016;5(3):67-70 doi: http://dx.doi.org/10.14740/wjnu272w
{"title":"A Rare Cause of Polyuria and Polydipsia in a Patient With Cystic Renal Disease: Maturity-Onset Diabetes of the Young Type 5","authors":"H. Nalcacioglu, B. Haliloglu","doi":"10.14740/wjnu272w","DOIUrl":"https://doi.org/10.14740/wjnu272w","url":null,"abstract":"Hepatocyte nuclear factor-1beta (HNF-1beta) is a transcription factor that is responsible for the development of kidney, pancreas, liver and genitourinary tract. Affected individuals may present a variety of renal developmental abnormalities and/or maturity-onset diabetes of the young type 5 (MODY 5). Here we report a boy with autosomal recessive polycystic kidney disease (ARPKD) diagnosed in neonatal period who developed insulin-dependent diabetes at the age of 11. He presented with poliuria and polydipsia. The diagnosis of ARPKD was made in neonatal period based on the findings of large hyperechogenic kidneys in antenatal ultrasound and no history of renal disease in parents. Laboratory investigations revealed hyperglycemia, glycosuria, and a reduced glomerular filtration rate (GFR). Based on autoantibody-negative diabetes and low-dose insulin requirement in addition to renal anomalies, he was suspected to have MODY 5. Genetic studies identified a known heterozygous HNF1B gene mutation (S148L) compatible with an MODY 5 phenotype. As a result, MODY 5 should be considered in children with developmental kidney disease and hyperglycemia. Also HNF-1beta mutations should be suspected in patients with undefined cystic kidney disease especially when associated with other systemic findings as in our case. World J Nephrol Urol. 2016;5(3):67-70 doi: http://dx.doi.org/10.14740/wjnu272w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"5 1","pages":"67-70"},"PeriodicalIF":0.0,"publicationDate":"2016-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67239203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asif Khan, George Freg, Elie J. El-Charabaty, S. El‐Sayegh
The co-occurrence of acute kidney injury secondary to rhabdomyolysis in a young patient can present as a prognostic and therapeutic challenge. Here we report a case with an unusually high creatinine phosphokinase of over 500,000 U/L after a 2-hour workout session at the gym. The challenge was to assess if the need for renal replacement therapy was warranted and whether IV fluid therapy with close monitoring would be enough to treat him, given he had a good urine output and no acid base disorder. The literature is reviewed as an attempt to delineate a rational approach to evaluating novice athletes at risk for rhabdomyolysis. World J Nephrol Urol. 2016;5(3):54-57 doi: http://dx.doi.org/10.14740/wjnu280e
{"title":"Lose 500,000 Creatine Phosphokinase With a 2-Hour Workout: A Case Report on Rhabdomyolysis in a Novice Athlete","authors":"Asif Khan, George Freg, Elie J. El-Charabaty, S. El‐Sayegh","doi":"10.14740/WJNU280E","DOIUrl":"https://doi.org/10.14740/WJNU280E","url":null,"abstract":"The co-occurrence of acute kidney injury secondary to rhabdomyolysis in a young patient can present as a prognostic and therapeutic challenge. Here we report a case with an unusually high creatinine phosphokinase of over 500,000 U/L after a 2-hour workout session at the gym. The challenge was to assess if the need for renal replacement therapy was warranted and whether IV fluid therapy with close monitoring would be enough to treat him, given he had a good urine output and no acid base disorder. The literature is reviewed as an attempt to delineate a rational approach to evaluating novice athletes at risk for rhabdomyolysis. World J Nephrol Urol. 2016;5(3):54-57 doi: http://dx.doi.org/10.14740/wjnu280e","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"148 1","pages":"54-57"},"PeriodicalIF":0.0,"publicationDate":"2016-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67239579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. B. Fernández, L. R. Villamil, S. F. Montes, B. Mendez, J. Fonseca, C. Menéndez, C. Garcia, R. G. Ugarteburu, I. G. Rodríguez, J. Madera
