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Diabetic Nephropathy
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Nephrotic syndrome is urinary excretion of more than 3 g of protein per day, because of a glomerular disorder accompanied by edema and hypoalbuminemia. It is more common in children and may be primary or secondary. In adult cases, secondary nephrotic syndrome may occur along with diabetic nephropathy. The disease is diagnosed by determining the urine protein:creatinine ratio, via a random urine sample, or a 24-hour urine collection. Nephrotic syndrome is also defined as nephrotic urine sediment, with edema and hypoalbuminemia. Usually, hypercholesterolemia and hypertriglyceridemia are also present. With nephrotic urine sediment, there are fatty casts, oval fat bodies, and small amounts of cells or cellular casts present.
Lupus Nephritis
Published in Richard K. Burt, Alberto M. Marmont, Stem Cell Therapy for Autoimmune Disease, 2019
The decision to treat lupus nephritis and the therapeutic regimen to be used depend on the clinical and pathologic features. Clinical features that are more common and often warrant treatment include nephritic urine sediment, worsening nephrotic syndrome, and deteriorating renal function. As noted, a renal biopsy can be of critical help in making the appropriate therapeutic decision.
Infective endocarditis in older adults
Published in Wilbert S. Aronow, Jerome L. Fleg, Michael W. Rich, Tresch and Aronow’s Cardiovascular Disease in the Elderly, 2019
Leukocytosis with left shift is commonly present (12), but less often in seniors than in young adults (14). Anemia appears to be more common in older adults (6), and elevation of the erythrocyte sedimentation rate occurs in 90% of cases (12,32). Microscopic examination of the urine sediment is recommended to detect proteinuria and microscopic hematuria, red blood cell casts, and bacteriuria. Up to 50% of cases have a positive rheumatoid factor. Reduced complement levels and increased circulating immune complexes may be noted (12,32).
RSV induced rhabdomyolysis: a case report
Published in Acta Clinica Belgica, 2023
Stijn Arnaert, Thomas Malfait, Astrid Deruyck, Farah Desoete, Maria Nersisjan, Inge Matthijs, Bart Maes
We present the case of an 18-year-old male patient without relevant medical history who was admitted to the emergency department referred by the primary physician with nearly asymptomatic rhabdomyolysis. He consulted his primary physician because of a cough with purulent sputa, he did not mention muscle pain or fever. The patient had a lean constitution and performed sports several times per week, he did not recall any traumatic injury. He did not take any medication or drugs. Routine blood sample showed a creatine kinase level of 40.400 U/L, a normal renal function and electrolytes and a mildly elevated CRP of 20.7 mg/L. Leucocytes were slightly elevated without neutrophilia (Table 1). Transaminases were elevated (AST 946 U/L, ALT 423 U/L). Troponins and CK-MB were normal, myoglobin was elevated (237 µg/L). Procalcitonin was low, suggesting the unlikeliness of a bacterial infection. A nasopharyngeal swab for respiratory viral PCR detected RSV, but was negative for COVID-19, Influenza A and B. Urine toxicology was negative. Urine sediment was normal. Radiography of the thorax did not show any consolidations.
Evaluation of the Atellica® UAS 800: a new member of the automated urine sediment analyzer family
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2021
Stijn J. A. Aper, Karlijn Gijzen, Jolien J. Luimstra, Johanna T. M. H. van der Valk, Anne Russcher, Rüya G. Koçer, Eline C. Liesting, Leo H. J. Jacobs, Eef G. W. M. Lentjes, Ayşe Y. Demir
Urine samples with a minimal volume of 2.0 mL (2.6 mL for the Atellica® 1500 combined system) were mixed by aspiration and dispensing. A volume of 200 µL was transferred to a cuvette and gently centrifuged (for 10 s at 200 g) to sediment urine at the bottom of the cuvette in one focal plane. Using a digital microscope with a dual-focusing technique, 15 images of the urine sediment were captured. These images were processed by a neural network-based image evaluation module (Automated Image Evaluation Module), which classified the urinary particles in 11 major categories: erythrocytes (RBC), leukocytes (WBC; and WBC clumps), bacteria (total bacteria count: BACt; and rods, cocci), yeast, crystals, hyaline casts, pathological casts, non-squamous epithelial cells (NSEC), squamous epithelial cells (SEC), mucus, and sperm. The Atellica® does not automatically subcategorize pathological casts and dysmorphic erythrocytes. Therefore the results of automated classifications were reviewed on-screen by a qualified and experienced technician; disagreements were corrected, and subcategories were assigned. These reviewed data were used for comparison with manual microscopy. Particle counts were expressed as mean number per µL observed in 15 images of the urine sediment. The conversion factor from number/µL to LPF is 3.63 (according to the manufacturer’s instructions).
Predicting lupus flares: epidemiological and disease related risk factors
Published in Expert Review of Clinical Immunology, 2021
Samuel de Oliveira Andrade, Paulo Rogerio Julio, Diego Nunes de Paula Ferreira, Simone Appenzeller
Although male sex, younger age at disease and non-Caucasian ethnicity is associated with more severe disease, greater frequency of nephritis, accrual damage, and death, the association of these demographic variables with flares are inconsistent in the literature independently of the score used (SLEDAI-2 K, BILAG, lupus nephritis flare index) [5,8–10]. Its significance decreases when flare predictors are adjusted for socio-demographic and disease-related variables [8,78]. In longitudinal cohort studies longer disease duration has been independent risk factor for flares when using SLEDAI-2 K score [6]. SLE patients with nephritis, longer time to remission was an independent risk factor for renal flares, defined as the presence of at least two determinations: (a) increase in proteinuria by more than 2 g/24 hours, (b) active urine sediment, or (c) increase in creatinine 30% [11].