Acute kidney injury secondary to rhabdomyolysis: a rare presentation of chikungunya fever

Chikungunya fever is an arthropod-borne viral illness characterised by high grade fever and incapacitating arthralgias. It is considered benign; however, in the recent outbreaks, several complications have been reported worldwide. We report a case of male patient with Chikungunya fever, possibly contracted from infected mosquitoes endemic in Karachi, Pakistan. The clinical presentation included fever, myalgias and anuria. Investigations revealed renal failure and significantly raised creatinine phosphokinase [CPK], suggesting rhabdomyolysis to be the cause of acute kidney injury [AKI]. Rhabdomyolysis is likely occurred due to virus-induced myositis; a rare presentation of Chikungunya fever. The patient gradually recovered from renal failure following supportive care and renal replacement therapy

Ductal and acinar adenocarcinoma of prostate: morphological and immunohistochemical characterization

We sought to characterize the ductal and acinar subtype of prostate adenocarcinoma using hematoxylin and eosin [H and E] staining and an immunohistochemical antibody cocktail. We also investigated the clinical features, prostate-specific antigen [PSA] levels, and biological aggressiveness of these tumors. We utilized tumor bearing prostate biopsies, obtained between 2010 and 2014 from Dow Diagnostic Research and Reference Laboratory, to identify cases of prostatic ductal and acinar adenocarcinoma using routine H and E and immunohistochemical staining. The immunohistochemical antibody cocktail 34beta E12/p63/AMACR was used for staining. The association of clinicopathological variables including patient's age at diagnosis, Gleason score, and PSA levels before surgery was retrospectively analyzed. A total of 10 ductal and 140 non-ductal cases were identified. Ductal cases were predominantly high grade with advanced histopathological features [90%; p=0.030]. Marked elevation in PSA level was also reported in most cases. No other significant statistical difference was observed. Pathological and immunohistochemical examination could be used to characterize ductal and acinar adenocarcinoma of the prostate. Ductal adenocarcinoma of the prostate is a rare subtype of prostate carcinoma and is be more likely to present with advanced grade cancer suggesting that timely detection of the disease is vital

Familial, hereditary and sporadic characterization of prostate cancer and impact on diagnostic modalities

Background: A family history of prostate cancer has been associated with increased risk of prostate cancer development, but the risks were inconsistent in terms of the affected family members and the data on prostate cancer characterization with respect to family history of disease among Pakistani men is limited

Objective: To characterize prostate cancer based on family history into familial including hereditary and sporadic cases and to investigate the association with diagnostic modalities; age of patient at diagnosis and pathological tumor grade

Methods: A self-administered written questionnaire was forwarded to 100 patients diagnosed with prostate adenocarcinoma, containing questions about age at diagnosis and cases of prostate cancer in family. The information regarding age of patient at diagnosis, cases of prostate cancer in relative, pathological tumor grade and age at death for all relatives affected by prostate cancer was acquired. The data was validated through the biopsy report of patient and medical records of relative affected by prostate cancer, provided by patient respectively. Patients were then divided into three groups according to their family history: familial prostate cancer [FPC], hereditary prostate cancer [HPC] and sporadic prostate cancer [SPC] groups

Results: 17% of the patients were categorized in the FPC group, of which 2% were identified as having HPC and 81% were assigned SPC group. Overall, there was no significant statistical difference between groups and study variables

Conclusion: We found no difference in age and pathological tumor grade, in patients diagnosed with adenocarcinoma of prostate following TURP. These results are consistent with previous studies except that patients with HPC in previous studies were significantly younger at diagnosis