Tularemia in a kidney transplant recipient Ozkok, Abdullah; Karadenizli, Aynur; Odabas, Ali Riza
American journal of kidney diseases : the official journal of the National Kidney Foundation,
10/2012, Letnik:
60, Številka:
4
Report
ObjectivesThis study aims to determine whether COVID-19 patients with different initial reverse transcriptase-polymerase chain reaction (RT-PCR), computed tomography (CT) and laboratory findings have ...different clinical outcomes. Materials and MethodsIn this multi-center retrospective cohort study, 895 hospitalized patients with the diagnosis of COVID-19 were included. According to the RT-PCR positivity and presence of CT findings, the patients were divided into four groups. These groups were compared in terms of mortality and need for intensive care unit (ICU). According to the COVID-19 Reporting and Data System (CO-RADS), all patients' CT images were staged. Multivariate binary logistic regression analysis was used to examine the relationship between CO-RADS and predictive inflammation and coagulation parameters. ResultsRT-PCR test positivity was 51.5%, the CT finding was 70.7%, and 49.7% of the patients were in the CO-RADS 5 stage. The need for ICU and mortality rates was higher in the group with only CT findings compared to the group with only RT-PCR positivity, (14.9% vs. 4.0%, p < 0.001; 9.3% vs. 3.3%, p > 0.05; respectively). Mortality was 3.27 times higher in patients with CO-RADS 4 compared to those with CO-RADS 1-2. Being in the CO-RADS 4 stage and LDH were discovered to be the most efficient parameters in determining mortality risk. ConclusionPerforming only the RT-PCR test in the initial evaluation of patients in SARS-CoV-2 infection may lead to overlooking groups that are more at risk for severe disease. The use of a chest CT to perform CO-RADS staging would be beneficial in terms of providing both diagnostic and prognostic information.
Donor and recipient artery problems are challenging complications in renal transplant patients. In this report, we present our treatment strategy in a 42-year-old renal transplant case with renal ...artery stenosis and a giant pseudoaneurysm at the anastomotic site. Open repair failed due to extreme adhesions. However, the patient was managed successfully using the hybrid approach with iliofemoral bypass and stent graft implantation to the renal artery, providing retrograde renal artery perfusion.
Psoriasis is a hereditary, chronic inflammatory disorder of the skin. Generally, the psoriatic process is limited to the skin; however, internal organs such as the kidneys may be involved in the ...course. Several glomerular diseases have been distinguished due to renal histological findings of psoriatic patients to date. The underlying pathogenetic mechanisms of these associations remain unclear because of the limited number of cases. We report a case of primary membranoproliferative glomerulonephritis (MPGN) in a psoriatic patient. This is the first reported case that demonstrates the coexistence of MPGN and psoriasis.
Antineutrophil cytoplasmic antibodies (ANCA) are autoantibodies directed at lysosomal constituens of leucocytes, with two major immunufluoresence staining patterns: cytoplasmic (c-ANCA), and ...perinuclear (p-ANCA). ANCA can be found mainly pauci-immune necrotising vasculitis and other inflammatory disease. We tested the prevalence of antineutrophil cytoplasmic antibodies during acute attacks in 18 patients with familial Mediterranean fever (FMF). There was a patient positivity among the FMF patients. There were no ANCA positivity among the 20 healthy control group. There were no statistically signification between FMF patients and healthy control group (p=0.474). We suggest that FMF, perhaps as a consequence of impaired control of inflammatory responses to vasculitis. The role of antineutrophil cytoplasmic antibodies in the inflammation pathogenesis of FMF patients is not clear.
Anti-nötrofilik sitoplazmik antikor (ANCA)'lar lökositlerin lizozomal. granüllerindeki proteinlere karşı gelişmiş olan otoantikorlardır. Bu antikorların immunflorasans yöntemine göre ayırt edilen farklı mikroskobik görünümlerine göre iki tipi belirlenmiştir. Söz konusu bu antikorlar perinükleer boyanma paterni gösteren (p-ANCA) ile diffüz sitoplazmik boyanma gösteren (c-ANCA) dır. Bu antikorlar daha çok pauci-immun vaskülitlerde pozitif bulunmakla birlikte başta inflamatuar hastalıklar olmak üzere birçok hastalıkta pozitif olarak bulunabilmektedir. Çalışmamızda ailevi Akdeniz ateşi (AAA) tanısıyla izlenen 18 hastada akut aktivasyon sırasında ANCA'ların sıklığı araştırıldı. Bir hastada ANCA pozitif olarak bulundu. Kontrol grubu olarak alınan 20 sağlıklı gönüllüde ise ANCA pozitifliğine rastlanmadı. Aralarında istatistiksel anlamlı fark yoktu (p=0.474). AAA'de inflamasyonun kontrolünde bir bozukluk olmasına ve bu bozukluğun vaskülitlerin seyri sırasında görülen inflamasyona benzerlik göstermesine karşın çalışmamızda ANCA'ların inflamasyon patogenezindeki rolü belirlenememiştir.
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