Elevated citrate levels in non-alcoholic fatty liver disease: the potential of citrate to promote radical production.

Plasma citrate levels were found to be elevated in non-alcoholic fatty liver disease (NAFLD) patients. Cellular experiments indicated that increased citrate levels might originate from an excess of fatty acids. The impact of elevated citrate levels on oxidative stress was examined. It was found that citrate stimulated hydrogen peroxide induced intracellular oxidative stress in HepG2 cells. This was related to the promotion of iron mediated hydroxyl radical formation from hydrogen peroxide by citrate. The stimulating effect of citrate on the reactivity of iron promotes oxidative stress, a crucial process in the progression of NAFLD.

[Pyelonephritis with renal abscess in a child]. / Pyelonefritis met nierabces bij een kind.

BACKGROUND: Pyelonephritis is a rare condition. It can sometimes be complicated by a renal abscess. CASE DESCRIPTION: A 7-year-old girl had a complicated course of a pyelonephritis. She was being administered intravenous antimicrobial agents and developed a fever with cold chills during treatment. Ultrasound and MRI revealed that the cause of the deterioration was a renal abscess. The patient was treated with ceftriaxone en gentamicin. Escherichia coli was isolated from the abscess. After two weeks of treatment, an MRI showed that the renal abscess had almost disappeared; this was confirmed by an additional ultrasound one week after the treatment had been discontinued. CONCLUSION: The symptoms of a renal abscess are high fever, cold chills, stomach pain, groin pain, weight loss, total malaise, and clinical deterioration whilst under treatment. Quick recognition of the condition is important. An abscess of less than 5 cm in diameter may be treated with antibiotics alone.