- A SURVEY OF PARASITE LESIONS IN WILD RED DEER ( CERVUS ELAPHUS) FROM ARGENTINA. [Journal Article]
- JWJ Wildl Dis 2018 May 23
- In Argentina there is little information about diseases that affect exotic ungulates and the health risks that they pose to native wildlife, livestock, and humans. The aim of this study was to evalua...
In Argentina there is little information about diseases that affect exotic ungulates and the health risks that they pose to native wildlife, livestock, and humans. The aim of this study was to evaluate the health status of red deer ( Cervus elaphus) in the Nahuel Huapi National Park and surrounding areas in Patagonia, Argentina. During three consecutive hunting seasons, necropsies were performed on 101 red deer, and tissues were examined histologically. The most common lesions were those associated with hepatic and pulmonary parasites. Fasciola hepatica was observed in 15 red deer and was associated with cholangiohepatitis (8%) and/or cholangitis (10%). Dictyocaulus sp. (likely Dictyocaulus eckerti) was associated with interstitial pneumonia (5%), bronchitis (5%), pulmonary emphysema (13%), and bronchus-associated lymphoid tissue hyperplasia (13%). Other findings included Sarcocystis spp. cysts in the myocardium (89%) associated with interstitial, focal, lymphoplasmacytic myocarditis (8%); periportal lymphoplasmacytic hepatitis (8%); hepatic centrilobular necrosis (6%); lymphoplasmacytic interstitial nephritis (25%); and follicular hyperplasia in mediastinal, prescapular, and prefemoral lymph nodes (86%). Our report of lesions caused by endemic parasites of livestock in free-ranging exotic red deer in Patagonia sets the foundation for a health-monitoring and -surveillance system of wildlife in this region, which is essential for the sustainable management of threatened Argentinean native fauna.
- The Eyes Have It: A Rheumatologist's View of Uveitis. [Review]
- ARArthritis Rheumatol 2018 May 23
- Uveitis is defined as intraocular inflammation. It is an extra-articular manifestation of many forms of joint disease which include spondyloarthritis, juvenile idiopathic arthritis, and Behcet's dise...
Uveitis is defined as intraocular inflammation. It is an extra-articular manifestation of many forms of joint disease which include spondyloarthritis, juvenile idiopathic arthritis, and Behcet's disease. Rheumatologists may be asked to consult on patients with uveitis in order to identify an associated systemic illness. Diagnoses such as spndyloarthritis, sarcoidosis, and interstitial nephritis with uveitis are frequently overlooked by referring ophthalmologists. Alternatively rheumatologists may be asked to help manage the immunosuppression including biologics which can be required to treat a subset of patients with uveitis. This review is written to provide rheumatologists with the necessary information to facilitate collaboration in co-managing patients with uveitis. This article is protected by copyright. All rights reserved.
- Treatment challenges in an atypical presentation of tubulointerstitial nephritis and uveitis (TINU). [Journal Article]
- AJAm J Ophthalmol Case Rep 2018; 10:253-256
- CONCLUSIONS: Although rare, TINU can present as panuveitis with choroidal involvement which may or may not be preceded by tubulointerstitial nephritis. A renal biopsy is required for definitive diagnosis, but abnormal urinalysis or renal function should raise suspicion for TINU.
- Complete Hypokalemic Quadriparesis as a First Presentation of Sjögren Syndrome. [Journal Article]
- CJCan J Kidney Health Dis 2018; 5:2054358118774536
- We hope to increase awareness that hypokalemic paralysis may be the first presentation of Sjögren syndrome, for which potassium-sparing diuretics can be an effective adjunct to potassium replenishmen...
We hope to increase awareness that hypokalemic paralysis may be the first presentation of Sjögren syndrome, for which potassium-sparing diuretics can be an effective adjunct to potassium replenishment.
- Microsatellite pattern analysis of Neospora caninum from a naturally infected goat fetus. [Journal Article]
- VPVet Parasitol 2018 May 15; 255:58-60
- Neospora caninum is an apicomplexan protozoan responsible for abortion in ruminants. The present study aimed to diagnose an abortion from an Anglo Nubian goat from a dairy herd located in Buenos Aire...
Neospora caninum is an apicomplexan protozoan responsible for abortion in ruminants. The present study aimed to diagnose an abortion from an Anglo Nubian goat from a dairy herd located in Buenos Aires province, Argentina. The goat delivered a fetus of approximately 3 months gestation that was studied by indirect fluorescent antibody test (IFAT), Immunoblot (IB), histopathology (HP), immunohistochemistry (IHC), and molecular assays (PCR, sequencing and microsatellite genotyping). Interferon gamma knock-out mice were inoculated with a pool of tissues for isolation attempts. The mother had IFAT titers of 1:3200 and 1:400 for N. caninum and Toxoplasma gondii, respectively, as well as positive IB reactions, whereas the fetus was seronegative to both parasites by IFAT and IB. The fetus had severe multifocal necrotizing myocarditis and hepatitis, moderate interstitial pneumonia, and nephritis. Myocardium sample resulted positive by IHC, evidencing clusters of N. caninum tachyzoites within myocardiocytes associated with histopathological lesions. Neospora caninum-DNA was detected by PCR in heart, liver, lungs, kidney, and muscle from the fetus, and was negative for T. gondii by PCR. NC-5 and 18 S rRNA gene fragment sequences showed 100% identity with N. caninum. Inoculated mice bled 30 days post-inoculation resulted seronegative to N. caninum and T. gondii by IFAT, and showed no clinical signs. Multilocus-microsatellite genotyping revealed a genetic profile that differed from previously reported N. caninum genotypes, with unique MS21 and MS10 alleles. These findings indicate that N. caninum was efficiently transmitted from the mother to the fetus. We report the first case of direct detection of N. caninum in a goat fetus in Argentina and N. caninum microsatellite genotyping in naturally infected goat.
