scholarly journals Acute Renal Failure in a Patient with Rivaroxaban-Induced Hypersensitivity Syndrome: A Case Report with a Review of the Literature and of Pharmacovigilance Registries

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Gisela Marcelino ◽  
Ould Maouloud Hemett ◽  
Eric Descombes
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Adverse Events ◽  
Case Reports ◽  
Vitamin K Antagonists ◽  
Clinical Manifestations ◽  
Hypersensitivity Syndrome ◽  
World Health ◽  
Low Grade ◽  
Review Of The Literature

Direct oral anticoagulants (DOACs) are among the most commonly prescribed medications, and DOAC-associated kidney dysfunction may be a problem that is underrecognized by clinicians. We report on the case of an 82-year-old patient who, two weeks after the prescription of rivaroxaban for atrial fibrillation, was hospitalized for a drug-induced hypersensitivity syndrome whose main clinical manifestations were low-grade fever with a petechial rash in the legs and acute renal failure (ARF). Within one week after rivaroxaban withdrawal, the patient’s clinical condition improved and the renal function normalized. In a review of the literature, we only found five case reports of rivaroxaban-related ARF: two patients had tubulo-interstitial nephritis (TIN), two had anticoagulant-related nephropathy (ARN), and the last one had IgA nephropathy. As some recent publications suggest that kidney injury due to anticoagulation drugs may be largely underdiagnosed, we also analyzed the data from the VigiAccess database, the World Health Organization pharmacovigilance program that collects drug-related adverse events from 134 national registries worldwide. Among all the rivaroxaban-associated adverse events reported in VigiAccess since 2006, 4,323 (3.5%) were renal side effects, of which 2,351 (54.3%) were due to unspecified ARF, 363 (8.4%) were due to renal hemorrhage (characteristically associated with ARN), and 24 (0.6%) were due to TIN. We also compared these results with those reported in VigiAccess for other DOACs and vitamin K antagonists. This analysis suggests that the frequency of renal adverse events associated with rivaroxaban and other DOACs may be appreciably higher than what one might currently consider based only on the small number of fully published cases.

scholarly journals Neuroendocrine Neoplasms of the Breast: The Latest WHO Classification and Review of the Literature

Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 196
Author(s):  
Yukinori Ozaki ◽  
Sakiko Miura ◽  
Ryosuke Oki ◽  
Teppei Morikawa ◽  
Keita Uchino
Keyword(s):  
Who Classification ◽  
Case Reports ◽  
Treatment Options ◽  
Case Series ◽  
Breast Tumors ◽  
World Health ◽  
Neuroendocrine Neoplasms ◽  
Low Grade ◽  
Review Of The Literature ◽  
Retrospective Case

Breast tumors with neuroendocrine (NE) differentiation comprise an uncommon and heterogeneous group of tumors, including invasive breast cancer of no special type (IBC-NST) with NE features, neuroendocrine tumors (NETs), and neuroendocrine carcinoma (NEC). The most recent World Health Organization (WHO) classification in 2019 defined neuroendocrine neoplasms (NENs) of the breast (Br-NENs) as tumors in which >90% of cells show histological evidence of NE differentiation, including NETs (low-grade tumors) and NEC (high-grade). Due to the low prevalence of these tumors and successive changes in their diagnostic criteria over the years, only limited evidence of these tumors exists, derived mainly from case reports and retrospective case series. Breast tumors with NE differentiation are usually treated like the more commonly occurring IBC-NSTs. Immunohistochemistry (IHC) of breast tumors with NE differentiation usually shows a hormone receptor (HR)-positive and human epidermal growth factor type 2 (HER2)-negative profile, so that hormonal therapy with cyclin-dependent kinase (CDK)4/6 inhibitors or other targeted agents would be reasonable treatment options. Herein, we present a review of the literature on breast tumors with NE differentiation as defined in the latest WHO 2019 classification, and discuss the clinical management of these tumors.

Clinical Outcomes in Patients with ADAMTS13-Deficient Thrombotic Thrombocytopenic Purpura (TTP) Who Received Platelet Transfusions (PT).

