Low cardiac output syndrome after congenital heart disease surgery / 中国小儿急救医学

Low cardiac output syndrome (LCOS) is a common complication of patients with congenital heart disease after surgery, with a high mortality rate.The etiology and pathophysiological mechanisms of LCOS can vary widely.Better understanding of LCOS pathogenesis would allow for target prevention and therapeutic approaches, and thereby reducing the incidence and mortality of LCOS, as well as improving the prognosis of patients.

A case report of bladder malakoplakia in systemic sclerosis patient / 中华泌尿外科杂志

Systemic sclerosis is a rare and complex autoimmune disease, and malakoplakia is a rare chronic granulomatous inflammatory disease. Systemic sclerosis combined with malakoplakia is extremely rare. Diagnosis is difficult before surgery. It is easy to misdiagnose bladder malakoplakia as bladder tumor. This paper reports a middle-aged female patient with systemic sclerosis complicated with bladder malakoplakia. The main clinical manifestations were hematuria and bladder irritation, accompanied by severe diarrhea. Transurethral resection of bladder tumor was performed. Postoperative pathology proved that it was bladder malakoplakia. After the surgery, she continued to take low-dose prednisolone and methotrexate in the treatment of systemic sclerosis. The patient was followed up for 6 months.Transurethral cystoscopy was performed twice, and there was no recurrence.

Coagulation factor XII deficiency: Clinical report of 7 patients and literature review / 中国输血杂志

【Objective】 To retrospectively analyze the clinical manifestations and laboratory characteristics of 7 patients with coagulation factor Ⅻ deficiency in our hospital from February 2016 to January 2020 in order to improve the understanding of diagnosis and treatment for the diseases. 【Methods】 The clinical data of 7 patients with coagulation factor Ⅻ deficiency were analyzed, and related literatures were reviewed. 【Results】 All the 7 patients showed significantly prolonged APTT without bleeding or thrombosis. Among them, 1 had a positive family history, and 1 acquired coagulation factor Ⅻ deficiency secondary to the tumor. 【Conclusion】 It is very necessary to comprehensively screen related internal and external coagulation factors and acquired factors in patients with prolonged APTT but no bleeding, so as to avoid missed diagnosis, misdiagnosis and over treatment.

Latest progress of study on etiology of myopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#In recent years, with the development of social economy, the progress of science and technology and the change of life style, the prevalence of myopia has increased year by year and has a younger trend, and with the outbreak of COVID-19, children and adolescents attending short-distance online classes for a long time has accelerated the occurrence and development of myopia. Visual impairment caused by myopia and serious complications caused by high myopia have seriously affected people's quality of life, study and work. Therefore, the World Health Organization, the International Association for the Prevention of Blindness and China's health departments have put the prevention and control of myopia among children and adolescents on the agenda. However, the etiology is complex, and now it is considered to be related to genetic, environmental and other factors, which is briefly discussed in this review.

Pathogenic potential of Brucella ovis field isolates with different genotypic profile and protection provided by the vaccine strain B. ovis ΔabcBA against B. ovis field isolates in mice / Vacina viva atenuada Brucella ovis Δ abcBA encapsulada protege camundongos frente a desafios de B. ovis isoladas de campo

Brucella ovis causes economic and reproductive losses in sheep herds. The goal of this study was to characterize infection with B. ovis field isolates in a murine model, and to evaluate protection induced by the candidate vaccine strain B. ovis ΔabcBA in mice challenged with these field isolates. B. ovis field strains were able to colonize and cause lesions in the liver and spleen of infected mice. After an initial screening, two strains were selected for further characterization (B. ovis 94 AV and B. ovis 266 L). Both strains had in vitro growth kinetics that was similar to that of the reference strain B. ovis ATCC 25840. Vaccination with B. ovis ΔabcBA encapsulated with 1% alginate was protective against the challenge with field strains, with the following protection indexes: 0.751, 1.736, and 2.746, for mice challenged with B. ovis ATCC25840, B. ovis 94 AV, and B. ovis 266 L, respectively. In conclusion, these results demonstrated that B. ovis field strains were capable of infecting and inducing lesions in experimentally infected mice. The attenuated vaccine strain B. ovis ΔabcBA induced protection in mice challenged with different B. ovis field isolates, resulting in higher protection indexes against more pathogenic strains.(AU)

