Cases reported "Fibrosis"

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21/32. Chemotherapy-related hemolytic-uremic syndrome after the treatment of head and neck cancer. A case report.

    A 62-year-old woman who was being treated for squamous cell carcinoma of the head and neck developed a chemotherapy-related hemolytic-uremic syndrome during the second cycle of neoadjuvant chemotherapy consisting of cisplatin, bleomycin, and methotrexate. Though the syndrome was suspected early, attempts at reversing the hematologic and renal abnormalities were unsuccessful. At postmortem examination, the characteristic microvascular lesions of the hemolytic-uremic syndrome were found in the kidneys.
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keywords = kidney
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22/32. Page kidney phenomenon in kidney allograft following peritransplant lymphocele.

    A case of kidney allograft dysfunction in a recipient with a prior lymphocele is described. We attribute it to a Page kidney phenomenon caused by a constrictive pericapsular fibrosis. Surgical exploration and excision of the fibrotic tissue were followed by the recovery of renal transplant function. To our knowledge, only 1 case of Page kidney in renal allograft due to peritransplant hematoma has been described in the literature.
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ranking = 11
keywords = kidney
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23/32. Bilateral ureteral stricture due to ureteral fibrosis. Case report.

    A case of bilateral ureteral fibrosis is reported. The patient, a 32-year-old man, was admitted as a result of acute renal failure. ultrasonography showed bilateral hydronephrosis, so that in-dwelling percutaneous nephrostomy tubes were immediately inserted in the bilateral kidneys. Since retrograde and antegrade pyelograms revealed bilateral midureteral stricture, idiopathic retroperitoneal fibrosis at first suspected, but no mass in the retroperitoneal space was found by a computed tomogram. An exploratory laparotomy showed no fibrous mass in the retroperitoneal space either, but that the wall of the ureter was thickened. biopsy of the ureter led to a histological diagnosis of fibrosis. Since evidence of inflammation such as elevation of the erythrocyte sedimentation rate and cross-reacting protein was found, 50 mg of prednisolone has been administered every other day, with the result that inflammation is now under control. This report deals with specific ureteral fibrosis related to idiopathic systemic fibrosis and collagen disease.
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keywords = kidney
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24/32. Idiopathic retroperitoneal and mediastinal fibrosis mimicking connective tissue disease.

    Combined retroperitoneal and mediastinal fibrosis is a rare manifestation of an idiopathic systemic sclerosing disease. This report describes a multisystem illness that clinically could best be described as polyserositis and progressive renal failure. Pathologically, it was characterized by diffuse infiltration of retroperitoneal and mediastinal tissues with plaquelike fibrofatty connective tissue encasing the kidneys, ureters, adrenal glands, and parietal pericardium. These features are diagnostic of a systemic sclerosing disease. It is important to recognize this unusual disorder to avoid confusion with other systemic connective tissue diseases such as systemic lupus erythematosus.
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keywords = kidney
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25/32. Fibrosing cholestatic hepatitis in a renal transplant recipient associated with the hepatitis b virus precore mutant.

    A patient with evidence of chronic infection with hepatitis b virus (seropositive for hepatitis B surface antigen, and with antibody to hepatitis B e antigen) underwent renal transplantation, which subsequently failed. The patient developed abnormal liver function tests and 8 months after the removal of the transplanted kidney, hepatitis b virus dna was detected in the serum in the absence of hepatitis B e antigen. Liver biopsy revealed the presence of fibrosing cholestatic hepatitis. sequence analysis of the serum hepatitis b virus dna showed the presence of the pre-core mutant. This case shows that fibrosing cholestatic hepatitis can occur outside the setting of liver transplantation, and coincided with the development of the pre-core mutant of hepatitis b virus.
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ranking = 1
keywords = kidney
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26/32. Chinese herbs nephropathy: a clue to Balkan endemic nephropathy?

    Rapidly progressive interstitial renal fibrosis has recently been reported in young women who have been on a slimming regimen including Chinese herbs. We examined four nephroureterectomies performed in three patients prior to or at the time of transplantation to determine the nature and topography of the kidney and urinary tract lesions in Chinese herbs nephropathy (CHN). Extensive, hypocellular, interstitial sclerosis, tubular atrophy and global sclerosis of glomeruli decreasing from the outer to the inner cortex, including the columns of Bertin, were observed in the four kidney specimens, together with severe fibromucoid to fibrous intimal thickening, mainly of interlobular arteries, normal or collapsed residual glomeruli, and mild to moderate atypia and atypical hyperplasia of the urothelium. In addition, bilateral pelvi-ureteric sclerosis was observed in one case. With the exception of the latter, these lesions are very similar to those described in Balkan endemic nephropathy (BEN). The clinical presentation of the patients was also similar to that observed in BEN: normal blood pressure, aseptic leukocyturia, low grade low molecular weight proteinuria, early and severe anemia. In conclusion, on morphological and clinical grounds, CHN appears similar to BEN. A common etiologic agent, aristolochic acid, is suspected. The known carcinogenic potential of this compound, taken together with our finding of multiple foci of cellular atypia of the urothelium suggest that CHN patients should undergo a regular follow-up for urothelial malignancy.
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ranking = 2
keywords = kidney
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27/32. A case of collagenofibrotic glomerulopathy associated with hepatic perisinusoidal fibrosis.

