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A busy haematuria clinic
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Hypertension is very common in patients with glomerulonephritis and needs to be well controlled. It can speed up the decline in renal function by causing renal damage. Often, hypertension is less evident in patients with the nephrotic syndrome because of their low serum protein.
Potential of Fenugreek in Management of Kidney and Lung Disorders
Published in Dilip Ghosh, Prasad Thakurdesai, Fenugreek, 2022
Amit D. Kandhare, Anwesha A. Mukherjee-Kandhare, Subhash L. Bodhankar
Glomerulonephritis or nephritis is a severe and life-threatening illness that occurs due to inflammation of the glomeruli. Although prevalence is low, nephritis can be rapidly progressive and the patient may need immediate treatment. Additionally, damage to the glomerulus results in arterial hypertension and renal failure. Glomerulonephritis includes many diseases, namely anti- GBM antibody disease, IgA nephropathy, lupus nephritis, and ANCA-associated vasculitis (McAdoo and Pusey 2017). The pathophysiology remains unknown for glomerulonephritis; however, bacterial and viral infections have been encountered frequently during a clinical investigation (Couser and Johnson 2014). The recommended treatment regimen for glomerulonephritis includes daily administration of oral steroids such as cyclophosphamide and plasma exchange to decrease the serum levels of anti-GBM antibodies. Although these therapies are more efficient in removing antibodies from serum, their cost and availability have acted as limitations in widespread clinical practice.
Nephrology, including fluid and electrolytes
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
Less than 5% of children with post-streptococcal glomerulonephritis develop chronic renal failure. Complications of acute glomerulonephritis include renal failure, cardiac failure, hypertension and hypertensive encephalopathy. Of the many markers of streptococcal infection, ASO titre is the most useful. Life-long penicillin prophylaxis is not recommended as second attacks of acute glomerulonephritis are rare. Serum complement levels are low only during the acute phase and return to normal within 3 months after the onset of the disease.
Cost-effectiveness of the adjuvanted quadrivalent influenza vaccine in the elderly Belgian population
Published in Expert Review of Vaccines, 2023
Sophie Marbaix, Nicolas Dauby, Joaquin Mould-Quevedo
Respiratory diagnoses other than influenza are the most frequent complications and include bronchitis, pneumonia or any URTI, and acute exacerbation of COPD. Myocarditis, MI, renal or CNS complications, and stroke are the nonrespiratory complications associated with influenza infection. Renal complications refer to acute renal failure, glomerulonephritis, and nephrotic syndrome. CNS complications include meningitis, psychosis, epilepsy and Guillain-Barré syndrome. The probabilities of developing these complications were mainly derived from an observational study conducted in the United Kingdom [4] and adapted for a previous cost-effectiveness analysis [20]. The nature of the complications and the risk of hospitalization due to complications were validated by Belgian experts. All nonrespiratory complications were assumed to require hospitalization. Bronchitis and URTIs were mainly managed in outpatient settings. The risk of hospitalization due to pneumonia was derived from a previous Belgian cost-effectiveness analysis [38]. A similar risk of hospitalization was assumed in the case of COPD exacerbations based on the number of hospitalizations due to influenza in combination with pneumonia and COPD diagnoses [3].
Shunt Nephritis: A Case of Mistaken Identity
Published in Acta Clinica Belgica, 2023
Tim Van Damme, Nic Veys, Marijn M. Speeckaert, Sigurd E. Delanghe
The most common pathogens that cause shunt infections and nephritis are coagulase-negative staphylococci, however other bacteria such as Staphylococcus aureus, Escherichia coli, Propionibacterium acnes, Corynebacterium, and Bacillus species can also be identified. Staphylococcus epidermidis accounts for approximately 75% of all shunt infections and was also the disease-causing pathogen in the case of shunt nephritis presented here [3]. In general, treatment of infection-related glomerulonephritis boils down to treating the causative infection through pathogenically-oriented therapy and/or surgery. The use of immunosuppressants has been reported in several cases, but is at the very least controversial. Immunosuppressive drugs do not appear to slow the disease development and may perhaps have a harmful impact [26–29]. This is supported by our findings: the referring center administered immunosuppressive therapy for one year, but recovery was only achieved after antibiotic therapy and shunt removal.
Renal biopsy in systemic infections: expect the unexpected
Published in Ultrastructural Pathology, 2023
Bangchen Wang, Alexandra Grand, Micah Schub, Harpreet Singh, David I. Ortiz Melo, David N. Howell
In cases of glomerulonephritis associated with known infections, renal biopsy is not typically performed because clinical history and laboratory findings are usually sufficient for making the diagnosis; however, when the clinical findings are atypical or the infections are occult and undetected, a renal biopsy is warranted to help clarify the etiology of the kidney disease. The findings are particularly crucial when the differential diagnosis includes both autoimmune and infection-related glomerular disorders, as the therapeutic approaches are different (and sometimes diametrically opposed). Arriving at the correct diagnosis usually requires concerted use of light, immunofluorescence, and electron microscopy. In this communication, we present three cases where the renal biopsy findings prompted the identification or treatment of systemic infections.