Brucella ovis é responsável por perdas econômicas e reprodutivas em rebanhos ovinos. O objetivo deste trabalho foi caracterizar a infecção com as cepas isoladas de campo de B. ovis em modelo murino e avaliar a eficiência vacinal da mutante B. ovis ΔabcAB para proteção contra desafio com as cepas isoladas de campo. Foram utilizadas sete cepas isoladas de campo foram capazes de colonizar e provocar lesões no fígado e no baço de camundongos após sete dias pós-infecção. Após triagem, duas cepas foram selecionadas para a melhor caracterização (B. ovis 94 AV and B. ovis 266L). Ambas apresentaram crescimento em placa de cultivo semelhante ao da cepa de referência B. ovis ATCC 25840. A vacinação com a cepa de Brucella ovis ΔabcBA encapsulada com alginato a 1% foi capaz de proteger camundongos desafiados com as cepas isoladas de campo, com os seguintes índices de proteção: 0,751, 1,736 e 2,746, para camundongos desafiados com B. ovis ATCC 25840, B. ovis 94 AV e B. ovis 266 L, respectivamente. Estes resultados demonstraram que as cepas isoladas de campo de B. ovis são capazes de infectar e induzir lesão em camundongos experimentalmente infectados. O uso da cepa mutante atenuada B. ovis ΔabcBA para vacinação de fêmeas C57BL/6 desafiados com diferentes cepas de B. ovis induziu proteção nos camundongos desafiados com diferentes cepas de B. ovis. Deste modo, mostrando-se eficiente na proteção das cepas de campo de B. ovis.(AU)

Research progress of dry eye with meibomian gland dysfunction / 国际眼科杂志(Guoji Yanke Zazhi)

@#Meibomian gland dysfunction(MGD)is a general term for various abnormal meibomian glands. Meibomian gland secretes meibomian ester to moisten the eye surface and maintain the stability of tear film. In this article, the etiology, pathology and related treatment of meibomian gland dysfunction were reviewed by referring to related literatures.

Litiasis urinaria en pediatria / Urinary lithiasis in pediatrics

Resumen La litiasis renal es una entidad infrecuente en la infancia y su incidencia va en aumento en los países desarrollados. Afecta más a los individuos de raza blanca que a los afroamericanos en una proporción 4:1, con predominio del sexo masculino. Existen factores geográficos, raciales, genéticos implicados en su patogenia, que depende también de factores fisicoquímicos (eliminación renal de agua y solutos, pH urinario, equilibrio entre factores estimulantes/inhibidores de la cristalización), alteraciones anatómicas, infecciones y cambios socioeconómicos; los cuales a lo largo del tiempo han producido cambios en los hábitos dietéticos, lo que ha modificado la frecuencia, composición química y localización de los cálculos. A pesar de su rareza se debe pensar en la litiasis, con el fin de evitar un daño renal irreversible. La disponibilidad de terapia menos agresiva ha reducido a un 5% las indicaciones quirúrgicas, abriendo nuevas perspectivas en el tratamiento de la urolitiasis en la infancia.

Abstract Renal lithiasis is an infrequent entity in childhood, and its incidence has decreased in developed countries. Affects white individuals more than African Americans in a 4: 1 ratio, with a predominance of males. There are geographic, racial, genetic factors involved in its pathogenesis, which also depends on physicochemical factors (renal elimination of water and solutes, urinary pH, balance between stimulating factors/inhibitors of crystallization), anatomical alterations, infections and socioeconomic changes. Over time, changes have occurred in dietary habits, which has changed the frequency, chemical composition and location of the stones. Despite its rarity, lithiasis must be considered in order to avoid irreversible kidney damage. The availability of less aggressive therapy has reduced surgical indications to 5%, opening new perspectives in the treatment of urolithiasis in childhood. The present article constitutes a bibliographic review about the organophosphorus intoxication, its clinical manifestations, diagnosis and treatment.

Introducción a la virología I / Introduction to virology I

Los virus han acompañado al hombre a través de toda su historia, provocando infecciones y plagas que han generado la muerte y el temor de poblaciones completas. Muchos han sido los investigadores que han contribuido a conocer la estructura, patogenia e inmunidad involucrada. Es fundamental conocer los aspectos básicos de los virus para entender la enfermedad y el tratamiento, por lo que esperamos contribuir a esto con los apuntes que a continuación presentamos...(AU)

Viruses have accompanied humankind through their history, causing infections and producing death and fear in population. A lot of researchers have contributed to know the structure, pathogeny and immunity involved. To understand the disease and treatment is fundamental to know the basic aspects, which is the reason to present these notes...(AU)

