ABSTRACT
Myocardial calcification secondary to acute myocarditis is a rare but possibly life-threatening complication. We report a 43-year-old woman with minimal change nephrotic syndrome who developed sepsis caused by Escherichia coli. We simultaneously detected the complication of acute myocarditis in the patient. Although echocardiography showed hypokinesis of the apical segment when acute myocarditis was diagnosed, no sign of myocardial calcification was observed. After two weeks, a CT showed myocardial calcification in the same area. Although myocardial calcification was still observed 12 months later, the patient's cardiac function had improved.
Subject(s)
Calcinosis , Cardiomyopathies , Escherichia coli Infections , Myocarditis , Sepsis , Acute Kidney Injury/etiology , Acute Kidney Injury/therapy , Adult , Anti-Bacterial Agents/therapeutic use , Calcinosis/diagnostic imaging , Calcinosis/etiology , Cardiomyopathies/diagnosis , Cardiomyopathies/etiology , Cardiomyopathies/physiopathology , Echocardiography/methods , Escherichia coli/isolation & purification , Escherichia coli Infections/etiology , Escherichia coli Infections/physiopathology , Escherichia coli Infections/therapy , Female , Heart Function Tests , Hemodiafiltration/methods , Humans , Myocarditis/etiology , Myocarditis/microbiology , Myocarditis/physiopathology , Nephrosis, Lipoid/complications , Sepsis/complications , Sepsis/microbiology , Sepsis/therapy , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
INTRODUCTION: Living kidney donation improves the lives of individuals with kidney failure; however, recent studies have suggested that living kidney donors may be at a relatively higher risk of reduced renal function than healthy non-donors. We therefore aimed to evaluate the clinical and pathological findings in living kidney donors who developed kidney disease. METHODS: From January 1991 to May 2019, 1,625 live kidney donations were performed at our hospital. Among the donors, 7 developed kidney disease after donation and underwent open renal biopsy. We studied the clinical and pathological findings of these patients from their clinical records. RESULTS: There were 3 patients with immunoglobulin A (IgA) nephropathy, 2 with membranous nephropathy, 1 with anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis, and 1 with secondary focal segmental glomerulosclerosis (FSGS). All patients with IgA nephropathy had latent IgA deposition on their baseline biopsy. One patient with membranous nephropathy demonstrated findings of membranous nephropathy on the baseline biopsy, despite being asymptomatic. All patients, except for those with ANCA-associated nephropathy and secondary FSGS, recovered from the nephritis or maintained an adequate renal function after treatment. DISCUSSION/CONCLUSION: Baseline biopsy is necessary for assessing the renal condition of kidney donors, and these donors require long-term follow-up based on their baseline biopsy findings. If donors develop kidney disease, appropriate diagnosis and treatment are essential.