    A patient with collagenofibrotic glomerulopathy associated with hepatic persinusoidal fibrosis is described. Renal biopsy revealed that the glomerular tufts contained homogeneous material that was proved by electron microscopy to be collagen fibers. The material was reactive to anti-type III collagen monoclonal antibody. Liver biopsy also showed an increase of type III collagen fibers in the perisinusoidal area. Since the serum procollagen III peptide level was elevated in this patient, fibrosis may have been simultaneously activated in kidney and liver by some unknown condition.
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28/32. Wegener's granulomatosis, acute laryngotracheal airway obstruction and death in a 17-year-old female: case report and review of the literature.

    OBJECTIVE: To alert practitioners to the risk of sudden airway obstruction and death in patients with Wegener's granulomatosis. DESIGN: Case report and literature review. SETTINGS: University and Community hospitals. PATIENT: A 17-year-old white female. INTERVENTION: (1) evaluation and treatment for mental status changes over 2 months. (2) Evaluation and surgical biopsy of nasal septal perforation under general anesthesia at a university children's hospital. (3) Evaluation and observation at a community hospital 2 days later. (4) autopsy. RESULTS: serology performed 3 days ante-mortem revealed (at 2 days post-mortem) cytoplasmic anti-neutrophil cytoplasmic antibody positive at 1:128. autopsy was significant for microscopic fibrosis and granulomas in the kidneys and essentially total obstruction of the subglottis and upper trachea by a 3.5 x 1 x 1 cm mass of fibrosis and granulomas overlying circumferentially necrotic mucosa. This mass was centered on the crico-tracheal junction. CONCLUSIONS: Wegener's granulomatosis can lead to proliferative tissue growth with acute airway obstruction in the larynx and trachea, and death. Any patient with WG under age 20, as well as patients with WG and laryngotracheal symptoms (e.g. strider, hoarseness, wheezing) would benefit from evaluation of the airway.
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29/32. Brief clinical report: glutamine-enriched total parenteral nutrition in a patient with radiation-induced renal and intestinal fibrosis.

    This brief clinical report illustrates the case of a 50-y-old male patient with severe radiation-induced renal and intestinal fibrosis who received glutamine-enriched total parenteral nutrition (TPN). The patient had end-stage renal disease and, therefore, underwent a kidney transplant. In the postoperative course the patient developed signs of bowel obstruction and cachexia. He received two courses of glutamine-enriched TPN before he underwent surgery for small bowel stenosis. Postoperatively, the patient received a third course of glutamine-enriched TPN. During the patient's hospital course the following indexes were monitored: patient's weight, serum concentrations of protein, albumin, and trialglycerol. Intestinal permeability was assessed with the lactulose-mannitol sugar test (L-M test). We measured changes in the patient's weight and the L-M test. We hypothesize that glutamine-enriched TPN may have been beneficial in the hospital course of this critically ill patient and may have influenced the patient's intestinal function and permeability.
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keywords = kidney
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30/32. Brief report: successful extension of the transplant renal vein with a synthetic vascular graft.

    Unexpected intraoperative vascular complications in the graft of the recipient during organ transplantation can be most vexing and require immediate attention and careful management so as not to impair the integrity and fate of the graft. We were confronted with a diabetic recipient with total fibrosis of the left iliac vein, patent inferior vena cava, totally and circumferentially calcified aorta and left iliac artery with the exception of a small area in the distal external iliac artery. The problem was solved by anastomosing the artery low onto the external iliac, and by interposing a venous polytetrafluoroethylene vascular graft between the renal vein and the inferior vena cava. The kidney function was excellent for 2 years but the patient succumbed to unrelated liver complications. A second patient with a renal vein PTFE graft has had normal graft function for 10 years. Probably because of the high blood flow through the kidney, venous synthetic grafts can be successfully used to correct venous problems during kidney transplantation.
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ranking = 3
keywords = kidney
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