AI Article Synopsis

  • A 29-year-old pregnant woman from Equatorial Guinea experienced severe malaria due to Plasmodium falciparum, leading to complications such as cerebral malaria and acute kidney injury (AKI), necessitating renal replacement therapy and a kidney biopsy.
  • During her hospitalization, various tests confirmed her malaria diagnosis, and she was treated with antimalarial medications while experiencing significant symptoms including hypotension and haematological issues.
  • The kidney biopsy revealed active tubulointerstitial nephritis, and after intensive dialysis, her kidney function improved, allowing for a successful cesarean delivery and subsequent recovery without deterioration in kidney health.*

Article Abstract

Background: The course of kidney function and outcomes of severe malaria infection in pregnant women is poorly understood. The indications for renal replacement therapy in pregnant patients with AKI are similar to the general population. This is the case of a pregnant patient with severe Plasmodium falciparum infection that caused cerebral malaria, acute kidney injury (AKI) who required renal replacement therapy and kidney biopsy during her hospitalization.

Case Presentation: A 29-year-old pregnant woman from Equatorial Guinea was admitted to the hospital with haemolytic anaemia, hyperbilirubinaemia and thrombocytopenia. During hospitalization, a thick blood smear was performed where parasitaemia by P. falciparum were observed and confirmed by real-time PCR assay. The patient developed cerebral malaria secondary to an ischaemic-type cerebral vascular event, hypotension and severe. After confirming diagnosis of P. falciparum infection, artesunate, artemether/lumefantrine and primaquine were started. Kidney biopsy revealed an active tubulointerstitial nephritis with acute tubular lesion and pigment tubulopathy with negative immunofluorescence. After CVVHDF, the patient received intermittent haemodialysis until the recovery of kidney function. After discharge, follow-up was carried until the successful resolution of the pregnancy by cesarean delivery and not shown deterioration in kidney function or proteinuria.

Conclusion: In this case, intensive dialysis was started and dialysis intensity progressively reduced when kidney function improved. Due to the evolution of kidney function, a kidney biopsy was performed which showed tubulointerstitial nephritis as a manifestation of the infection. While the kidney biopsy was of interest for discriminating between tubular and glomerular involvement, the availability of placental biomarkers (sflt1-PlGF) would have been of help for ruling out preeclampsia and placental damage. The multidisciplinary approach to AKI during pregnancy should be the rule, with diligent care of maternal-fetal well-being during pregnancy and monitoring of kidney function after delivery.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572360PMC
http://dx.doi.org/10.1186/s12936-024-05182-9DOI Listing

Publication Analysis

Top Keywords

kidney function
24
kidney biopsy
16
kidney
12
falciparum infection
12
plasmodium falciparum
8
infection pregnant
8
pregnant patient
8
renal replacement
8
replacement therapy
8
cerebral malaria
8

Similar Publications

Emphysematous polycystic renal infection (EPRI) has a poor prognosis with conservative management, and early surgical nephrectomy has been recommended. However, percutaneous cyst drainage may be a possible treatment option. We experienced 6 patients with autosomal dominant polycystic kidney disease (ADPKD) presenting with EPRI.

View Article and Find Full Text PDF

Inefficient control of elevated blood sugar levels can lead to certain health complications such as diabetic nephropathy (DN) and cardiovascular disease (CVD). The identification of effective biomarkers for monitoring diabetes was performed in the present study. The present study aimed to investigate the implications of long non-coding RNA megacluster (lnc-MGC), microRNA (miR)-132 and miR-133a, and their correlation with lactate dehydrogenase (LDH) activity and glycated hemoglobin (HbA1C) levels to identify biomarkers for the early diagnosis of diabetes mellitus, induced DN and CVD.

View Article and Find Full Text PDF

Calciphylaxis is a rare but potentially life-threatening disease that is not yet completely understood. It occurs mainly in patients with chronic kidney disease termed calcific uremic arteriolopathy (CUA) but also affects patients with normal renal function. Although this disease's pathogenesis is unclear, it is associated with the dysregulation of calcium and phosphate and subsequent calcification of peripheral arterioles.

View Article and Find Full Text PDF

High anion gap metabolic acidosis (HAGMA) is a common biochemical abnormality in hospitalized patients, often linked to conditions such as lactic acidosis, renal failure, or drug toxicity. A rare etiology, 5-oxoprolinuria, resulting from acetaminophen use, malnutrition, and sepsis, is increasingly recognized in critically ill patients. We report a 29-year-old male with a history of intellectual disability and normal baseline kidney function who was admitted with acute necrotizing pancreatitis and developed severe metabolic acidosis and acute kidney injury (AKI).

View Article and Find Full Text PDF

Transcatheter Caval Implantation for Severe Tricuspid Regurgitation.

Curr Cardiol Rep

January 2025

Department of Cardiovascular Medicine, Heart Vascular & Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-3, Cleveland, OH, 44195, USA.

Purpose Of Review: We describe the evolution of caval valve implantation (CAVI) as a treatment for severe symptomatic tricuspid regurgitation (TR) in the high surgical risk patient.

Recent Findings: Surgical treatment of severe TR is often limited by the high surgical risk of the patients who tend to develop severe secondary TR. Coaptation, annuloplasty, and orthotopic replacement strategies are all limited by annular and leaflet geometry, prior valve repair, and the presence of cardiac implantable device leads.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!