RESUMEN
BACKGROUND: C3 glomerulonephritis (C3GN) is an unusual entity that is caused by dysregulation and hyperactivity of the alternative complement pathway. Renal biopsy immunofluorescence study shows C3 deposits with absence of immunoglobulins and markers of the classical complement pathway. More than 50% of cases develop end-stage renal disease. Less well-known is the course of C3GN after kidney transplantation. CASE REPORT: We present the case of a 60-year-old woman with chronic kidney disease secondary to chronic glomerulonephritis of unknown origin who received a kidney transplant. Two years later, she presented worsening renal function with non-nephrotic proteinuria and microhematuria. Complement testing revealed low serum levels of C3. Kidney biopsy showed alterations compatible with C3GN that we interpreted as a relapse of the underlying disease.
Asunto(s)
Complemento C3/inmunología , Glomerulonefritis/complicaciones , Fallo Renal Crónico/cirugía , Trasplante de Riñón/efectos adversos , Biopsia , Femenino , Glomerulonefritis/diagnóstico , Glomerulonefritis/inmunología , Humanos , Fallo Renal Crónico/etiología , Persona de Mediana Edad , Recurrencia , Factores de RiesgoAsunto(s)
Hiperoxaluria Primaria/diagnóstico , Fallo Renal Crónico/etiología , Nefrocalcinosis/etiología , Transaminasas/deficiencia , África del Norte/etnología , Artritis Infecciosa/complicaciones , Examen de la Médula Ósea , Infecciones Relacionadas con Catéteres/complicaciones , Terapia Combinada , Descompresión Quirúrgica , Diagnóstico Tardío , Discitis/complicaciones , Discitis/cirugía , Resultado Fatal , Humanos , Hiperoxaluria/complicaciones , Hiperoxaluria/diagnóstico , Hiperoxaluria/genética , Hiperoxaluria Primaria/genética , Hiperoxaluria Primaria/patología , Hipertiroidismo/complicaciones , Hallazgos Incidentales , Fallo Renal Crónico/terapia , Fallo Renal Crónico/orina , Laminectomía , Masculino , Diálisis Renal , Trombofilia/complicaciones , Transaminasas/genética , Vitamina B 6/uso terapéutico , Adulto JovenRESUMEN
Primary Sjögren s syndrome is a multisystemic inflammatory disorder that mainly affects the exocrine glands and usually presents as dryness of the mouth and eyes. The wide clinical spectrum of the disease also includes general symptoms, extraglandular manifestations and lymphoma. It is frequently associated with renal diseases. Interstitial nephritis is the most common renal manifestation, but glomerular involvement and acute renal failure may also (rarely) occur. We describe a case of a female patient with primary Sjögren s syndrome complicated by severe acute renal failure due to cryoglobulinemic glomerulonephritis. Treatment with steroids, cyclophosphamide, plasma exchange and rituximab successfully led to recovery from acute renal failure.
Asunto(s)
Lesión Renal Aguda/etiología , Complicaciones Posoperatorias/etiología , Síndrome de Sjögren/complicaciones , Implantación Dental/efectos adversos , Femenino , Humanos , Persona de Mediana EdadRESUMEN
Rhabdomyolysis is a syndrome characterized by injure of skeletal muscle with the release of intracellular constituents into the circulation. Acute renal failure is a common complication and is the leading cause of morbidity and mortality in these patients. The most common aetiology is traumatisms, muscle compressions and extreme exertions. Most commonly, the cause of rhabdomyolysis is evident from the careful clinical history. Nevertheless, when the precipitant is not obvious the diagnosis is difficult and a raised clinical suspicion is required. We should investigate used medication or drugs, infections, electrolyte abnormalities and a number of inherited enzyme deficiencies, in which cases the muscle is unable to use available energy. We report two clinical cases of acute renal failure due to rhabdomyolysis by metabolic myopathies due to a carnitine palmitoyltransferase deficiency on the one hand and by myophosphorylase deficiency on the other. We describe their clinical features and progress.