1/17. New aspects of urinary tuberculosis.In urinary tuberculosis, during recent years, there has been remarkable progress in treatment but some new aspects are reported, which raise problems in diagnosis and therapeutics. There is an increase of silent forms, forms with rapid destructive development, even under treatment, and forms masked by association with other diseases. The percentage of elderly patients has increased, as has the number of cases presenting with advanced lesions with little clinical manifestation. This calls for more careful searching, assessment and survey of any suspected case.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
2/17. High-output heart failure caused by a huge renal arteriovenous fistula after nephrectomy: report of a case.Postnephrectomy renal arteriovenous fistula (AVF) with an aneurysmal lesion is a rare clinical entity that may cause high-output heart failure. In this report, we describe the case of a 68-year-old man who had undergone nephrectomy for renal tuberculosis 43 years previously, in whom an acquired large renal AVF presenting as an aneurysm caused congestive cardiac failure. We also discuss the hemodynamic, hormonogenic (human arterial natriuretic polypeptide; hANP), and radiographic findings before and after surgery for the AVF. The AVF with an aneurysmal lesion was clearly visualized by three-dimensional-computerized tomographic (CT) scanning, and proximal ligation of the renal artery was followed by an uneventful recovery. This procedure can produce good results when a fistula is too large to allow safe embolization and when excision would be hazardous due to inflammation surrounding the fistula.- - - - - - - - - - ranking = 2.1187840795214keywords = fistula (Clic here for more details about this article) |
3/17. Renal tuberculosis mimicking xanthogranulomatous pyelonephritis: ultrasonography, computed tomography and magnetic resonance imaging findings.The incidence of tuberculosis has been increasing in recent years, and its treatment has also become challenging. The diagnosis of renal tuberculosis is often difficult and delayed. Early and correct diagnosis of tuberculosis with different organ system involvement is very important and can be easier with ultrasonography, computed tomography and/or magnetic resonance imaging. Although renal tuberculosis is the result of hematogenous spread more commonly from the lungs, less than 5%, of patients with urinary tract tuberculosis have active pulmonary disease. Renal tuberculosis may show variable radiological findings depending on the stage of the infection. Although an end-stage "autonephrectomized" kidey in tuberculosis is classically defined to be small in size, enlargement may on rare occasions be observed, which is the case in our patient. This form greatly mimics diffuse xanthogronulomatous pyelonephritis. Both diseases show thickening of the perirenal fasciae and spread of inflammation into the adjacent organs. Computed tomography and magnetic resonance imaging may show some specific features to differentiate these two entities.- - - - - - - - - - ranking = 0.2keywords = urinary (Clic here for more details about this article) |
4/17. Senior-Loken syndrome (nephronophthisis and tapeto-retinal degeneration): a study of 8 cases from 5 families.The association of nephronophthisis and tapeto-retional degeneration was described by both Senior and Loken in 1961, but prior to 1974 only 28 cases had been published. This report describes 8 new cases in 27 members of 5 families. The severe juvenile type produces blindness in infancy and death from renal failure before the age of ten. The adult type is characterized by later onset, slower progression of the renal disease and milder ocular manifestations. The eye disease may be congenital amaurosis of Leber type, pigmentary retinal degeneration or retinitis punctata albescens and the electroretinogram (ERG) is of value in the diagnosis of these varieties of hereditary tapeto-retinal degeneration. Renal involvement is often asymptomatic. Defective urinary concentration leading to polyuria and polydipsia is the earliest sign. proteinuria is inconstant and urinary sediment is often normal. Two patients had aminoaciduria. The disease progresses inexorably to chronic renal failure. One patient has been successfully transplanted and two others are on chronic hemodialysis. Renal histological changes are those of nephronophthisis with tubulointerstitial lesions and multiple cysts. Senior-Loken syndrome appears to be transmitted by a single autosomal recessive pleotropic gene of variable expression. Degeneration of neuroepithelium and renal tubular epithelium, both tissues of ectodermal origin, may represent a genetically determined enzyme abnormality.- - - - - - - - - - ranking = 0.4keywords = urinary (Clic here for more details about this article) |
