A Case of IgA kappa Light Chain Deposition Disease and Combined Adult Fanconi Syndrome with Auer rod-like Intracytoplasmic Inclusions in Plasma Cells and Proximal Renal Tubular Cells / 대한진단검사의학회지

We report a case of IgA kappa light chain deposition disease and combined adult Fanconi syndrome with Auer rod-like intracytoplasmic inclusions in plasma cells and proximal renal tubular cells in a 54-yr-old female. Cytochemical stainings revealed a strong acid phosphatase activity of the inclusions and weak periodic acid-Schiff positivity, whereas the reactions for peroxidase and alpha-naphthyl acetate esterase were negative. An immunostaining verified IgA-kappa inside the plasma cells. Kidney biopsy revealed Bence Jones cast nephropathy with kappa light chain positivity, and Congo red staining was negative. Electron microscopy showed needle-shaped crystals located in tubular epithelial cells.

A Case of Hyponatremia Due to Angiotensin Converting Enzyme Inhibitor

We describe a patient with hyponatremia induced by the use of angiotensin-converting enzyme (ACE) inhibitor; imidapril HCl. Although the mechanism of severe hyponatremia due to ACE inhibitor is not clear, it is conceivable that ACE inhibitor therapy may complicate the syndrome of inappropriate secretion of antidiuretic hormone and induce hyponatremia. In addition, the possibility should be considered that hyponatremia in our patient is a presumptive interaction between oxcarbazepine and imidapril HCl.

Graft Functions and Survivals according to the Serum Creatinine Level at 3 Days after Renal Transplantation in Living-donor Renal Transplantation / 대한이식학회지

PURPOSE: The aim of this study was to evaluate whether serum creatinine levels at 3 days after renal transplantation can predict long-term graft survival and its associated clinical aspects. METHODS: Three hundred and seventy six renal transplant recipients who received grafts from living donors were included. Recipients were classified into two groups according to their serum creatinine levels (1.2 mg/dL group) at 3 days after renal transplantations. Demographic characteristics (age, sex, weight, body mass index, donor/recipient body weight ratio, pre-transplant dialysis type, underlying disease and pre-transplant transfusion), transplant variables (immuno-suppressive agents, HLA mismatch and HLA DR mismatch) and post-transplant variables (routine graft biopsy, number of acute rejection episodes within first year after renal transplantation, serum creatinine level and graft survival at each first, second, and fifth years) were assessed. RESULTS: Among total 376 recipients, serum creatinine 1.2 mg/dL groups were 224 (59.6%) recipients. The characteristics of patients with good graft function (serum creatinine 1.2 mg/dL group (first year, 100% vs. 95.7%; fifth year, 96.7% vs. 89.8%; P<0.05). Conclusion: Serum creatinine levels at 3 days after renal transplantation can predict long-term kidney transplant survival. It was associated with immunological (frequency of acute rejection) and non- immunological aspect (match of kidney size and donor's age).