INTRODUCTIONDuring the pandemic caused by the SARS-CoV-2 virus, some patients who develop severe forms of COVID-19 present thrombotic microangiopathy in the course of the disease's clinical progression.METHODS Data came from direct patient observation and clinical records. We performed a kidney biopsy and used optical microscopy and immunofl uorescence techniques. RESULTSWe present the case of a 78-year-old male patient, mestizo, overweight with a history of high blood pressure, ischemic cardiopathy and chronic obstructive pulmonary disease who was fi rst admitted to the hospital due to respiratory symptoms and diarrhea related to COVID-19, from which he recovered. He was subsequently readmitted with symptoms of acute renal dysfunction accompanied by mild anemia and thrombocytopenia; at the same time, he resulted negative for COVID-19 via a real-time polymerase chain reaction test. A kidney biopsy revealed thrombi in glomerular capillaries, acute tubular necrosis, thickening of extraglomerular blood vessel walls, and C3 deposits in the glomerular tufts.CONCLUSIONS We describe a case of thrombotic microangiopathy with kidney biopsy in a patient recovering from COVID-19. Acute renal dysfunction is a form of thrombotic microangiopathy that has been observed in patients recovering from COVID-19.
Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disease characterized by an overexpression and mislocalization of epidermal growth factor receptor (EGFR) to the apical membranes of cystic epithelial cells. Nimotuzumab is a humanized antibody that recognizes an extracellular domain III of human EGFR. The aim of this study was to assess the pharmacokinetic behavior of nimotuzumab in patients with ADPKD given as a single dose. A phase I, single‐center, and noncontrolled open clinical study was conducted. Five patients were enrolled at each of the following fixed‐dose levels: 50, 100, 200, and 400 mg. Intravenous continuous infusions of nimotuzumab were administered every 14 days during a year, except the first administration, when blood samples were drawn during 28 days for pharmacokinetic assessments. Subjects were closely monitored during the trial and at completion of the administration of nimotuzumab, including the anti‐idiotypic response. For the first time, nimotuzumab was used for treating a nononcological disease. The administration of nimotuzumab showed dose‐dependent kinetics. Nimotuzumab does not develop anti‐idiotypic response against the murine portion present in the hypervariable region of the antibody present in the serum of the patients treated. No significant differences were found in the systemic clearance between the 100‐ and 400‐mg dose, which indicates that the optimal biological dose is in this range of dose.
Conocer aspectos relevantes relacionados con la realización de la biopsia renal percutánea (BRP), en los sujetos mayores de 60 años del Instituto de Nefrología (INEF) en el periodo 1988-2018. Material y métodos: Estudio descriptivo transversal. Los datos primarios se obtuvieron de la boleta de biopsia. Todas las biopsias renales fueron realizadas en el INEF siguiendo el protocolo institucional. La información fue procesada con el paquete estadístico SPSS 22.0. Se utilizó análisis de distribución de frecuencias, media y desviación estándar en las variables cuantitativas, y el test de independencia. Resultados: De 2,472 biopsias de riñones propios realizadas en el periodo, 283 correspondieron a pacientes de 60 años y más. La edad media de los pacientes fue de 67.6 años (DE 5.85 años). El 55.1% eran hombres. Se presentaron cinco sangrados (1.8%). El síndrome nefrótico (50.5%) y la disfunción renal aguda (27.3%) fueron las indicaciones más frecuentes. Predominaron las enfermedades glomerulares, y de ellas las glomerulopatías primarias, especialmente glomeruloesclerosis segmentaria y focal (GESF) (17.3%) y glomerulopatía membranosa (GM) (14.5%). Conclusiones: Las indicaciones más comunes de BRP en pacientes ancianos son: síndrome nefrótico y disfunción renal aguda. Los diagnósticos más frecuentes, GESF y GM, que suelen presentarse como síndrome nefrótico.
nefritis tubulointersticial aguda (NTIA) en las últimas tres décadas, sus formas de presentación, etiología, manifestaciones clínicas y hallazgos en el sedimento urinario. Material y métodos: Estudio descriptivo, de corte retrospectivo, desarrollado en pacientes cubanos a quienes se les practicó una biopsia renal de riñones propios en el Instituto de Nefrología, La Habana, Cuba, en el periodo de 1988-2018. La información fue procesada de forma automatizada (SPSS 22.0). Se utilizó análisis de distribución de frecuencias, promedio y el test de homogeneidad.
Identificar la frecuencia de las enfermedades renales diagnosticadas por biopsia renal y compararla en dos períodos de trabajo tomando en consideración variables demográficas, formas clínicas de presentación y diagnósticos. Método: Estudio descriptivo y transversal. Se incluyeron pacientes cubanos mayores de 18 años que se hicieron biopsias
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