RESUMO
Acute kidney injury after exercise is most commonly secondary to rhabdomyolysis. Non-rhabdomyolysis AKI is secondary to a limited number of disorders of which renal hypouricemia (RHUC) needs a special mention. It is relatively a rare genetic disorder and is reported in Japanese and Ashkenazi Jews. Humans have lost the ability to metabolize uric acid as the "uricase" gene is suppressed. Renal tubules handle uric acid and aid in maintaining serum concentrations in the soluble range. Uric acid excretion is increased in RHUC patients due to proximal tubular defects. This leads to the loss of antioxidant capabilities of the kidney, predisposing them to severe AKI following anaerobic exercise. We report a case of exercise-induced AKI secondary to renal hypouricemia.
RESUMO
Human immunodeficiency virus (HIV) infection has posed as a major global health epidemic for almost three decades. With the advent of highly active antiretroviral therapy in 1996 and the application of prophylaxis and management of opportunistic infections, acquired immunodeficiency syndrome mortality has decreased markedly. The most aggressive HIV-related renal disease is end-stage renal disease due to HIV-associated nephropathy. Presence of HIV infection used to be viewed as a contraindication to renal transplantation for multiple reasons; concerns for exacerbation of an already immunocompromised state by administration of additional immunosuppressants; the use of a limited supply of donor organs with unknown long-term outcomes. Multiple studies have reported promising outcomes at three to five years after kidney transplantations in patients treated with highly active antiretroviral therapy, and HIV is no longer a contraindication for renal transplant. Hence, we present eight HIV-positive patients who received live-related renal transplantation at our center and their follow-up.
Assuntos
Nefropatia Associada a AIDS/cirurgia , Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Falência Renal Crônica/cirurgia , Transplante de Rim/métodos , Nefropatia Associada a AIDS/diagnóstico , Nefropatia Associada a AIDS/imunologia , Nefropatia Associada a AIDS/virologia , Fármacos Anti-HIV/efeitos adversos , Terapia Antirretroviral de Alta Atividade , Tomada de Decisão Clínica , Progressão da Doença , Feminino , Rejeição de Enxerto/imunologia , Rejeição de Enxerto/prevenção & controle , Sobrevivência de Enxerto/efeitos dos fármacos , Infecções por HIV/diagnóstico , Infecções por HIV/imunologia , Infecções por HIV/virologia , Humanos , Hospedeiro Imunocomprometido , Imunossupressores/uso terapêutico , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/imunologia , Falência Renal Crônica/virologia , Transplante de Rim/efeitos adversos , Doadores Vivos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores de Tempo , Resultado do TratamentoRESUMO
Bullous systemic lupus erythematosus is a rare distinctive subepidermal blistering disorder that can occur in patients with systemic lupus erythematosus (SLE). It is histologically characterized by a neutrophil-predominant infiltrate in the subepidermal region with deposition of immunoglobulins (IgG, IgA, IgM), C3, and auto-antibodies against collagen VII. Herein, we report a case of a 13-year-old girl who presented with bullous SLE and Class III lupus nephritis, which is extremely rare at this age.