Suspected Levetiracetam-Induced Acute Rhabdomyolysis in a Patient With Retinoblastoma: A Case Report and Literature Review.

Rhabdomyolysis is a condition characterized by the destruction of the skeletal muscle and the release of its content into the circulation, and it can cause acute kidney injury (AKI). There are numerous causes for the development of this condition, and some of them are rare. Levetiracetam, an antiepileptic agent, has been speculated as a rare possibility for the development of rhabdomyolysis. In this report, we highlight a case of a 36-year-old gentleman with retinoblastoma since childhood, who was maintained on levetiracetam for two years for epilepsy. He was brought to our hospital with a history of generalized fatigue and unwitnessed seizure. Upon further investigations, he was found to have severe rhabdomyolysis and AKI that required renal replacement therapy. Levetiracetam was suspected as a culprit and therefore was discontinued with gradual improvement of renal function over a few months.

Is percutaneous gastrostomy tube insertion contraindicated in adult peritoneal dialysis patients? A single-centre experience of three successful cases: It is time to revisit.

Percutaneous endoscopic gastrostomy (PEG) tube placement in adults who are already established on peritoneal dialysis (PD) remains challenging due to the limited experience and data in this area which lacks clear guidance. Given the fact that peritoneal dialysis is one of the relative contraindications for PEG tube insertion, and PEG tube on its own is a risk for peritonitis, how to overcome these obstacles and utilize the advantage of PEG tube for feeding malnourished PD patients remains uncertain. Here we report our unique successful experience of treating three adult peritoneal dialysis patients in whom the PEG tube was inserted successfully with no complications. To the best of our knowledge, this is the first successful case series in the literature for treating adult prevalent PD patients by PEG tube placement.

Coexistence of Interstitial Nephritis and the Cellular Variant of Focal Segmental Glomerulosclerosis Secondary to Anabolic Steroid Abuse.

Anabolic-androgenic steroids (AAS) have been widely used by young people to enhance performance and increase muscle mass. The use of AAS can affect the kidneys and lead to a myriad of presentations, ranging from mildly elevated serum creatinine and blood urea nitrogen to irreversible chronic kidney disease and focal segmental glomerulosclerosis (FSGS). To the best of our knowledge, the coexistence of interstitial nephritis and the cellular variant of FSGS [Immunoglobulin M (IgM)] secondary to AAS abuse has not been previously reported in the literature. Here, we report the case of a 40-year-old bodybuilder who developed simultaneous interstitial nephritis and the cellular variant of FSGS (IgM) after short-term use of AAS and other dietary supplements.

Quality of Life among Renal Transplant Recipients in Bahrain: A Single-Center Experience.

Although a positive effect of renal transplantation on quality of life (QOL) scores was demonstrated in numerous international studies, there are a few studies in renal transplant recipients in Arabic countries. The purpose of this study was to assess the QOL in renal transplant recipients in Bahrain. We used the standard QOL Index (QOLI) score instrument in Arabic languages. This study included 58 patients, aged 26-71 years, and 63.8% of them were males. We excluded patients below 18 years old and failed renal transplant at the time of the study. The highest QOL score was in the psychological/spiritual domain (87.4 ± 12.2), followed by the family domain (85.5 ± 13.1), the health and functioning domain (82.7 ± 13.3), and the social and economic domain (80.5 ± 13.9). There was a highly significant high positive correlation between the QOLI and each of the tested domains (P <0.001). Married participants had a significantly higher QOL score in the family domain, compared to unmarried participants (P = 0.025). The QOL scores in the health and functioning domain were significantly affected by the patient's social status, residence, and coexisting diabetes mellitus. In addition, the QOLI scores were significantly greater among patients who did their transplants in Bahrain (P = 0.045). Most of the renal transplant patients in Bahrain are satisfied with their QOL. Their QOL was also variably impacted by the different sociodemographic and clinical factors.