Renal-limited systemic lupus erythematosus: Avoiding delay in diagnosis

Nephrotic syndrome (NS) and glomerulonephritis (GN) are disorders of varied etiologies. Systemic lupus erythematosus (SLE) is one of the multisystemic diseases causing NS and GN. SLE is often suspected whenever NS/GN is associated with extrarenal manifestations. However, it presents solely as NS or GN without extrarenal features in a handful of cases. This affects the prognosis adversely as negligent delay in diagnosis of SLE and initiation of immunosuppressive therapy is associated with poorer response. We present a series of five women who presented solely with renal manifestations. The diagnosis of SLE was delayed, as the women did not have any extrarenal features. We started immunosuppressive therapy after a diagnosis of lupus nephritis was made in retrospect after a kidney biopsy. This case series highlights the importance of performing serology tests for SLE in all young female patients who present with NS/GN to avoid delay in diagnosis.

Aortoarteritis: A rare pulmonary-renal disease

Takayasu arteritis (TAK) is an autoimmune disease majorly affecting young females. It alters the vascular wall, resulting in stenosis, occlusion, or dilatation. It has no distinct clinical manifestation. Here, we present the case of an 18-year-old girl who presented with generalized tonic-clonic seizure and hypoxia. Blood investigations showed deranged urea and creatinine values. Computed tomography angiography revealed bilateral artery occlusion, decreased kidney size, and pulmonary artery dilatation, confirming generalized vascular disease that caused hypertension and ischemic nephropathy in the patient. Our case represents a rare autoimmune disease, leading to pulmonary hypertension and renal artery stenosis. TAK should be considered as a differential diagnosis in young female patients presenting with pulmonary as well as renal signs and symptoms, especially if there is discrepancy in blood pressure levels in all limbs.

Carbohydrates and polyphenolics of extracts from genetically altered plant acts as catalysts for in vitro synthesis of silver nanoparticle

Eco-friendly biosynthetic approach for silver nanoparticles production using plant extracts is an exciting advancement inbio-nanotechnology and has been successfully attempted in nearly 41 plant species. However, an established model plantsystem for systematically unraveling the biochemical components required for silver nanoparticles production is lacking.Here we used Arabidopsis thaliana as the model plant for silver nanoparticles biosynthesis in vitro. Employing biochemical, spectroscopic methods, selected mutants and over-expressor plants of Arabidopsis involved in pleotropicfunctions and sugar homeostasis, we show that carbohydrates, polyphenolics and glyco-proteins are essential componentswhich stimulated silver nanoparticles synthesis. Using molecular genetics as a tool, our data enforces the requirement ofsugar conjugated proteins as essentials for AgNPs synthesis over protein alone. Additionally, a comparative analysis ofAgNPs synthesis using the aqueous extracts of some of the plant species found in a brackish water ecosystem (Gracilaria,Potamogeton, Enteromorpha and Scendesmus) were explored. Plant extract of Potamogeton showed the highest potentialof nanoparticles production comparable to that of Arabidopsis among the species tested. Silver nanoparticles production inthe model plant Arabidopsis not only opens up a possibility of using molecular genetics tool to understand the biochemicalpathways and components in detail for its synthesis.