Case reports
Association of parvovirus B19 infection with acute glomerulonephritis in healthy adults: case report and review of the literature
Y. Mori, H. Yamashita, Y. Umeda,Y.U. Uchiyama-Tanaka, A. Nose,N. Kishimoto, Y. Kijima, T. Nagata,M. Mori, H. Matsubara, H. Yoshida and T. Iwasaka
Price
42.00 $
Volume 57 (2002) p. 69 - 73
Abstract
Y. Mori, H. Yamashita, Y. Umeda,Y.U. Uchiyama-Tanaka, A. Nose,N. Kishimoto, Y. Kijima, T. Nagata,M. Mori, H. Matsubara, H. Yoshida and T. Iwasaka
1Department of Medicine II, Kansai Medical University, Osaka, and
2Department of Clinical Laboratory Medicine, Fukui Medical University,
Fukui, Japan
An otherwise healthy 20-year-old woman presented with an erythematous rash on her face as well as arthralgia and anemia. She also had systemic edema, proteinuria and hypertension. Laboratory data on admission showed hypocomplementemia, human parvovirus B19 (HPV) DNA and both immunoglobulin (Ig) M and IgG antibodies to HPV in her serum. Renal biopsy specimens showed features of endocapillary glomerulonephritis under light microscopy. Electron microscopy showed massive subendothelial electron-dense deposits. No cause was probable other than immune complex-mediated glomerulonephritis associated with HPV infection. In a review of this and similar cases reported in the literature, several characteristic features come to light: female dominance, onset in the second or third decade of life, hypocomplementemia, histologic renal endocapillary and/or mesangioproliferative glomerulonephritis with subendothelial deposits and spontaneous recovery.
Originals
Renal blood flow measurement with contrast-enhanced harmonic ultrasonography: evaluation of dopamine-induced changes in renal
cortical perfusion in humans
N. Kishimoto, Y. Mori, T. Nishiue, Y. Shibasaki, O. Iba, A. Nose, Y. Uchiyama-Tanaka, H. Masaki, H. Matsubara and T. Iwasaka
Price
42.00 $
Volume 59 (2003) p. 423 - 428
Abstract
N. Kishimoto, Y. Mori, T. Nishiue, Y. Shibasaki, O. Iba, A. Nose, Y. Uchiyama-Tanaka, H. Masaki, H. Matsubara and T. Iwasaka
1Renal Division and 2Cardiovascular Center, Department of Medicine II, Kansai Medical University, Osaka, Japan
Background: An accessible non-invasive method for evaluating renal regional blood flow in real time is highly desirable in the clinical setting. Recent progress in ultrasonography with microbubble contrast has allowed quantification of regional blood flow in animal models. Aims: Goal of this study was to establish a convenient contrast-enhanced harmonic ultrasonography (CEHU) method for evaluating renal cortical blood flow in humans. Methods: We carried out intermittent second harmonic imaging in 9 healthy volunteers. Pulse interval was progressively decreased from 4 s ? 0.2 s during continuous venous infusion of the microbubble contrast agent. Results: Pulse interval versus CEHU-derived acoustic intensity plots provided microbubble velocity (MV) and fractional vascular volume (FVV) during renal cortical perfusion in humans. Low-dose dopamine infusion (2 mg/min/kg) resulted in a significant increase in MV which correlated well with the increase in total renal blood flow (RBF) determined by a conventional study of p-aminohippurate clearance (CPAH) (r = 0.956, p < 0.0001). Although FVV was not significantly increased, alterations in CEHU-derived renal cortical blood flow calculated by the products of MV and FVV were also correlated with alterations in total RBF (r = 0.969, p < 0.0001). Thus, low-dose dopamine infusion increases renal cortical blood flow observed in CEHU, mainly by increasing MV. Conclusions: The present study shows that renal cortical blood flow in humans can be measured non-invasively by CEHU and that CEHU can be used for quantitatively evaluating changes induced by a therapeutic agent such as dopamine in flow velocity and in FVV.
