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Thrombotic microangiopathy (TMA) is a severe condition characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end-organ damage, often involving the kidneys. Complement-mediated hemolytic uremic syndrome (cHUS), a rare form of TMA, arises from dysregulated alternative complement pathway activation, frequently due to genetic mutations. We report the case of a 23-year-old male presenting with TMA secondary to a heterozygous mutation in the membrane cofactor protein (MCP/CD46) gene.

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[Uremic pericarditis in a not-so-terminal chronic kidney disease].

Rev Med Suisse

November 2024

Service de médecine interne, Réseau de l'arc, Hôpital de Moutier, 2740 Moutier.

Article Synopsis
  • - A 90-year-old patient with stage G4 chronic kidney disease developed pneumonia and congestive heart failure, but his condition worsened despite treatment with levofloxacin and furosemide.
  • - A CT scan showed pericardial effusion, suggesting uremic pericarditis, which is often seen in end-stage renal disease due to the buildup of toxins.
  • - Initiating daily hemodialysis led to major improvement, highlighting the importance of early diagnosis and treatment to prevent complications in patients with kidney issues.
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We present an interesting and complex case of cardiac tamponade due to uremic pericarditis (UP), resolving with intensive hemodialysis (HD). HD should be considered as first line management for patients with UP and pericardial effusion. Intensification of HD should be considered based on clinical presentation and severity of presentation.

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Article Synopsis
  • Pericardial effusion (PE) is an abnormal accumulation of fluid in the pericardial space, with diverse incidence rates influenced by various factors, as highlighted in a study of 93 patients from Mogadishu Somali Turkish Training and Research Hospital.
  • The study aimed to analyze the clinical features, causes, echocardiographic characteristics, and outcomes of patients suffering from PE, noting that 86% of them had at least one comorbidity.
  • Key findings revealed that cardiac disease was the most frequent cause of PE, symptoms included shortness of breath and chest pain, and the majority of patients were treated with medications like furosemide and anti-inflammatories.
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Echocardiographic manifestations in end-stage renal disease.

Heart Fail Rev

March 2024

Department of Cardiology, Osaka Medical and Pharmaceutical University, 2-7, Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan.

End-stage renal disease (ESRD) is a common but profound clinical condition, and it is associated with extremely increased morbidity and mortality. ESRD can represent four major echocardiographic findings-myocardial hypertrophy, heart failure, valvular calcification, and pericardial effusion. Multiple factors interplay leading to these abnormalities, including pressure/volume overload, oxidative stress, and neurohormonal imbalances.

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