Schwannoma is a rare slow-growing neurogenic tumor of the nerve sheath origin. They are commonly seen in middle-aged with a female to male ratio of 1:1.2. Here we present three cases of retroperitoneal schwannoma in our urology department. In two cases, we decided surgery management and in one case, we used watchful waiting. After a 3-year follow-up, case 1 was asymptomatic without changes in the lesion. World J Nephrol Urol. 2016;5(3):58-62 doi: http://dx.doi.org/10.14740/wjnu277w
{"title":"Management of Retroperitoneal Schwannoma: Case Reports and Review of the Literature","authors":"R. B. Fernández, L. R. Villamil, S. F. Montes, B. Mendez, J. Fonseca, C. Menéndez, C. Garcia, R. G. Ugarteburu, I. G. Rodríguez, J. Madera","doi":"10.14740/WJNU277W","DOIUrl":"https://doi.org/10.14740/WJNU277W","url":null,"abstract":"Schwannoma is a rare slow-growing neurogenic tumor of the nerve sheath origin. They are commonly seen in middle-aged with a female to male ratio of 1:1.2. Here we present three cases of retroperitoneal schwannoma in our urology department. In two cases, we decided surgery management and in one case, we used watchful waiting. After a 3-year follow-up, case 1 was asymptomatic without changes in the lesion. World J Nephrol Urol. 2016;5(3):58-62 doi: http://dx.doi.org/10.14740/wjnu277w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"5 1","pages":"58-62"},"PeriodicalIF":0.0,"publicationDate":"2016-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67239504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Kirpalani, G. Filler, J. Grimmer, Vladimir Belostosky, S. Arora, Ajay P Sharma
Steroid-resistant nephrotic syndrome (SRNS) is a challenging condition. In pediatric SRNS, cyclosporine is the first-line treatment choice, with approximately 60% success rate. In cyclosporine-resistant disease, treatment modalities such as cyclophosphamide, mycophenolate mofetil (MMF), tacrolimus, vincristine, galactose, plasmapheresis and rituximab have been tried with variable success. In this paper, we report a patient with SRNS who remained resistant to all the above stated medications except a moderate response to rituximab. After rituximab, MMF re-initiation did not induce further improvement. Prednisone retrial thereafter induced a prompt remission. The significance of this finding in context with current literature has been discussed. World J Nephrol Urol. 2016;5(2):33-36 doi: http://dx.doi.org/10.14740/wjnu267w
{"title":"Steroid Retrial After Rituximab and Mycophenolate Mofetil in Pediatric Refractory Nephrotic Syndrome","authors":"A. Kirpalani, G. Filler, J. Grimmer, Vladimir Belostosky, S. Arora, Ajay P Sharma","doi":"10.14740/WJNU267W","DOIUrl":"https://doi.org/10.14740/WJNU267W","url":null,"abstract":"Steroid-resistant nephrotic syndrome (SRNS) is a challenging condition. In pediatric SRNS, cyclosporine is the first-line treatment choice, with approximately 60% success rate. In cyclosporine-resistant disease, treatment modalities such as cyclophosphamide, mycophenolate mofetil (MMF), tacrolimus, vincristine, galactose, plasmapheresis and rituximab have been tried with variable success. In this paper, we report a patient with SRNS who remained resistant to all the above stated medications except a moderate response to rituximab. After rituximab, MMF re-initiation did not induce further improvement. Prednisone retrial thereafter induced a prompt remission. The significance of this finding in context with current literature has been discussed. World J Nephrol Urol. 2016;5(2):33-36 doi: http://dx.doi.org/10.14740/wjnu267w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"5 1","pages":"33-36"},"PeriodicalIF":0.0,"publicationDate":"2016-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67239225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gitelman syndrome is a relatively rare renal tubular disorder. Though it has been reported as a recessively inherited disorder, sporadic cases have also been reported. Traditionally, Gitelman syndrome is considered as benign or mild tubulopathy. We present the case of an 18-year-old male patient with severe hypokalemia and periodic paralysis. Subsequent laboratory investigation revealed renal wasting hypokalemia, metabolic alkalosis, secondary hyperaldosteronism, hypomagnesemia and hypocalciuria, indicating that the patient might have had a renal tubular disorder. The confirmation of Gitelman syndrome was determined by evaluating tubular function using thiazide and furosemide challenge test. Genetic study was bypassed due to our technical unavaibility. Treament included magnesium aspartate/potassium aspartate, potassium chloride tablets and potassium-sparing diuretic. We are presenting our case seeing that Gitelman syndrome is not a syndrome to be overlooked as it bears a risk of severe complications. Gitelman syndrome may present in adulthood and should be borne in mind in the diagnosis of hypokalemia. World J Nephrol Urol. 2016;5(2):40-47 doi: http://dx.doi.org/10.14740/wjnu270e