Pathogeny and treatment of cirrhotic portal hypertension complicated by peripheral blood cytope-nia / 临床外科杂志

There are three causes of cirrhotic portal hypertension(CPH)complicated by peripher-al blood cytopenia:splenic factors(about 80%),non-splenic factors(about 4%)and comprehensive fac-tors(about 16%).The treatment includes non-surgical treatment and surgical treatment.Mild to moderate peripheral blood cell reduction is suitable for non-surgical treatment.Severe peripheral blood cytopenia is feasible to surgical treatment.Splenic factors are the main cause of peripheral cytopenia in CPH,but not all;The treatment method should be based on the degree of peripheral blood cytopenia.

Incidencia de mycobacterium tuberculosis en muestras extrapulmonares procesadas por el ensayo MODS ­ TB en el Instituto SELADIS de junio del 2015 a diciembre del 2016 / Incidence of Mycobacterium Tuberculosis in Extrapulmonary Specimens Processed by the MODS - TB Assay Seladis Institute from June 2015 to December 2016

La tuberculosis extrapulmonar es una manifestación de la tuberculosis que se da cuando la bacteria Mycobacterium tuberculosis pasa del parénquima pulmonar a otros órganos por vía hematógena, linfática o por contigüidad. Entre diversos métodos de detección del bacilo de Koch en sitios diferentes al parénquima pulmonar, el ensayo de Susceptibilidad a Fármacos mediante Observación Microscópica para tuberculosis (MODS TB) consiste en un cultivo en medio líquido selectivo para M. tuberculosis y que permite además hallar el perfil de susceptibilidad a Isoniacida y Rifampicina. En este estudio se recurrió a los reportes del laboratorio de Microbiología Molecular del Instituto SELADIS, tomando en cuenta las muestras ingresadas de junio del 2015 a diciembre del 2016, hallándose los siguientes resultados: la incidencia de tuberculosis extrapulmonar es del 17,16% en muestras de origen extrapulmonar; el líquido cefalorraquídeo (LCR), líquido ascítico y líquido pleural son los tipos de muestra extrapulmonar con mayor incidencia de Mycobacterium tuberculosis (con 65%, 21,74% y 8,7% de resultados positivos respectivamente); los pacientes de género masculino, adultos (de 27 a 59 años de edad) y procedentes de la Ciudad de La Paz son los que presentan mayor incidencia de tuberculosis extrapulmonar. Los resultados de este estudio permiten tener un panorama de la situación de la tuberculosis extrapulmonar en La Paz, contando con la herramienta MODS TB, cuya sensibilidad y especificidad ha sido reportada en otros trabajos y ha sido validada en el laboratorio de Microbiología Molecular del Instituto SELADIS, donde se realizó este trabajo. La información proporcionada permitirá además aumentar el conocimiento científico ­ epidemiológico que se tiene de la tuberculosis extrapulmonar e incentivar la investigación en este campo.

Extrapulmonary tuberculosis manifests tuberculosis that happens when the bacteria Mycobacterium tuberculosis crosses the pulmonary parenchyma to other organs through hematogenous, lymphatic vias or by contiguity. Among diverse detection methods of the Koch bacillus in different place's trough pulmonary parenchyma, the Microscopic Observation Drug Susceptibility Assay (MODS TB) consists in a liquid medium selective culture for M. tuberculosis that allows finding susceptibility profiles for Isoniazid and Rifampicin. In this study we appealed to the Molecular Microbiology laboratory reports of SELADIS Institute, from June 2015 to December 2016. Found out the following results: the incidence of extrapulmonary tuberculosis is of 17,16% in samples of extrapulmonary origin; cerebrospinal fluid (LCR), ascetic liquid and pleural liquid are the kinds of extrapulmonary samples with the highest incidence of Mycobacterium tuberculosis (with 65%, 21,74% and 8,7% of positive results respectively); male patients, adults (from 27 to 59 years-old) and citizens from La Paz City showed a higher occurrence of extrapulmonary tuberculosis. The results of this study allow having an overview of extrapulmonary tuberculosis in La Paz. Counting with the MODS TB tool, wich sensitivity and specificity has been reported in other jobs and has been standardized at the Molecular Microbiology laboratory of SELADIS Institute, where this this research accomplished. The provided information will allow to increase the cientific ­ epidemiological knowledge that we have about extrapulmonary tuberculosis and encourage the research in this field.