5/17. erythema induratum of Bazin and renal tuberculosis: report of an association.erythema induratum of Bazin is a disease that usually affects women, in whom erythematous subcutaneous nodules and plaques appear on the posterior part of the lower extremities, some of which ulcerate. In many countries, tuberculosis is still the main etiologic factor. We report a case of a 40-year-old woman who presented a course of protracted and recurrent episodes over five years of cutaneous lesions on her legs. These tend to involute, but new crops appear at irregular intervals. It was painful, erythematous-violaceous nodules, some of which drained a reddish secretion. The histopathologic features of the lesions demonstrated inflammatory infiltration, with predominance of neutrophils in dermis and hypodermis, necrotizing vasculitis in the arterioles and septal fibrosis. There was no granuloma. The Ziehl-Neelsen stain did not revealed acid-fast bacilli, and the culture of biopsy specimen was negative. The tuberculin skin test was strongly positive (17 mm). The chest X-ray was normal. Few months later she presented adynamia and urinary complaints, such as polacyuria and dysuria. It has been done an urynalysis, which demonstrated acid pH urine, sterile pyuria and microscopic hematuria. It was then raised the diagnostic hypothesis of renal tuberculosis. The urine culture for M. tuberculosis was positive in two out of ten samples. The treatment was instituted with rifampin, isoniazid and pyrazinamide, with complete regression. This case illustrates a clear association between erythema induratum and renal tuberculosis, demonstrated by the remission of the cutaneous lesions after the treatment of the renal tuberculosis.- - - - - - - - - - ranking = 0.2keywords = urinary (Clic here for more details about this article) |
6/17. High-output heart failure caused by arteriovenous fistula long after nephrectomy.A 70-year-old Japanese woman was admitted to our hospital because of anasarca. At 32 years of age, she had undergone nephrectomy for renal tuberculosis. A continuous abdominal bruit was heard. The chest X-ray showed cardiomegaly and dilatation of the pulmonary artery. Abdominal three-dimensional computed tomography scanning clearly revealed an arteriovenous fistula. cardiac catheterization disclosed cardiac output of 9.2 l/min and a step-up of oxygen saturation at the renal vein level of the inferior vena cava. Surgical closure of the fistula promptly decreased her cardiac output and improved the heart failure. This is a rare case of an arteriovenous fistula developing long after nephrectomy and causing high-output heart failure.- - - - - - - - - - ranking = 2.1187840795214keywords = fistula (Clic here for more details about this article) |
7/17. Tubulovillous adenoma developing after urinary reconstruction using ileal segments.A case of tubulovillous adenoma arising in an augmented bladder is described. Ureteroileal substitution and ileocystoplasty was performed when the patient was 18 years old. She noticed gross hematuria 44 years after the surgery. cystoscopy revealed a non-papillary multiple tumor at the site of ileovesical anastomosis and transurethral resection biopsy was performed. Histopathological examination revealed a tubulovillous adenoma. A tubulovillous adenoma developing at the augmented bladder is rare. To our knowledge, this is the second case in which a tubulovillous adenoma developed in an augmented bladder.- - - - - - - - - - ranking = 0.8keywords = urinary (Clic here for more details about this article) |
8/17. Bovine genitourinary tuberculosis revisited.Bovine tuberculosis is now rare in the western world. We report a case of bovine genitourinary tuberculosis causing obstructive renal failure. This combination does not appear to have been previously reported.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
9/17. Tuberculous epididymitis occurring 35 years after renal tuberculosis.An unusual case of tuberculous epididymitis occurring 35 years after renal tuberculosis is reported. The possible mechanisms of this delayed presentation of the epididymal lesion are discussed. This case emphasizes the importance of adequate treatment as well as long-term followup of patients with genitourinary tuberculosis.- - - - - - - - - - ranking = 0.2keywords = urinary (Clic here for more details about this article) |
10/17. Cryptogenic tuberculosis as a preventable cause of end-stage renal failure.A women with a history of urethral stenosis, not causing significant urinary tract obstruction but requiring dilation, presented at the age of 49 with renal failure (creatinine clearance of 16-20 ml/min). Investigations (including pyelography) directed to finding the cause of her renal failure were negative with the exception of renal biopsy which revealed granulomata, one of which showed caseation. Treatment with antituberculous drugs arrested the decline in glomerular filtration rate and was later associated with sustained improvement in renal function. tuberculosis should always be considered as a possible cause of unexplained renal failure even if the classical pyelographic features of tuberculosis, i.e. calyceal distortion and calcification, are absent. Appropriate treatment may improve renal function and avert the need for renal replacement therapy.- - - - - - - - - - ranking = 0.2keywords = urinary (Clic here for more details about this article) |
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