We report a patient with Crohn's disease who presented with renal insufficiency and the nephrotic syndrome after initiating therapy with adalimumab. Renal biopsy showed stages 2 to 3 membranous glomerulonephritis, and immunostaining showed glomerular deposition of immunoglobulin G and C3. The patient's serum creatinine decreased after discontinuation of adalimumab, and treatment with prednisone and mycophenolic acid reversed his proteinuria. The pathogenesis of glomerular disease induced by antitumor necrosis factor antibodies is uncertain, and the potential roles of the generation of autoantibodies, development of antiadalimumab antibodies, and the interaction of adalimumab with glomerular tumor necrosis factor are discussed.

These results suggest that the development of new wall motion abnormalities suggestive of ischemia during DSE is associated with prolongation of the QTc interval and delayed heart rate early in the recovery period. These two parameters should be further studied not only as additional markers in the identification of ischemia in patients referred for DSE but also to assess their potential significance during short- and long-term follow-up.

These results suggest that the development of new wall motion abnormalities suggestive of ischemia during DSE is associated with prolongation of the QTc interval and delayed heart rate early in the recovery period. These two parameters should be further studied not only as additional markers in the identification of ischemia in patients referred for DSE but also to assess their potential significance during short- and long-term follow-up.

Glomerular filtration rate (GFR) is an essential clinical assessment of renal function post-renal transplantation. Creatinine clearance (CrCl) measured over 12 h and estimated GFR (e-GFR) (calculated by the Modification of Diet in Renal Disease equation) were compared in 28 stable renal transplant recipients (RTRs). This single center study included 14 African American (AA) and 14 Caucasian (CC) recipients. The 12-h creatinine clearance (CrCl-12 h) was determined by monitored urine collection and by e-GFR on two occasions (two phases) separated by at least 2 weeks. Statistics included mixed model analysis of CrCl-12 h and e-GFR relative to race, phase, and difference between parameters. In the first phase, the e-GFR was higher in AA males (58.4 AE 14.8 mL/min) than the CC males (46.2 AE 10.2 mL/min) ( p ¼ 0.032), whereas the CrCl-12 h of AA males (70.8 AE 8.7 mL/min) and CC males (63.3 AE 21.7 mL/min) was not different ( p ¼ 0.740). During the second phase, the e-GFR in AA and CC RTRs was 55.4 AE 10.1 mL/min and 47.6 AE 10.7 mL/min ( p ¼ 0.117), respectively, whereas CrCl-12 h in AAs was 64.71 AE 17.9 mL/min and in CCs was 62.0 AE 14.9 mL/min ( p ¼ 1.000). The CrCl-12 h was higher than the e-GFR ( p < 0.001) irrespective of race or phase. CrCl-12 h was not different on both occasions ( p ¼ 0.289) in all the patients. CrCl-12 h was consistently greater than e-GFR. The difference between these e-GFR estimates may have an importance in the care of RTRs.