Study on the classification of dominant pathogens related to febrile respiratory syndrome, based on the method of Bayes discriminant analysis / 中华流行病学杂志

Objective To understand the dominant pathogens of febrile respiratory syndrome (FRS) patients in Gansu province and to establish the Bayes discriminant function in order to identify the patients infected with the dominant pathogens.Methods FRS patients were collected in various sentinel hospitals of Gansu province from 2009 to 2015 and the dominant pathogens were determined by describing the composition of pathogenic profile.Significant clinical variables were selected by stepwise discriminant analysis to establish the Bayes discriminant function.Results In the detection of pathogens for FRS,both influenza virus and rhinovirus showed higher positive rates than those caused by other viruses (13.79％,8.63％),that accounting for 54.38％,13.73％ of total viral positive patients.Most frequently detected bacteria would include Streptococcus pneumoniae,and haemophilus influenza (44.41％,18.07％) that accounting for 66.21％ and 24.55％ among the bacterial positive patients.The original-validated rate of discriminant function,established by 11 clinical variables,was 73.1％,with the cross-validated rate as 70.6％.Conclusion Influenza virus,Rhinovirus,Streptococcus pneumoniae and Haemophilus influenzae were the dominant pathogens of FRS in Gansu province.Results from the Bayes discriminant analysis showed both higher accuracy in the classification of dominant pathogens,and applicative value for FRS.

Study on the classification of dominant pathogens related to febrile respiratory syndrome, based on the method of Bayes discriminant analysis / 中华流行病学杂志

Objective To understand the dominant pathogens of febrile respiratory syndrome (FRS) patients in Gansu province and to establish the Bayes discriminant function in order to identify the patients infected with the dominant pathogens.Methods FRS patients were collected in various sentinel hospitals of Gansu province from 2009 to 2015 and the dominant pathogens were determined by describing the composition of pathogenic profile.Significant clinical variables were selected by stepwise discriminant analysis to establish the Bayes discriminant function.Results In the detection of pathogens for FRS,both influenza virus and rhinovirus showed higher positive rates than those caused by other viruses (13.79％,8.63％),that accounting for 54.38％,13.73％ of total viral positive patients.Most frequently detected bacteria would include Streptococcus pneumoniae,and haemophilus influenza (44.41％,18.07％) that accounting for 66.21％ and 24.55％ among the bacterial positive patients.The original-validated rate of discriminant function,established by 11 clinical variables,was 73.1％,with the cross-validated rate as 70.6％.Conclusion Influenza virus,Rhinovirus,Streptococcus pneumoniae and Haemophilus influenzae were the dominant pathogens of FRS in Gansu province.Results from the Bayes discriminant analysis showed both higher accuracy in the classification of dominant pathogens,and applicative value for FRS.

Clinical study of chronic hyponatremia after liver transplantation / 器官移植

Objective To summarize clinical characteristics, prevention and treatment of postoperative chronic hyponatremia after liver transplantation(LT). Methods Clinical data of 26 patients presenting with chronic hyponatremia after LTwereretrospectivelyanalyzed.BaselinedataandmaincomplicationsofpatientswithhyponatremiaafterLTwererecorded. Thecorrelationbetweenpostoperativelengthofhospitalstayandthedurationofhyponatremiawasanalyzed.Clinicaltreatment and prognosis were summarized. Results Among 26 patients, the median blood sodium concentration was 131 mmol/L (range 125 to 133 mmol/L). Al patients were diagnosed with mild or moderate degree of hyponatremia. Main complications included pulmonary infection (n=13, 50%), acute rejection of liver graft (n=7, 27%) and digestive tract hemorrhage (n=7, 27%). Postoperative length of hospital stay was correlated with the duration of hyponatremia. After ful evaluation of patient's conditionandexcludingthepotentialinducers,aportionof3%ofhypertonicsalinewasadministeredviagastro-intestinaltract and/or vein. After positive treatment, 23 cases (88%) were healed and 3 (12%) died from infection complicated with multiple organ failure. Conclusions After LT, the incidence of chronic hyponatremia is low with mild severity. Postoperative length of hospitalstayiscorrelatedwiththedurationofhyponatremia.Thekeyoftreatmentistotimelyexcludetheinducers,correctthe low level of sodium based upon the individual principles and prevent the incidence of postoperative complications.

