• Title/Summary/Keyword: Renal Manifestation

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Plasmaphresis therapy for pulmonary hemorrhage in a pediatric patient with IgA nephropathy

  • Yim, Dae-Kyoon;Lee, Sang-Taek;Cho, Heeyeon
    • Clinical and Experimental Pediatrics
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    • v.58 no.10
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    • pp.402-405
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    • 2015
  • IgA nephropathy usually presents as asymptomatic microscopic hematuria or proteinuria or episodic gross hematuria after upper respiratory infection. It is an uncommon cause of end-stage renal failure in childhood. Pulmonary hemorrhage associated with IgA nephropathy is an unusual life-threatening manifestation in pediatric patients and is usually treated with aggressive immunosuppression. Pulmonary hemorrhage and renal failure usually occur concurrently, and the pulmonary manifestation is believed to be caused by the same immune process. We present the case of a 14-year-old patient with IgA nephropathy who had already progressed to end-stage renal failure in spite of immunosuppression and presented with pulmonary hemorrhage during oral prednisone treatment. His lung disease was comparable to diffuse alveolar hemorrhage and was successfully treated with plasmapheresis followed by oral prednisone. This case suggests that pulmonary hemorrhage may develop independently of renal manifestation, and that plasmapheresis should be considered as adjunctive therapy to immunosuppressive medication for treating IgA nephropathy with pulmonary hemorrhage.

Renal fibrosis

  • Cho, Min-Hyun
    • Clinical and Experimental Pediatrics
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    • v.53 no.7
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    • pp.735-740
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    • 2010
  • Renal fibrosis, characterized by tubulointerstitial fibrosis and glomerulosclerosis, is the final manifestation of chronic kidney disease. Renal fibrosis is characterized by an excessive accumulation and deposition of extracellular matrix components. This pathologic result usually originates from both underlying complicated cellular activities such as epithelial-to-mesenchymal transition, fibroblast activation, monocyte/macrophage infiltration, and cellular apoptosis and the activation of signaling molecules such as transforming growth factor beta and angiotensin II. However, because the pathogenesis of renal fibrosis is extremely complicated and our knowledge regarding this condition is still limited, further studies are needed.

Inborn Metabolic Disorders Involving Kidney (신장계 이상을 동반하는 선천성대사이상질환)

  • Beom Hee Lee
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.23 no.1
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    • pp.12-16
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    • 2023
  • Patients with inborn metabolic disorder (IMD) show multisystemic manifestations. Heterogenous renal manifestations can develop in IMD patients as well. In this review, the major renal manifestations of IMD and their representative IMDs are described. The major renal manifestations include Fanconi syndrome, renal tubular acidosis, nephrolithiasis, renal cysts and glomerulopathy, and diverse types of IMDs such as carbohydrate metabolism disorders, lysosomal disorders, organic acidemias, mitochondrial disorders, purine and pyrimidine disorders present renal manifestations. Therefore, general and regular renal function evaluation is recommended in addition to specific investigation according to IMD phenotypes.

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Correlation between Clinicomorphologic Findings and Clinical Outcome in Childhood $Henoch-Sch\"{o}nlein$ Purpura Nephritis (소아 $Henoch-Sch\"{o}nlein$ 자반병 신염의 임상양상 및 병리소견과 임상경과)

  • Huh Yun-Jung;Shin Jae-Il;Park Jee-Min;Jeong Hyeon-Joo;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.30-37
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    • 2003
  • Purpose : $Henoch-Sch\"{o}nlein$ purpura(HSP) is usually a self-limited disease with a good eventual outcome. The prognosis of HSP is mainly determined by the renal involvement. In this study, We evaluated children with biopsy-proven $Henoch-Sch\"{o}nlein$ purpura nephritis about the clinical outcome correlated with renal manifestation and morphologic findings. Methods : The clinical features, initial laboratory and pathologic findings, and clinical out-come were evaluated in 60 children with biopsy-proven $Henoch-Sch\"{o}nlein$ purpura nephritis at Yonsei University Severance Hospital during the period from Jan. 1990 to Dec. 2002. Results : The ratio of male to female patients was 1.2:1. The interval between the onset of $Henoch-Sch\"{o}nlein$ purpura and renal manifestation was less than 3 months in 81% of the patients. Initial renal manifestation was microscopic hematuria in 100% of patients, isolated hematuria in 15%, acute nephritic syndrome in 7%, nephrotic syndrome In 22% of patients. Renal manifestation correlated with clinical outcome. Grade II and III were the most common in histologic grades of ISKDC. Renal pathologic finding correlated with clinical outcome. Conclusion : Renal manifestation and pathologic findings correlated with the clinical out-come. It is necessary to evaluate the correlation between pathologic findings and treatment.

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A Case of Asphyxiating Thoracic Dystrophy with Chronic Renal Failure (만성 신부전이 동반된 Asphyxiating Thoracic Dystrophy 1례)

  • Cho Hyun-Jung;Lee Yoon-Kyung;Kim Dong-Un;Lee Ik-Jun
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.196-199
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    • 1998
  • The classical manifestation of asphyxiating thoracic dystrophy comprise narrow chest, short limbs, and pelvic changes. The degree of respiratory distress varied from negligible to lethal. The development of progressive renal failure may indicate that the condition is asphyxiating thoracic dystrophy. We have experienced a case of asphyxiating thoracic dystrophy who died from chronic renal failure in a 5-month old infant. Abriefreviewofassociatedliteratureisalsopresented.