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1302-1302
Author(s):  
Karen K. Swisher ◽  
Johanna A. Kremer Hovinga ◽  
Bernhard Lämmle ◽  
Deirdra R. Terrell ◽  
Sara K. Vesely ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Adverse Events ◽  
Case Reports ◽  
Invasive Procedure ◽  
Venous Catheter ◽  
Neurological Complications ◽  
First Episode ◽  
Adamts13 Activity ◽  
Microvascular Thrombosis

Abstract Case reports describe neurological complications, acute renal failure and death in patients with TTP following PT; these observations have led to recommendations to avoid PT. The Oklahoma TTP-HUS Registry enrolled 254 consecutive patients with their first episode of clinically diagnosed TTP from 11-13-1995 (the date of our initial ADAMTS13 measurement) to 12-31-2006 for whom plasma exchange treatment (PEX) was requested; ADAMTS13 activity was measured in 235 (93%) patients immediately before their first PEX; 44 (19%) patients had ADAMTS13 activity <10%. To avoid selection bias, the 19 patients without ADAMTS13 measurements were also included; 9 died before a sample was obtained. We excluded 11 of the 63 patients because of alternative etiologies or subsequent diagnoses (drug-associated TTP-HUS (5), sepsis (4), cancer (1), post-BMT (1)). The initial episodes of 52 patients were analyzed (42 with ADAMTS13 <10%; 10 not measured). 26 (50%) patients received PT; 23 (88%) only before the first PEX. 13 patients had 1 PT; 9 had 2–3, and 4 had 4–14. 17 (65%) patients received PT for an indication such as central venous catheter placement or hemorrhage, 5 (19%) only because of thrombocytopenia, and 4 (15%) had multiple PT for both reasons. Patients PT (n=26) No PT (n=26) P *median; **seizure, stroke, coma, focal abnormalities anytime during the course; †most abnormal values at diagnosis ± 7 days, median; §defined by ↑ Cr ≥ 0.5 mg/dL x 2 days or Cr ≥4.0 and dialysis. Age* (years) 40 41 0.649 Female (%) 69% 88% 0.090 Race (% black) 35% 38% 0.773 Severe neurologic abnormalities** 46% 50% 0.789 Platelet count† (/μL) 11,000 13,000 0.058 Hematocrit† (%) 21 22 0.339 LDH† (U/L) 1639 1226 0.045 Creatinine† (mg/dL) 1.3 1.0 0.156 Acute renal failure§ 8% 4% 1.000 Death (30 days) 27% 12% 0.159 There were no clinically important differences between the groups of patients who did or did not receive PT. 22 of 26 (85%) patients who received PT had no adverse events in <24 hours. Although there was no difference in the overall occurrence of severe neurologic abnormalities, 2 patients who received PT had new neurologic events <24 hours after a PT (stroke, seizure). Patients who received PT had a higher but not significantly different mortality. 7 patients who received PT died; 3 died 9, 12, and 72 hours after PT; autopsies were performed in 2 of these 3 patients documenting systemic microvascular thrombosis; another patient died 6 hours after PT from intrathoracic hemorrhage due to subclavian line placement. The other 3 patients died 14, 18, and 18 days after PT from S. epidermidis sepsis, respiratory failure, and stroke. 3 patients who had not received PT died; 2 died immediately after diagnosis before PEX could begin; autopsies in both documented systemic microvascular thrombosis. 1 patient died of enterococcal sepsis 11 days after diagnosis. Conclusions: PT are commonly given to patients with TTP, most often before the diagnosis is established and PEX is begun. Although PT may be followed by severe complications or death, the relation of PT to these adverse events is uncertain. It is prudent to avoid PT in patients with TTP; however in patients with overt hemorrhage or who require a high risk invasive procedure, PT may be appropriate supportive care.

Acute Renal Failure Caused by Imiquimod 5% Cream in a Renal Transplant Patient: Review of the Literature on Side Effects of Imiquimod

Dermatology ◽  
2011 ◽  
Vol 222 (2) ◽  
pp. 109-112 ◽  
Author(s):  
J. Santos-Juanes ◽  
A. Esteve ◽  
A. Mas-Vidal ◽  
P. Coto-Segura ◽  
E. Salgueiro ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Side Effects ◽  
Renal Transplant ◽  
Renal Transplant Patient ◽  
Transplant Patient ◽  
Review Of The Literature

scholarly journals Renal involvement in human rabies: clinical manifestations and autopsy findings of nine cases from northeast of Brazil

2005 ◽  
Vol 47 (6) ◽  
pp. 315-320 ◽  
Author(s):  
Elizabeth De Francesco Daher ◽  
Geraldo Bezerra da Silva Júnior ◽  
Marúsia Thomaz Ferreira ◽  
Fernando Antonio de Sousa Barros ◽  
Tiago Magalhães Gurgel ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Renal Involvement ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Hemodynamic Instability ◽  
Human Rabies ◽  
Tubular Necrosis ◽  
Post Mortem Findings ◽  
Histopathologic Findings

