ABSTRACT
Acute kidney injury after exercise is most commonly secondary to rhabdomyolysis. Non-rhabdomyolysis AKI is secondary to a limited number of disorders of which renal hypouricemia (RHUC) needs a special mention. It is relatively a rare genetic disorder and is reported in Japanese and Ashkenazi Jews. Humans have lost the ability to metabolize uric acid as the "uricase" gene is suppressed. Renal tubules handle uric acid and aid in maintaining serum concentrations in the soluble range. Uric acid excretion is increased in RHUC patients due to proximal tubular defects. This leads to the loss of antioxidant capabilities of the kidney, predisposing them to severe AKI following anaerobic exercise. We report a case of exercise-induced AKI secondary to renal hypouricemia.
ABSTRACT
Human immunodeficiency virus (HIV) infection has posed as a major global health epidemic for almost three decades. With the advent of highly active antiretroviral therapy in 1996 and the application of prophylaxis and management of opportunistic infections, acquired immunodeficiency syndrome mortality has decreased markedly. The most aggressive HIV-related renal disease is end-stage renal disease due to HIV-associated nephropathy. Presence of HIV infection used to be viewed as a contraindication to renal transplantation for multiple reasons; concerns for exacerbation of an already immunocompromised state by administration of additional immunosuppressants; the use of a limited supply of donor organs with unknown long-term outcomes. Multiple studies have reported promising outcomes at three to five years after kidney transplantations in patients treated with highly active antiretroviral therapy, and HIV is no longer a contraindication for renal transplant. Hence, we present eight HIV-positive patients who received live-related renal transplantation at our center and their follow-up.
Subject(s)
AIDS-Associated Nephropathy/surgery , Anti-HIV Agents/therapeutic use , HIV Infections/drug therapy , Kidney Failure, Chronic/surgery , Kidney Transplantation/methods , AIDS-Associated Nephropathy/diagnosis , AIDS-Associated Nephropathy/immunology , AIDS-Associated Nephropathy/virology , Anti-HIV Agents/adverse effects , Antiretroviral Therapy, Highly Active , Clinical Decision-Making , Disease Progression , Female , Graft Rejection/immunology , Graft Rejection/prevention & control , Graft Survival/drug effects , HIV Infections/diagnosis , HIV Infections/immunology , HIV Infections/virology , Humans , Immunocompromised Host , Immunosuppressive Agents/therapeutic use , Kidney Failure, Chronic/diagnosis , Kidney Failure, Chronic/immunology , Kidney Failure, Chronic/virology , Kidney Transplantation/adverse effects , Living Donors , Male , Middle Aged , Risk Factors , Time Factors , Treatment OutcomeABSTRACT
Bullous systemic lupus erythematosus is a rare distinctive subepidermal blistering disorder that can occur in patients with systemic lupus erythematosus (SLE). It is histologically characterized by a neutrophil-predominant infiltrate in the subepidermal region with deposition of immunoglobulins (IgG, IgA, IgM), C3, and auto-antibodies against collagen VII. Herein, we report a case of a 13-year-old girl who presented with bullous SLE and Class III lupus nephritis, which is extremely rare at this age.
