Tuberculosis, a global public health concern, is emerging as an important complication in children with nephrotic syndrome. We report a case of an adolescent with nephrotic syndrome who developed fatal miliary tuberculosis after initiation of steroid therapy, presenting as a bronchoesophageal fistula. The case highlights the importance of maintaining a high index of suspicion prior to starting immunosuppressive therapy in pediatric patients of nephrotic syndrome.
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http://dx.doi.org/10.1007/s12070-017-1130-5 | DOI Listing |
J Nephrol
January 2025
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.
Background: In an Italian cohort of lupus podocytopathy patients, we aimed to characterize the presenting features, therapy, and outcomes, and explore differences between relapsing and non-relapsing patients.
Methods: We identified 29 patients with lupus podocytopathy from 1994 to 2023 in 11 Italian Nephrology/Rheumatology Units, and divided them into two groups: relapsing and non-relapsing. Given the limited sample size, a p-value ≤ 0.
Pediatr Nephrol
January 2025
Division of Molecular Medicine, University of São Paulo School of Medicine, São Paulo, Brazil.
Predicting the risks of progression to chronic kidney disease (CKD) stage 5 in idiopathic nephrotic syndrome (NS) and recurrence of the disease (rNS) following kidney transplantation (KT) is a key assessment to provide essential management information. NS has been categorized etiologically as genetic and immune-based. A genetic cause can be identified in ~ 30% of children with steroid-resistant NS (SRNS), a finding associated with a very low risk of rNS following KT.
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January 2025
University of Western Ontario, London, ON, Canada.
Background: The 2023 IPNA guidelines recommended a 12-h mycophenolic acid (MPA) area under the curve (AUC) estimation for managing pediatric nephrotic syndrome and MPA AUC > 50 mg * h/L for an optimal therapeutic response to mycophenolate mofetil (MMF). The IPNA guidelines endorsed two limited AUC formulae based on three-point MPA measurements to predict 12-h MPA AUC. The relative performance of these two limited AUC formulae has not been tested.
View Article and Find Full Text PDFCureus
December 2024
Department of Infectious Diseases, University of Tsukuba Hospital, Tsukuba, JPN.
is a ubiquitous organism classified as a nontuberculous mycobacterium that rarely causes indolent skin or soft-tissue infections, especially in immunocompromised patients. Given the rarity of infection, diagnosis can be difficult because cutaneous lesions may be considered a worsening of the underlying disease or a benign condition. Here, we report a case of a rapidly progressing cutaneous infection in a patient with nephrotic syndrome.
View Article and Find Full Text PDFFront Pharmacol
January 2025
Department of Nephrology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Background: Minimal change disease (MCD) is a podocytopathy more commonly seen in children, but it also accounts for 10%-25% of adult nephrotic syndrome. High-dose oral glucocorticoids were recommended for initial treatment of MCD. However, long-term use of systemic corticosteroids is associated with significant adverse events, such as steroid-induced diabetes and infections.
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