Case reports
Membranous glomerulonephritis associated with hepatitis C virus infection: case report and literature review
Y. Uchiyama-Tanaka, Y. Mori, N. Kishimoto, A. Nose, Y. Kijima, T. Nagata, Y. Umeda, H. Masaki, H. Matsubara and T. Iwasaka
Price
42.00 $
Volume 61 (2004) p. 144 - 150
Abstract
Y. Uchiyama-Tanaka, Y. Mori, N. Kishimoto, A. Nose, Y. Kijima, T. Nagata, Y. Umeda, H. Masaki, H. Matsubara and T. Iwasaka
Renal Division and 2Cardiovascular Center, Department of Medicine II, Kansai Medical University, Osaka, Japan
We describe the case of a 51-year-old man with hepatitis C virus (HCV) infection and a 3-month history of facial edema. Laboratory tests upon admission for renal biopsy showed normal renal function and normocomplementemia. Serum HCV antibody (Ab) and cryoglobulin were positive. Renal biopsy specimens showed features of membranous glomerulonephritis. The likely cause was immune complex-mediated glomerulonephritis associated with HCV infection. Reports of similar cases in the literature show the normocomplementemia and negative or slightly positive cryoglobulins observed in our case as well as seropositivity for circulating immune complexes containing HCV RNA. In our case, electron microscopic examination of the subepithelial glomerular lesions revealed massive virus-like particles within unusual multilayers of electron-dense deposits (EDDs), suggesting the existence of HCV in the glomeruli. In the addition to the unique histopathological feature the presence of La/SS-B antibody in his serum indicated an abnormal immune response associated with HCV. We advise him to undergo the therapy with new type of IFN such as pegIFN-a2a and/or anti-viral agent like ribavirin to achieve clinical and histopathological improvement.
Case report
Community-acquired Clostridium difficile-associated diarrhea in a patient on chronic peritoneal dialysis
M. Seo, N. Takahashi, T. Morita, S. Morimoto and T. Iwasaka
Price
42.00 $
Volume 74 (2010) p. 141 - 143
Abstract
Clinical Nephrology, Vol. 74 – No. 2/2010 (141-143)
Community-acquired Clostridium difficile-associated diarrhea in a patient on chronic peritoneal dialysis
M. Seo, N. Takahashi, T. Morita, S. Morimoto and T. Iwasaka
Second Department of Internal Medicine, Kansai Medical University, Hirakata, Osaka, Japan
A 66-year-old woman on chronic peritoneal dialysis was admitted because of intermittent diarrhea and abdominal pain, and anorexia for 1 month. She had not been given antibiotics nor hospitalized for at least 6 months prior to the onset of symptoms. Clostridium difficile and its toxin were detected in the stool and Clostridium difficile-associated diarrhea (CDAD) was diagnosed. Colonoscopic examination revealed pseudomembrane formation and colitis in the whole colon. Clostridium difficile and its toxin became negative 12 days after vancomycin administration. Thus, clinical suspicion to CDAD is important in dialysis patients presenting with abdominal symptoms even if it is apparently community-acquired with no history of antibiotic use and hospitalization.Correspondence to:
N. Takahashi, MD
Second Department of Internal Medicine
Kansai Medical University
2-3-1 Shinmachi, Hirakata
Osaka 573-1191, Japan
Email: [email protected]
Letter to the Editor
Peritonitis after gynecological and gastroscopic examinations in a peritoneal dialysis patient
S. Morimoto, E. Kido, M. Higashi, N. Sumitani, H. Takagishi, S. Kakimoto, K. Someya, T. Morita, T. Iwasaka, K. Suzuki and A. Yasui
Volume 74 (2010) p. 491 - 492
Abstract
Peritonitis after gynecological and gastroscopic examinations in a peritoneal dialysis patient
S. Morimoto, E. Kido, M. Higashi, N. Sumitani, H. Takagishi, S. Kakimoto, K. Someya, T. Morita, T. Iwasaka, K. Suzuki and A. Yasui
