RESUMEN
The present report describes a case of disseminated Trichosporon asahii infection. Trichosporon species has emerged as opportunistic infectious yeast in immunocompromised patients and is resistant to echinocandins. These antifungal drugs are not recommended for trichosporonosis treatment and yeast species identification be attempted for all clinical isolates, particularly with respect to the choice of antifungal therapy for specific Trichosporon species.
Asunto(s)
Micosis/diagnóstico , Sepsis/microbiología , Trichosporon/aislamiento & purificación , Anciano , Antifúngicos/uso terapéutico , Farmacorresistencia Fúngica Múltiple , Humanos , Huésped Inmunocomprometido , Masculino , Micosis/tratamiento farmacológico , Infecciones Oportunistas/diagnóstico , Infecciones Oportunistas/tratamiento farmacológico , Sepsis/tratamiento farmacológicoRESUMEN
We report the case of a patient suffering from atypical hemolytic uremic syndrome with inaugural intra-alveolar hemorrhage. Clinical features and detection of circulating anti-glomerular basal membrane antibodies first raise the possibility of a Goodpasture syndrome. Renal biopsy allows to correct the diagnosis. Partial remission is obtained thanks to specific care and eculizumab infusions.
Asunto(s)
Enfermedad por Anticuerpos Antimembrana Basal Glomerular/diagnóstico , Síndrome Hemolítico-Urémico/diagnóstico , Riñón/patología , Enfermedades Pulmonares/etiología , Anticuerpos Monoclonales Humanizados/uso terapéutico , Diagnóstico Diferencial , Hemorragia/etiología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
DEFINITION OF HYPOURICEMIA: Hypouricemia (serum uric acid less than 120 micro mol/l) is a biological abnormality often discovered accidentally and with a low prevalence depending on its permanent or transitory nature ranging from 0.15 to 3.38%. NEW PHYSIOLOGICAL CONCEPTS OF ITS PATHOGENESIS: Recently, our knowledge of the physiopathological mechanisms of hypouricemia has been emphasized by the identification of three systems of renal and extra-renal uric acid transport: a Cl/urate (URAT1) transporter, a multispecific organic anion transporter (OAT) and a urate transporter/channel. ETIOLOGY AND COMPLICATIONS OF HYPOURICEMIA: Through questioning, drugs and toxics (allopurinol.) are generally rapidly recognized as responsible for half of the hypouricemia encountered. It can be concomitant to a known disease: severe liver disease, neoplasia, diabetes, AIDS, syndrome of inappropriate antidiuretic hormone secretion. Hypouricemia can also be isolated and justifies the measurement of uric acid clearance, the normality or reduction of which orients towards a deficiency in xanthine-oxydase, the increase in which suggests an abnormality in uric acid transport in the proximal tubule (Fanconi syndrome, primary hereditary anomaly of tubular uric acid transport). Hypouricemia does not appear to expose the patient to any danger, but the onset of nephrolithiasis or acute renal failure secondary to the combination of severe hypouricemia and oxidant stress is always possible.
Asunto(s)
Proteínas Portadoras/genética , Túbulos Renales Proximales/fisiología , Proteínas Asociadas a Resistencia a Múltiples Medicamentos/genética , Transportadores de Anión Orgánico/genética , Ácido Úrico/sangre , Proteínas Portadoras/fisiología , Humanos , Proteínas Asociadas a Resistencia a Múltiples Medicamentos/fisiología , Transportadores de Anión Orgánico/fisiología , Proteínas de Transporte de Catión Orgánico , Prevalencia , Insuficiencia Renal/etiología , Ácido Úrico/metabolismoRESUMEN
Thrombotic microangiopathy includes a set of conditions characterized by the association of mechanical hemolytic anemia, thrombocytopenia and organ failure which accurate diagnosis is sometimes difficult. We report the case of a patient who presented a thrombotic microangiopathy (TMA) due to an atypical hemolytic and uremic syndrome (HUS) associated with an immunoglobulin A (IgA) nephropathy with a favorable outcome under corticosteroid.
Asunto(s)
Glomerulonefritis por IGA/diagnóstico , Síndrome Hemolítico-Urémico/complicaciones , Microangiopatías Trombóticas/complicaciones , Femenino , Glomerulonefritis por IGA/complicaciones , Humanos , Persona de Mediana EdadAsunto(s)
Fiebre Hemorrágica con Síndrome Renal/diagnóstico , Leptospirosis/diagnóstico , Diagnóstico Diferencial , Fiebre Hemorrágica con Síndrome Renal/complicaciones , Fiebre Hemorrágica con Síndrome Renal/patología , Humanos , Leptospirosis/complicaciones , Leptospirosis/patología , Masculino , Persona de Mediana EdadRESUMEN
We report the case of a patient with predominantly renal sarcoidosis. Renal failure responded well to systemic corticosteroid therapy. The clinical presentation was particular, notably the absence of lung involvement and the presence of cutaneous lymphedema.