Pitfalls of Current Diagnostic Criteria of Tumor Lysis Syndrome.

BACKGROUND: Tumor Lysis syndrome (TLS) is a well-recognized medical emergency in patients with cancer diagnosis. The diagnostic criteria of TLS have been revised many times since it was recognized, but still have many drawbacks limit diagnosis accuracy. SUMMARY: Autopsy studies in patients with perimortem diagnoses of TLS have shown that they may not have actually had TLS. Therefore, many cancer patients who are at risk for TLS, clinical and laboratory criteria may be fulfilled due to other causes of acute kidney injury. In this review, we aim to cast a spotlight on the shortcomings and pitfalls of the current diagnostic criteria for TLS, and propose a roadmap for developing a more rigorous criteria that improve on the diagnostic accuracy. KEY MESSAGES: Causes of AKI in patients with cancer other than TLS should be considered. Because current diagnostic criteria may miss those differential diagnosis, specific biomarkers that can tell when TLS is the underlying process is an important need, besides appropriate criteria that can jump over the pitfalls in the current criteria and enhance the recognition of TLS among other causes.

Percutaneous transluminal interventions of transplant renal artery stenosis: A case series study.

Introduction: and importance: Transplant renal artery stenosis (TRAS) is a well-recognized vascular complication after kidney transplant that can lead to graft loss, when it is diagnosed early and treated appropriately it may prevent kidney damage and related systemic squeals. Case presentation: This case-series represents our center experience in managing TRAS using percutaneous transluminal angioplasty [either balloon angioplasty (PTA) or stent placement (PTAS)] in 11 patients. Clinical discussion: All treated patients experienced immediate total recovery of renal function and normalization of arterial blood pressure without any drug or reducing the number of drugs used; no complications related to the intervention were reported. Conclusion: PTA or PTAS of TRAS can be considered safe and effective when it diagnosed and treated early.

Case reports and research productivity among Syrian medical students: Review, reality, and suggested solutions.

Medical students are precious seeds for better future medical research. Case reports writing may represent a relatively simple first step for beginners. Only 47 case reports are published in the literature by Syrian Medical Institutions compared to more than 500 case reports in a comparable country in the last 5 years. Many obstacles stand against developing fruitful research environment in Syria. Increasing awareness to research productivity in Syria along with comparative analysis is discussed in this article.

Successful kidney transplant in a patient with IgG anti HLA Class-I auto-antibodies: a case report.

Donor specific antibodies (DSA) play a significant role in graft rejection. Many laboratory methods, varied in sensitivity and specificity, are used to detect them. We report a case of a 38-year-old man presented with end stage renal disease considered for kidney transplantation. He had no history of blood transfusions nor transplantation procedures. Dilemma rose when he got multiple positive crossmatches with matching donors and a positive autologous crossmatch due to IgG anti HLA auto-antibodies, which are at the same time against matched donors. Since positive crossmatch is a contraindication for transplant, we couldn't perform transplant from any matched donor. Therefore, we considered a total mismatched donor then transplantation was performed. Observation after surgery showed normalization of creatinine, blood pressure and a good function of the planted allograft for two years of follow up.

Renal artery embolization for managing uncontrolled hypertension in a kidney transplant candidate.

We report a case of pre-operative bilateral renal artery embolization to control the resistant and malignant hypertension in a patient prepared for kidney transplantation. A 34-year-old man with end-stage renal disease as a result of the focal segmental glomerulosclerosis and uncontrolled hypertension that precluded the transplantation surgery and the patient's post-transplant blood pressure and the renal function remained within normal limits following the transplant for 6 months of follow-up.