- Early renal damage among children living in the region of highest burden of chronic kidney disease of unknown etiology (CKDu) in Sri Lanka. [Journal Article]
- BNBMC Nephrol 2018 May 16; 19(1):115
- CONCLUSIONS: This study provides evidence to suggest that children in CKDu endemic regions are having an early renal damage. This observation needs to be investigated further in order to understand the worldwide epidemic of CKDu.
- IgG4-related kidney disease: the effects of a Rituximab-based immunosuppressive therapy. [Journal Article]
- OOncotarget 2018 Apr 20; 9(30):21337-21347
- IgG4-related disease (IgG4-RD) is a recently recognized disorder, characterized by elevated serum IgG4 concentrations, dense tissue infiltration of IgG4-positive plasma cells and storiform fibrosis. ...
IgG4-related disease (IgG4-RD) is a recently recognized disorder, characterized by elevated serum IgG4 concentrations, dense tissue infiltration of IgG4-positive plasma cells and storiform fibrosis. Treatment is usually based on steroids, however, relapses and long-term adverse effects are frequent. We prospectively studied 5 consecutive patients with histologically-proven IgG4-RD and renal involvement, treated with an extended Rituximab protocol combined with steroids. Two doses of intravenous cyclophosphamide were added in 4 patients. Five patients with IgG-RD were investigated: three had tubulointerstitial nephritis (TIN), while two had retroperitoneal fibrosis (RPF). In the patients with TIN, renal biospy was repeated after 1 year. In the patients with TIN, estimated glomerular filtration rate (eGFR) at 12 months increased from 9 to 24 ml/min per 1.73 m2; IgG/IgG4 decreased from 3,236/665 to 706/51 mg/dl; C3/C4 increased from 49/6 to 99/27 mg/dl; CD20+ B-cells decreased from 8.7% to 0.5%; Regulatory T-cells decreased from 7.2% to 2.5%. These functional and immunologic changes persisted at 24 months and in two patients at 36 months. A repeat renal biopsy in the patients with TIN showed a dramatic decrease in interstitial plasma cell infiltrate with normalization of IgG4/IgG positive plasma cells. The patients with RPF showed a huge regression of retroperitoneal tissue. In this sample of patients with aggressive IgG4-RD and renal involvement, treatment aimed at depleting B cells and decreasing antibody and cytokine production was associated with a substantial, persistent increase in eGFR, and a definite improvement in immunologic, radiologic and histological parameters.
- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- IgA nephropathy, also known as Berger disease, is the most common primary glomerulonephritis and the most prevalent chronic glomerular disease in the world. It was first described morphologically by ...
IgA nephropathy, also known as Berger disease, is the most common primary glomerulonephritis and the most prevalent chronic glomerular disease in the world. It was first described morphologically by Dr. Jean Berger (nephrologist) and Nicole Hinglais (microscopist) in 1968 by electron microscopy. Later, immunofluorescence microscopy was used to show more specific findings associated with the disease, such as deposits of the IgA in the mesangial matrix and its subsequent proliferation, types of immunoglobulins, and complement. The hallmark of the disease is deposition of IgA in the glomerular mesangium, causing progressive kidney disease in a majority of patients. Because gross hematuria often follows an episode of upper tract respiratory infection, IgA nephropathy is also called synpharyngitic glomerulonephritis. Other names used are IgA nephritis, IgA-IgG nephropathy, nephropathy with mesangial IgA and IgG deposits. Major clinical risk factors for progression are hypertension, proteinuria, and reduced GFR; whereas, microscopic hematuria is not a significant risk factor for progressive loss of renal function. The Oxford classification involves scoring based histologic findings, including mesangial hypercellularity, endocapillary proliferation, segmental glomerulosclerosis, tubular atrophy, or interstitial fibrosis.
- Programmed cell death protein 1 inhibitor treatment is associated with acute kidney injury and hypocalcemia: meta-analysis. [Journal Article]
- NDNephrol Dial Transplant 2018 May 11
- CONCLUSIONS: Treatment with PD-1 inhibitors is associated with a higher risk of AKI compared with non-nephrotoxic agents. It will be important to characterize the AKI patients to better understand the etiology behind the event. In addition, treatment with PD-1 inhibitors is associated with an increased risk of hypocalcemia. This study highlights a rare but serious adverse event of anti-PD-1 antibodies and we recommend, in addition to electrolytes panel, routine calcium monitoring.
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- Measurement of urinary biomarkers in a case of tubulointerstitial nephritis and uveitis syndrome during glucocorticoid treatment. [Journal Article]
- CCCEN Case Rep 2018 May 14
- Tubulointerstitial nephritis and uveitis (TINU) is a rare syndrome in which idiopathic interstitial nephritis coexists with chronic recurrent uveitis. This syndrome often represents systemic disorder...
Tubulointerstitial nephritis and uveitis (TINU) is a rare syndrome in which idiopathic interstitial nephritis coexists with chronic recurrent uveitis. This syndrome often represents systemic disorders such as arthralgia, rash, prolonged fever, anaemia and ocular symptoms that require medication including glucocorticoid administration. Recently, novel urinary biomarkers, such as kidney injury molecule-1, neutrophil gelatinase-associated lipocalin and liver-type fatty acid-binding protein, were shown to be associated with tubulointerstitial damage and were elevated in interstitial nephritis. We evaluated these urinary biomarkers in a case of TINU syndrome before and during treatment and found that their levels were elevated at onset and decreased during treatment, especially NGAL. We conclude that these urinary biomarkers are useful to evaluate and predict prognosis in interstitial nephritis.