Clinical pathological analysis of 422 primary conjunctival masses / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To improve accuracy of the diagnosis of primary conjunctival masses(PCM) through analyze the clinicopathological characteristics and pathogenic causes of 422 cases of PCM.METHODS:Clinical manifestations, histological characteristics and immunopheno types were reviewed.Relevant literatures were reviewed.RESULTS:Benign conjunctival masses were 403 cases (95.5%).Those included masses from squamous cell papilloma (71 cases, 17.6%), conjunctival cyst (68 cases, 16.9%), inflammatory masses (62 cases, 15.4%), pigmented nevus (60 cases, 14.9%), lipoma (58 cases, 14.4%).Malignant conjunctival neoplasms were 19 cases (4.5%).Those included tumors from B Cell Lymphoma (6 cases,31.6%), melanoma (6 cases,31.6%), and squamous cell carcinoma (5 cases, 26.3%).Different types of primary conjunctival masses were induced by the same cause.CONCLUSION:The pathological types of primary conjunctival masses are various and the majority of which is benign.For the diagnosis of primary conjunctival masses, morphological analysis, immunohistochemical examination shoud be combined to increase the diagnostic accuracy and decrease misdiagnosis rate.

Primary Study on Pathogeny and Pathogenesis Caused by Tobacco / 中国中医药信息杂志

This article conducted the discussion based on the flavor and meridian tropism, invasive pathways, pathogenesis features, and transmission prognosis of tabacco. It proposed that the lung defence are firstly attacked by tobacco evil qi; then evil qi is accumulating to be toxic; toxin hides in the Taiyin; viscera is weak; qi is exhausted and the body fluidis impaired; toxin victimizes vessel and fumigates the viscera, so all kinds of diseases engender.

Discussion on Etiology and Pathogenesis of Rheumatoid Arthritis from the Theory of Fuxie / 浙江中医药大学学报

[Objective] To explore the etiology and pathogenesis of rheumatoid arthritis from the perspective of the theory of Fuxie, so as to more comprehensively understand the rheumatoid arthritis, broaden the thinking of clinical diagnosis and treatment, and improve the clinical efficacy. [Methods] The theory of Fuxie theory was summarized, from the aspects of interpretation, theoretical origin, modern medical knowledge and so on, combined with the regularity of the pathogenesis of the pathogen, the etiology, pathogenesis and treatment of rheumatoid arthritis were discussed. [Results] Fuxie theory is originally derived from Huangdi Neijing, it is considered that Fuxie is divided into exogenous and endogenous Fuxie foxier, etiology of rheumatoid arthritis with hidden pathogenic objective basis, its pathogenesis with hidden pathogenic mechanism, the treatment principle and treatment method by pathogen consistentcy. [Conclusion] Understanding of rheumatoid arthritis, according to the characteristics and development of Fuxie disease transmission rules, can better grasp the nature of the disease, diagnosis and treatment of Fuxie theory of rheumatoid arthritis has important clinical significance, rheumatoid arthritis from Fuxie theory provides new ideas and methods for clinical treatment.

Study on Origin and Development of Stroke / 浙江中医药大学学报

[Objective]On the origin and development of stroke research and interpretation. [Methods]Reading from pre-Qin period to the Ming and Qing dynasties in the ancient literature related to stroke the literature, according to the treatment of disease, etiology, pathogenesis, therapeutic principle, prevention and curing of Chinese medical induction, summary, combining the origin of stroke, analysis of pathogenesis and therapeutic principle of stroke, and it is filtered and classified the ancient literature and research, summarizes the extraction.[Methods]Reading and analyzing ancient documents related to the stroke.[Results]The termstrokeand theoretical source inNei Jing, the treatment based on syndrome differentiation is initiated Treatise on Febrile and Miscellaneous Diseases.Jin and Yuan dynasties developed stroke theory;modern perfect stroke syndrome differentiation system. Previously, during the Tang and Song dynasties, it is mainly based on the theories of vital Qi deficiency,pathogenic wind into the argument, treatment of strengthening the body and removal of scattered wind. After the Jin Yuan dynasties, they are internal injury based, wind from the endogenous theories. the treatment is mainly focused on internal injuries. [Conclusion]That ancient physicians paid attention to the etiology and treatment of stroke more, keeping in good health and prevention mentioned less, so we should pay attention to the prevention and recovery.

