The use of TDF leads to an increased rate of tubular dysfunction, and modulated by age, baseline eGFR, and classical factors, is associated with kidney function decline.

No abstract

This study extends previous observations by showing that HLO infection in cats is associated with large lymphoid follicles in the stomach. In addition, HLOs were demonstrated submucosally within gastric lymphoid follicles and on patches of gastric metaplasia in the duodenum.

A 47-year-old man with a 1-month history of generalized arthralgias experienced the abrupt onset of fever, myalgias, abdominal pain, and diarrhea. Twenty-four hours later, his fingers and toes appeared cyanotic and then rapidly became necrotic (Figure 1). Aside from an oral temperature of 102°F, his physical examination was otherwise unremarkable.Pertinent laboratory data included 3ϩ proteinuria, a serum creatinine value of 4.3 mg/dL, sterile blood and urine cultures, and a negative hepatitis panel. A host of other serological and hematologic studies gave negative or normal results. The chest radiograph disclosed cardiomegaly. Percutaneous renal biopsy showed necrotic parenchyma. Renal angiography demonstrated bilateral arterial microaneurysms (Figure 2).With a presumptive diagnosis of polyarteritis nodosa, the patient received prednisone and cyclophosphamide. His condition stabilized, and he underwent amputation of the necrotic digits. However, 4 months after onset of his symptoms, he suffered a cerebellar hemorrhage and died. At autopsy, the significant finding was polyarteritis nodosa affecting multiple organs.