1/11. nephrosis and papillary necrosis after pyelonephritis.We present a case of nephrotic syndrome complicating acute pyelonephritis in a 45-year-old man. His first attack of acute bacterial pyelonephritis had two unusual features: transient nephrotic syndrome and chronic recurrent episodes of papillary necrosis. The former, which lasted for two weeks, was characterized by edema, excretion of 7.7 g of urinary protein per 24 hours and hypoproteinemia (1.8 g per 100 ml). A percutaneous renal biopsy two weeks after the height of the nephrotic state showed normal glomeruli by light and electron microscopy and immunohistologic studies. Interstitial changes were noted. Over two years the patient has passed approximately 50 fragments, characterized as necrotic tissue containing tubular structures. He has no evidence of diabetes mellitus, urinary-tract obstruction or ureteral reflux, analgesic abuse or atypical vasculitis. He is afebrile but has recurrent bacteriuria despite antibiotics. This case demonstrates that acute pyelonephritis must be added to the list of diseases causing the nephrotic state.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
2/11. Renal papillary necrosis as first presentation of a Nigerian sickle cell patient.The clinical features of the sickle syndromes do not appear until after the sixth month of life, at which time most of the HbF has been replaced by HbS. Thrombo-embolic complications, retinopathy and renal papillary necrosis are more frequent in HbSC disease than in other sickle cell syndromes. First presentation of HbSC disease after the second decade is considered late in this environment. A 25 year-old Nigerian female patient is hereby presented with renal papillary necrosis as first presentation of HbSC disease. The patient presented with a sudden onset of total haematuria without history suggestive of urinary tract infection, trauma, instrumentation and significant analgesic consumption. No history of usage of herbal remedies, diabetes mellitus, sore throat, abdominal pains, skin rashes or joint pains. physical examination did not show any characteristic habitus or findings. Findings on intravenous urography suggested renal papillary necrosis.- - - - - - - - - - ranking = 0.5keywords = urinary (Clic here for more details about this article) |
3/11. Pregnancy in a spinal cord-injured bilateral total leg amputee: management and considerations.A 35-year-old woman, gravida 2, para 0, was seen at 20 weeks' gestation with complete T10 spinal cord transection at age 15 years, subsequent bilateral total leg amputation, urinary diversion, colostomy, and lumbar spine resection. pregnancy complications included recurrent urinary tract infections, preterm contractions without cervical change, lumbosacral abscesses, and fetal malpresentation. Delivery was through cesarean section near term.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
4/11. Infection and papillary necrosis. Scanning electron microscopic comparison with bladder infection.A case of papillary necrosis in a diabetic patient with escherichia coli urinary tract infection is reported. Infectious contribution to the disease is presented, and the electron microscopic similarities of bladder response to infection are discussed.- - - - - - - - - - ranking = 0.5keywords = urinary (Clic here for more details about this article) |
5/11. Necrotizing emphysematous pyelonephritis: a case report.Emphysematous pyelonephritis (EP) is comparatively rare in urological practice. From 1898 to the present time only 45 cases have been described. In this report we describe the case of a 43-year old diabetic man, with right EP without obstruction of the urinary tract and with a urinary infection of E. Coli. This appears to be rather rare as it is more frequently associated with obstruction of the urinary tract. Surgical exploration enabled us to discover a fistula between the kidney and the wall of the vena cava which would have caused fatal complications if it had not been discovered. The micro-organisms more frequently involved were E. Coli, proteus, Aerobacter and various anaerobes. mortality has been reported as 75% in patients receiving medical therapy only and 23% in those undergoing surgery. The authors therefore believe that surgical exploration even with no urinary tract obstruction makes it possible to detect complicating pathologies which may remain undiscovered by medical examination and the urinary excretory tract and renal sheath drained. This provides a better opportunity of estimating possible reversibility of the renal lesion.- - - - - - - - - - ranking = 2.5keywords = urinary (Clic here for more details about this article) |
6/11. Renal papillary necrosis and pyelonephritis accompanying fenoprofen therapy.Renal papillary necrosis occurred after fenoprofen calcium administration in a patient with systemic lupus erythematosus and urinary tract infection. Possible mechanisms of renal damage may be hypersensitivity, decreased blood flow, and decreased production of a prostaglandin E-like substance.- - - - - - - - - - ranking = 0.5keywords = urinary (Clic here for more details about this article) |
7/11. Renal papillary necrosis: an update.The clinical and diagnostic features of renal papillary necrosis (RPN) of 27 patients were studied. diabetes mellitus was the most frequent (56%) condition associated with RPN. Analgesic abuse, sickle hemoglobinopathy and urinary tract obstruction were present in 4 patients each; in 6 of these 12 patients these conditions were present as a coexistent disease with diabetes mellitus. There was evidence of an acute or chronic infection of the urinary tract in 18 patients, as a coexistent condition with another underlying disease that itself can cause RPN in 14 patients and as the only cause of RPN in another 4. Thus, the presence of more than one diagnostic condition which might be implicated in the causation of RPN was present in 15 patients or 55% of the cases in this series. When infection was excluded, six patients or 22% of the cases had two coexisting diseases, each of which has been implicated as a cause of RPN. This observation underlines the multifactorial nature of this entity and might explain why RPN is not encountered more frequently in each of the various primary diseases with which it has been associated. The average age of the patients at the time of diagnosis was 53 years for women and 56 years for men. Only six of the patients were younger than 40 years, and three of these had sickle hemoglobinopathy. The diagnosis of RPN was based on x-ray findings in eight patients, on the histologic examination of papillary tissue in urine in one, and on autopsy findings in the rest. Papillary necrosis was bilateral in three-fourths of the cases. The clinical picture varied. Most of the patients (67%) presented with chills and fever. flank pain and dysuria were present in 11 patients (41%). As a rule oliguria was rare and progressive uremia was uncommon. In cases diagnosed at post-mortem, the patients had succumbed to infection or to a primary severe extrarenal disorder with the possibility of RPN having been entertained clinically in only half these cases prior to autopsy.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
8/11. Torulopsis pyelonephritis associated with papillary necrosis: a case report.A case of Torulopsis glabrata pyelonephritis associated with papillary necrosis is presented. Torulopsis glabrata is a potential pathogen in the urinary tract capable of producing renal damage, sepsis and death. In this case the involved kidney sustained progressive damage, necessitating nephrectomy for cure. Examination of the kidney showed fungal involvement of the parenchyma and collecting system.- - - - - - - - - - ranking = 0.5keywords = urinary (Clic here for more details about this article) |
9/11. Renal papillary necrosis caused by urinary calculus-induced obstruction alone.We report a case of renal papillary necrosis in a 18-year-old female. Urinary tract obstruction induced by a calculus seems to be the only etiologic factor in this case, although the multifactorial nature of this lesion has been stressed.- - - - - - - - - - ranking = 2keywords = urinary (Clic here for more details about this article) |
10/11. Papillary necrosis and medullary sponge kidney in a patient with hemoglobin SC.A 22-year-old woman with hemoglobin SC who was hematologically asymptomatic, developed gross hematuria associated with urinary tract infection, without any urological antecedents. Investigations revealed a unilateral hematuria due to papillary necrosis on the left kidney. medullary sponge kidney was also discovered by radiologic investigations. Papillary cysts could play a role in the occurrence of papillary necrosis.- - - - - - - - - - ranking = 0.5keywords = urinary (Clic here for more details about this article) |
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