Clinical Analysis of 18 cases with orbital apex syndrome / 中国神经精神疾病杂志

Objective To explore the clinical characteristics, etiology and prognosis of orbit apex syndrome. Methods Clinical data of 18 patients with orbit syndrome was summarized and analyzed. Results All patients developed vision loss, ptosis and diplopia, such as a headache or sore eyes forehead performance. However, the onset symptoms varied including vision decline or loss in 8 cases, headache in 7 cases, eye pain in 1 case, toothache in 1 case, stuffy nose and runny nose in 1 case and exophthalmos in 1 cases. The Causes included trauma in 6 cases (33％), mass lesion in 5 cases (28％), nonspecific inflammation in 1 cases (22％), infection in 3 cases (17％). Vision and eye movements disorder were improved in 5 cases of 6 patients with trauma in which 3 mild cases recovered better and one severe case did not recovered. Of 5 patients with mass lesion, the vision and eye movement were improved in one patients with sphenoid sinus mucocele receiving surgical operation. but not in the rest 4 cases with orbital adenoid cystic carcinoma or osteosarcoma patients receiving either surgical operation or radiotherapy. Of 4 patients with nonspecific inflammatory disease, eye movements were improved in 2 mild cases but not in 2 severe cases. Of 3 infectious diseases, eye movements were improved in 1 mild case. Conclusion Orbital apex syndrome is a heterogeneous disorder with multiple etiologies, presenting with a variety of initial symptoms. The prognosis depends on causes, timely diagnosis, early diagnosis and early treatment.

Clinical analysis of home blood pressure monitoring in patients with transient hypertension / 重庆医学

Objective To screen the incidence of transient hypertension in conventional hypertensive management population of hypertension and analysis it's related etiology and constituent ratio.Methods People who met the diagnosis of hypertension were selected from inpatient and outpatient of this department.All patients were followed up for 2 months of home blood pressure monitoring,if the patients who were normal when monitoring home blood pressure were included in the trial and symptomatic hypertension was excluded.Results Three hundred of patients met the diagnostic criteria for hypertension,46 cases (15.3％) met the standard of transient hypertension,the etiology and constituent ratio of transient hypertension in the observed cases were as follows:25 cases (54.3％) of anxiety and depression,8 cases (17.4％) of acute cerebrovascular disease,7 cases (15.2％) of sleep disorders,4 cases(8.7％) of a variety of head and face pain,1 (2.2％)case of epilepsy tonic clonus,1 (2.2％)case of vertigo.Conclusion The application of interactive management of home blood pressure measurement is particularly helpful for screening patients with transient hypertension,and it can timely avoid excessive anti-hypertensive treatment.

Nefropatía por IgA. revisión y conducta terapéutica a propósito de un caso clínico / Therapeutic management of an IgA nephropathy case and disease review

La Nefropatía por Inmunoglobulina A (NIgA), también conocida como enfermedad de Berger, fue descrita por primera vez en 1968 por Berger e Hinglais. Se trata de una enfermedad heterogénea, tanto desde el punto de vista clínico, como histológico, caracterizada por la presencia de depósitos mesangiales de IgA. La clínica de presentación es extremadamente variable, pudiendo manifestarse desde microhematuria aislada hasta un deterioro agudo de la función renal por una glomerulonefritis extracapilar superpuesta. Inicialmente se la consideraba una entidad de buen pronóstico, pero con el paso del tiempo y a partir de un mayor conocimiento de la NIgA, se constató que la realidad era otra y que del 20 al 30% de los pacientes a los 20 años evolucionaban a la insuficiencia renal crónica (IRC) terminal y otro 20% mostraba una pérdida significativa de la función renal. En el presente artículo se describe un caso clínico de un paciente en el que se detectan casualmente marcadores de daño renal en la orina, y en quien los hallazgos histológicos observados en la biopsia renal modificaron su pronóstico y la conducta terapéutica. A partir de este caso clínico se realiza una actualización sobre la Nefropatía por IgA

Inmunoglobulin A (NIgA) Nephropathy also known as Berger disease, was described for the first time in 1968 by Berger and Hinglais. It is a heterogeneous disease, not only from clinical point of view but also from the histologicalone. Characterized by the presence of IgA mesangials deposits. Clinical presentation is extremely variable and can vary from isolated microhematuria up to a severe damage of renal function due to superimposed extracapillary glomerulonephritis. Initially it was considered an entity with good prognosis, but over time and more knowledge about IgAN, it was shown that 20 to 30% of 20 years old patients evolved to end stage renal failure and other 20% had important renal function loss. In the present article we describe a case of a patient in whom we detected by chance renal damage markers in the urine, and then the histologic findings observed in renal biopsy, modified the prognosis and therapeutic procedure. From this clinical case, we performed an update on IgA Nephropathy