RESUMO
Rationale: Genitourinary tuberculosis can develop during the disease course of disseminated disease and the distinctive histological finding is epithelioid granuloma with or without caseation and accompanied Langhans-type giant cells. Barely, the lesion is only restricted to kidney involving both glomerular and extraglomerular compartment. Association with immune complex-mediated glomerulonephritis has been sparsely reported in the literature. Patient concern: A 42-year-old non-diabetic, non-hypertensive male presented with generalized body swelling and frothing of urine for 3 months. Diagnosis: Membranous nephropathy with tuberculous interstitial nephritis. Intervention: Anti-tuberculous therapy for extrapulmonary tuberculosis was administered along with low dose corticosteroid. Outcomes: Reduction of proteinuria was achieved at one month follow-up visit. Lessons: Tuberculosis should be considered as a potentially treatable cause of secondary membranous nephropathy as pharmacotherapy greatly helps improve the outcome.
RESUMO
Rationale: Genitourinary tuberculosis can develop during the disease course of disseminated disease and the distinctive histological finding is epithelioid granuloma with or without caseation and accompanied Langhans-type giant cells. Barely, the lesion is only restricted to kidney involving both glomerular and extraglomerular compartment. Association with immune complex-mediated glomerulonephritis has been sparsely reported in the literature. Patient concern: A 42-year-old non-diabetic, non-hypertensive male presented with generalized body swelling and frothing of urine for 3 months. Diagnosis: Membranous nephropathy with tuberculous interstitial nephritis. Intervention: Anti-tuberculous therapy for extrapulmonary tuberculosis was administered along with low dose corticosteroid. Outcomes: Reduction of proteinuria was achieved at one month follow-up visit. Lessons: Tuberculosis should be considered as a potentially treatable cause of secondary membranous nephropathy as pharmacotherapy greatly helps improve the outcome.
RESUMO
Background@#India is home to a large number of thalassemic children. Despite malnutrition being an essential determinant of their therapeutic goals and quality of life (QoL), it was hardly ever explored. With this background, this study aimed to estimate the proportion of β-thalassemia major (β-TM) children experiencing malnutrition, its attributes, and impact on their QoL. @*Methods@#This cross-sectional, hospital-based, analytical observational study was conducted among 328 β-TM children attending the thalassemia day care unit of a medical college from May 2016 to April 2017, with a structured schedule. Data were analyzed following appropriate statistical methods using SPSS statistical package ver. 16.0 (SPSS Inc., Chicago, IL, USA). @*Results@#Among the study participants, 48.2% were malnourished with a mean body mass index of 13.9 kg/m2 . In the multivariable logistic regression model, participants’ age (adjusted odds ratio [AOR], 1.15; 95% confidence interval [CI], 1.02–1.29), caste (AOR, 2.11; 95% CI, 1.23–3.60), mothers’ educational level (AOR, 2.05; 95% CI, 1.22– 3.44), blood transfusion frequency (AOR, 1.25; 95% CI, 1.16–1.31), and palpable spleen size (AOR, 1.22; 95% CI, 1.08–1.37) were significant predictors of malnutrition after adjusting for pre-transfusion hemoglobin level and hemolytic facies status. In multiple linear regression analysis, malnutrition negatively impacted total QoL (unstandardized beta [standard error], -4.4 [1.7]; P=0.009) and various domains of the study participants except the social and school domains adjusted for age, sex, caste, place of residence, parents’ educational level, and socioeconomic status. @*Conclusion@#Almost half of the study participants had malnutrition. Malnutrition had a negative impact on their QoL.
RESUMO
Background@#India is home to a large number of thalassemic children. Despite malnutrition being an essential determinant of their therapeutic goals and quality of life (QoL), it was hardly ever explored. With this background, this study aimed to estimate the proportion of β-thalassemia major (β-TM) children experiencing malnutrition, its attributes, and impact on their QoL. @*Methods@#This cross-sectional, hospital-based, analytical observational study was conducted among 328 β-TM children attending the thalassemia day care unit of a medical college from May 2016 to April 2017, with a structured schedule. Data were analyzed following appropriate statistical methods using SPSS statistical package ver. 16.0 (SPSS Inc., Chicago, IL, USA). @*Results@#Among the study participants, 48.2% were malnourished with a mean body mass index of 13.9 kg/m2 . In the multivariable logistic regression model, participants’ age (adjusted odds ratio [AOR], 1.15; 95% confidence interval [CI], 1.02–1.29), caste (AOR, 2.11; 95% CI, 1.23–3.60), mothers’ educational level (AOR, 2.05; 95% CI, 1.22– 3.44), blood transfusion frequency (AOR, 1.25; 95% CI, 1.16–1.31), and palpable spleen size (AOR, 1.22; 95% CI, 1.08–1.37) were significant predictors of malnutrition after adjusting for pre-transfusion hemoglobin level and hemolytic facies status. In multiple linear regression analysis, malnutrition negatively impacted total QoL (unstandardized beta [standard error], -4.4 [1.7]; P=0.009) and various domains of the study participants except the social and school domains adjusted for age, sex, caste, place of residence, parents’ educational level, and socioeconomic status. @*Conclusion@#Almost half of the study participants had malnutrition. Malnutrition had a negative impact on their QoL.