{"title":"Gitelman Syndrome: An Important Cause of Severe Hypokalemia and Periodic Paralysis","authors":"Friska Sinaga, Ridho M. Naibaho, W. H. Sibuea","doi":"10.14740/WJNU270E","DOIUrl":"https://doi.org/10.14740/WJNU270E","url":null,"abstract":"Gitelman syndrome is a relatively rare renal tubular disorder. Though it has been reported as a recessively inherited disorder, sporadic cases have also been reported. Traditionally, Gitelman syndrome is considered as benign or mild tubulopathy. We present the case of an 18-year-old male patient with severe hypokalemia and periodic paralysis. Subsequent laboratory investigation revealed renal wasting hypokalemia, metabolic alkalosis, secondary hyperaldosteronism, hypomagnesemia and hypocalciuria, indicating that the patient might have had a renal tubular disorder. The confirmation of Gitelman syndrome was determined by evaluating tubular function using thiazide and furosemide challenge test. Genetic study was bypassed due to our technical unavaibility. Treament included magnesium aspartate/potassium aspartate, potassium chloride tablets and potassium-sparing diuretic. We are presenting our case seeing that Gitelman syndrome is not a syndrome to be overlooked as it bears a risk of severe complications. Gitelman syndrome may present in adulthood and should be borne in mind in the diagnosis of hypokalemia. World J Nephrol Urol. 2016;5(2):40-47 doi: http://dx.doi.org/10.14740/wjnu270e","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"5 1","pages":"40-47"},"PeriodicalIF":0.0,"publicationDate":"2016-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67239418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leiomyoma with bizarre nuclei (LM-BN) is a very rare finding which cannot be distinguished clinically from the very commonly occurring benign prostatic hyperplasia (BPH). If correctly diagnosed, LM-BN has a favorable prognosis after complete surgical excision. It is important to keep this alternative diagnosis in mind when treating a patient with complaints indicating prostatic hyperplasia. This case involves a 77-year-old male presenting with lower urinary tract symptoms; based on clinical presentation, the patient was diagnosed with BPH. A transurethral prostate resection was performed. Resected prostate tissue was collected for analysis and diagnosis of prostatic LM-BN was made. World J Nephrol Urol. 2016;5(2):37-39 doi: http://dx.doi.org/10.14740/wjnu249w
{"title":"Prostatic Leiomyoma With Bizarre Nuclei: A Case Report","authors":"V. Kristensen, A. Loya, K. Brasso","doi":"10.14740/WJNU249W","DOIUrl":"https://doi.org/10.14740/WJNU249W","url":null,"abstract":"Leiomyoma with bizarre nuclei (LM-BN) is a very rare finding which cannot be distinguished clinically from the very commonly occurring benign prostatic hyperplasia (BPH). If correctly diagnosed, LM-BN has a favorable prognosis after complete surgical excision. It is important to keep this alternative diagnosis in mind when treating a patient with complaints indicating prostatic hyperplasia. This case involves a 77-year-old male presenting with lower urinary tract symptoms; based on clinical presentation, the patient was diagnosed with BPH. A transurethral prostate resection was performed. Resected prostate tissue was collected for analysis and diagnosis of prostatic LM-BN was made. World J Nephrol Urol. 2016;5(2):37-39 doi: http://dx.doi.org/10.14740/wjnu249w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"58 1","pages":"37-39"},"PeriodicalIF":0.0,"publicationDate":"2016-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67239029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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