A retrospective study was conducted in nine patients with rabies admitted to a hospital of Fortaleza, Brazil. Autopsy was performed in all cases. The ages ranged from three to 81 years and six were males. They all were bitten by dogs. The time between the accident and the hospital admission ranged from 20 to 120 days (mean 45 ± 34 days). The time until death ranged from one to nine days (mean 3.3 ± 5.5 days). The signs and symptoms presented were fever, hydrophobia, aerophobia, agitation, disorientation, dyspnea, sialorrhea, vomiting, oliguria, sore throat, pain and hypoesthesia in the site of the bite, headache, syncope, cough, hematemesis, mydriasis, hematuria, constipation, cervical pain and priapism. In three out of six patients, there was evidence of acute renal failure, defined as serum creatinine > 1.4 mg/dL. The post-mortem findings in the kidneys were mild to moderate glomerular congestion and mild to intense peritubular capillary congestion. Acute tubular necrosis was seen in only two cases. This study shows some evidence of renal involvement in rabies. Histopathologic findings are nonspecific, so hemodynamic instability, caused by autonomic dysfunction, hydrophobia and dehydration must be responsible for acute renal failure in rabies.

scholarly journals Low-Dose Aminophylline for the Treatment of Neonatal Non-Oliguric Renal Failure—Case Series and Review of the Literature

2008 ◽  
Vol 13 (2) ◽  
pp. 80-87
Author(s):  
Bethany A. Lynch ◽  
Peter Gal ◽  
J. Laurence Ransom ◽  
Rita Q. Carlos ◽  
Mary Ann V.T. Dimaguila ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Chart Review ◽  
Low Dose ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Review Of The Literature ◽  
Oliguric Renal Failure ◽  
The Impact

OBJECTIVE Aminophylline is a methylxanthine with multiple physiologic actions. At low doses, aminophylline can antagonize adenosine and improve renal function via increased glomerular filtration rate. Despite its clinical use, little data exists in neonates for this indication. Therefore, the objective of this report is to describe the impact of aminophylline on renal function indices in a series of neonates with acute renal failure. MATERIALS AND METHODS This was a retrospective chart review of 13 neonates with acute renal failure who received aminophylline during a 15-month study period. Aminophylline was administered at 1 mg/kg intravenously or orally every twelve hours. Forty-six percent (n = 6) of the patients received a 5 mg/kg loading dose before initiation of maintenance therapy. Most patients had already received other treatments for renal failure, including diuretics and dopamine. RESULTS Resolution of acute renal failure (with normalization of serum creatinine and blood urea nitrogen) was documented in 10 patients (77%). Four of the thirteen patients died from complications due to their prematurity. Failure of low-dose aminophylline was observed in 3 of the 4 patients who died. CONCLUSIONS Low-dose aminophylline in neonates with acute renal failure is associated with an improvement in renal function indices.

scholarly journals Development of the proteinuria dosage

2021 ◽  
Vol 14 (3) ◽  
pp. 079-081
Author(s):  
Andriamiarimbola Irène Rakotoniaina ◽  
Miora Koloina Ranaivosoa ◽  
Annick Anjatiana Raherinaivo ◽  
Andry Rasamindrakotroka
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Kidney Disease ◽  
Urine Sample ◽  
Protein Detection ◽  
Urine Collection ◽  
Creatinine Ratio ◽  
Review Of The Literature ◽  
Creatinine Excretion ◽  
Albumin Creatinine Ratio

The 24-hour urine proteinuria or albuminuria ratio is still prescribed for protein detection in urine, despite the fact that it has been replaced by the albuminuria or protein/creatininuria ratio. The use of this ratio eliminates the misinterpretation of 24-hour urine proteinuria. The objective of this development is to clarify the importance of the ratio for the search for albumin or protein in the urine. We conducted a review of the literature focusing on different diagnostic recommendations. Indeed, 24-hour urine collection is tedious and prone to many errors. The ratio is therefore a simple, reliable and standardized indicator for assessing proteinuria except in acute renal failure patients. The correlation between these ratios and 24-hour urine has been demonstrated in several studies in various populations and is currently considered to be the most adequate measure for proteinuria quantification despite the variability in creatinine excretion. The Kidney Disease Improving Global Outcomes recommendations therefore suggest the use of the albumin/creatinine ratio and the protein/creatinine ratio on a 1st morning urine sample to test for proteinuria.