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A Case of Neurofibromatosis Combined with Ectopic Kidney (이소성 신장을 동반한 신경섬유종 1례)

  • Yang, Eu Gene;Kim, Bo Hyun;Lee, Joon Soo
    • Clinical and Experimental Pediatrics
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    • v.48 no.4
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    • pp.448-452
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    • 2005
  • Neurofibromatosis(NF) is an autosomal dominant disorder, probably of neural crest origin that affects all three germinal layers. It is a group of heterogeneous multisystemic neurocutaneous disorders involving both neuroectodermal and mesenchymal derivatives. Type 1(von Recklinghausen disease) is the most common neurocutaneous disorder among the eight subtypes. Previous reports showed various involvements in the renal organ. Renovascular hypertension is the most common major manifestation of renal involvement in this disease. However, we experienced a case of ectopic kidney concurrent with neurofibromatosis type 1. The diagnosis of neurofibromatosis had been made by typical skin manifestation on physical examination, and ectopic kidney was discovered accidentally during routine abdominal sonography. The etiological basis of this association is not clear. We report a rare case of coexisting neurofibromatosis and ectopic kidney in a 7-year-old girl with a brief review.

A case of diffuse alveolar hemorrhage associated with Henoch-Schoenlein purpura (헤노호-쉔라인 자반증 (Henoch-Schoenlein purpura)에 합병된 미만성 폐포출혈 1예)

  • Cho, Won-Kyoung;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Yoo, Eun-Sil;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.461-466
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    • 1996
  • Diffuse alveolar hemorrhage is a very rare manifestation in Henoch-Schoenlein purpura. Recently we experience a case of diffuse alveolar hemorrhage associated with Henoch-Schoenlein purpura which was diagnosed by typical clinical manifestation and renal biopsy. A 25 year old male was admitted due to hemoptysis and dyspnea. Chest X-ray, HRCT and BAL revealed diffuse alveolar hemorrhage. He also had a history of skin rash, polyarthralgia, and hematochezia with abdominal pain. Renal biopsy which was taken for the evaluation of microscopic hematuria showed IgA nephropathy. Under the diagnosis of Henoch-Schoenlein purpura, we treated him with solumedrol pulse therapy, plasma-pheresis and prednisolone with cytoxan. After then he showed marked improvement in clinical manifestation and was discharged with prednisolone and cytoxan.

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Various Renal Manifestations in Children with Tuberous Sclerosis Complex (소아 결절성 경화증에서 나타나는 다양한 신증상들)

  • Lim, Ja Hyun;Park, Moon Sung;Pai, Ki Soo;Kim, Sung Hwan;Shin, Jae Il;Park, Se Jin
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.132-136
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    • 2014
  • Tuberous sclerosis complex (TSC) is a genetic disorder that affects multiple organ systems and causes tumors. It is important that physicians are aware of the manifestations of TSC, and that they follow the recommendations for screening and evaluation. Several types of renal abnormalities may develop in individuals with TSC. Individuals with TSC may require ongoing treatment that can be adapted for each arising manifestation of renal disease. Herein, we report 4 patients with TSC who presented with a range of different renal manifestations, including angiomyolipoma, renal cell carcinoma, renal infarction, renal cyst, and nephrolithiasis.

An Anesthetic Management in a Pedodontic Patient with Lowe Syndrome - A case report - (Lowe 증후군을 동반한 소아치과 환자의 전신 마취 경험 -증례 보고-)

  • Choi, Young-Kyoo;Oh, Jae-Yeol;Kim, Dong-Ok;Shin, Ok-Young;Lee, Keung-Bo
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.2 no.1 s.2
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    • pp.33-37
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    • 2002
  • The oculo-cerebro-renal syndrome of Lowe (Lowe syndrome) is an X-linked recessive disorder involving the eyes, nervous systems, and kidneys. The clinical manifestation of this syndrome is characterized by congenital cataracts, glaucoma, seizure disorder, psychomotor growth retardation, hypotonia, renal tubular acidosis, aminoaciduria, rickets, and osteoporosis. We report a 5-year old boy underwent general anesthesia for the treatment of multiple dental carries. During intraoperative period, marked metabolic acidosis was noted and such acidosis was partially corrected by hyperventilation. We suggest that patients with Lowe's syndrome should be attention and treated to possible anesthetic hazards such as metabolic acidosis due to renal tubular dysfunction, rise of intraocular pressure in patient with glaucoma, the fragility of the bone structures due to rickets and osteoporosis.

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Severe Case of Hypermagnesemia Caused by Ingesting Magnesium Containing Fertilizer (마그네슘 포함 비료 음독 후 발생한 중증의 고마그네슐혈증의 1례)

  • Lee, Ka-young;Yu, Jin-young;Cho, Nam-Jun;Park, Samel;Lee, Eun-young;Gil, Hyo-Wook
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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    • pp.141-144
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    • 2020
  • Hypermagnesemia is a rare condition that is usually iatrogenic in patients with elderly or renal failure. Severe hypermagnesemia is uncommon in patients with a normal renal function. Symptoms due to hypermagnesemia can range from mild symptoms, such as nausea, to severe symptoms, such as cardiac and respiratory arrest. This paper describes a case of a 49-year-old woman who ingested a magnesium-containing fertilizer with normal renal function. Cardiac arrest occurred eight hours after poisoning. Electrocardiography changed from a narrow QRS to a wide QRS and then to a complete atrioventricular block. Her hemodynamic state was unstable. Continuous renal replacement therapy was performed to remove magnesium from the blood, with the subsequent resolution of arrhythmia and hemodynamic stabilization. This paper reviews the pathophysiologic effects of magnesium on the cardiovascular system, clinical manifestation, and treatment of hypermagnesemia.