Bee sting leading to stroke: a case report and review of the literature

2021 ◽  
Vol 14 (11) ◽  
pp. e240693
Author(s):  
Shivakumar K Masaraddi ◽  
Rohan J Desai ◽  
Swanit Hemant Deshpande ◽  
Sameet Patel
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Diffusion Mri ◽  
Left Middle Cerebral Artery ◽  
Acute Pulmonary Oedema ◽  
Middle Cerebral Artery Territory ◽  
Review Of The Literature ◽  
Bee Sting ◽  
Local Reactions ◽  
Left Middle

In India, bee stings are very common, seen mainly in farmers and honey collectors. Usually, it presents with local reactions and anaphylaxis. It rarely requires urgent hospitalisation. Other major complications seen are acute renal failure, intravascular coagulation, rhabdomyolysis and acute pulmonary oedema. Stroke as a presentation is uncommon. We report a case of a 45-year-old man presenting with right-sided hemiplegia and aphasia due to multiple bee stings. Diffusion MRI showed left middle cerebral artery territory hyperacute infarct.

Thrombotic Microangiopathy in Cocaine Abuse–Associated Malignant Hypertension: Report of 2 Cases With Review of the Literature

2007 ◽  
Vol 131 (12) ◽  
pp. 1817-1820 ◽  
Author(s):  
Xin Gu ◽  
Guillermo A. Herrera
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Thrombotic Microangiopathy ◽  
Cocaine Abuse ◽  
Illicit Drugs ◽  
Malignant Hypertension ◽  
Fibrinoid Necrosis ◽  
Elevated Blood ◽  
Review Of The Literature ◽  
Accelerated Hypertension

Abstract Cocaine is one of the most commonly used illicit drugs. Acute renal failure is an emergent complication in patients with acute cocaine intoxication. It is well known that rhabdomyolysis and vasoconstriction can be important pathogenetic mechanisms resulting in acute renal failure in these patients. Clinically, although cocaine abuse is associated with elevated blood pressure, persistent accelerated hypertension reaching levels diagnostic of malignant hypertension is uncommon. Cocaine-induced malignant hypertension associated with morphologic features of thrombotic macroangiopathy has been rarely mentioned in the literature. We report 2 cases of cocaine abuse–associated malignant hypertension with renal failure. Kidney biopsies revealed thrombotic microangiopathy with fibrinoid necrosis of arterioles and glomerular tufts. Cocaine-mediated endothelial injury and platelet activation may play important pathogenetic roles in cocaine abusers who develop acute renal failure and malignant hypertension.

scholarly journals Factors associated with mechanical and systemic adverse events after colonoscopy (France, 2010-2015)

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Laanani ◽  
A Weill ◽  
P O Blotière ◽  
J Pouchot ◽  
F Carbonnel ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Adverse Events ◽  
Older Patients ◽  
Public Hospitals ◽  
Serious Adverse Events ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Increased Risk ◽  
Experienced Endoscopists

Abstract Background More than one million colonoscopies are performed every year in France. They are associated with risks of mechanical and systemic serious adverse events (SAEs) which can be associated with patient, procedure, endoscopist, and facility characteristics. We tried to identify the factors associated with colonic perforation, gastrointestinal bleeding, splenic injury, shock, myocardial infarction, stroke, pulmonary embolism, acute renal failure, and urolithiasis after colonoscopy. Methods We analysed data from the French national claims databases (SNDS). A total of 4,088,799 patients, 30 years or older, undergoing a first screening or diagnostic colonoscopy between 2010 and 2015 were identified. SAE rates were estimated, and risk factors associated with SAEs were identified using multilevel logistic regression models, adjusted for patient, colonoscopy, endoscopist, and facility characteristics. Results Increasing age was associated with an increasing incidence of mechanical and systemic SAEs. Cancer and cardiovascular comorbidities were associated with mechanical SAEs, and a higher number of pre-existing conditions was associated with shock and acute renal failure. Polypectomy, especially of polyps larger than 1 cm, was associated with an increased risk of perforation (OR = 4.1; 95% CI, 3.4-5.0) and bleeding (OR = 13.3; 95% CI, 11.7-15.1). Mechanical SAEs were associated with the endoscopist’s experience, while systemic SAEs were more frequent in public hospitals than in private clinics. Conclusions SAEs related to colonoscopy were more frequent in older patients and in those with comorbidities. Mechanical SAEs were more frequent when colonoscopy was performed by less experienced endoscopists. Systemic SAEs were more frequent in public hospitals, reflecting patient selection processes. The risk of both mechanical and systemic SAEs should be taken into account when deciding to perform colonoscopy, particularly in older patients with multiple pre-existing conditions. Key messages Systemic SAEs are not uncommon after colonoscopy and, together with intestinal SAEs, should be considered when considering the need for colonoscopy. Patients at risk of SAEs should be identified and colonoscopy should be performed by experienced endoscopists in these patients. Less invasive alternatives should also be considered in these patients.

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