Urinary ascites due to retroperitoneal fibrosis: a case report.

Urinary ascites in adults is usually secondary to iatrogenic or traumatic injuries. A case of a 69-year-old male with abdominal pain and decreased renal function is described. Ultrasound showed bilateral hydronephrosis and ascites. Computed tomography revealed retroperitoneal fibrosis complicated by a rupture at the right ureteropelvic junction and urine extravasation in the perirenal and intraperitoneal spaces. Delayed scans showed leaking of contrast media from the anterior perirenal space to the peritoneal cavity. The urinary ascites resolved using a double-J stent.

Isolated profound thrombocytopenia associated with clopidogrel.

Clopidogrel is a new oral antiplatelet agent with a structure and mechanism of action similar to ticlopidine; they both block the adenosine diphosphate receptor. Because of better side-effect profile and simpler dosing regime, clopidogrel has largely replaced ticlopidine. In fact, the excellent safety and tolerability profile of clopidogrel compares favorably with that of aspirin as documented in the CAPRIE (Clopidogrel versus Aspirin in Patients at Risk of Ischemic Events) study. After marketing, several cases of clopidogrel-associated thrombotic thrombocytopenic purpura (TTP) were reported. We report our experience with a case of isolated profound thrombocytopenia without evidence of TTP after clopidogrel administration with prompt recovery of platelet counts upon discontinuation of clopidogrel and treatment with intravenous immunoglobulin.

Acute profound thrombocytopenia without bleeding complications after abciximab administration.

Abciximab (c7E3) is the Fab fragment of the chimeric monoclonal antibody directed against glycoprotein IIb/IIIa found on the surface of platelets. It is the first FDA-approved platelet receptor glycoprotein inhibitor. Severe thrombocytopenia (defined as platelet count < 50 x 109/L) on first administration is a rare complication, occurring in only 1.6% of patients in the EPIC (Evaluation of 7E3 for the Prevention of Ischemic Complications) study. Bleeding complications were the rule in these thrombocytopenic patients as reported by EPIC investigators, Kereiakes et al. and Berkowitz et al. Platelet transfusions are required to reverse the bleeding diathesis. Intravenous IgG has not reportedly been helpful in reversing thrombocytopenia, and experience with corticosteroids is not reported in the literature. We report a case of acute profound thrombocytopenia following abciximab administration treated with platelet transfusion augmented by intravenous corticosteroids, in whom there was no bleeding complication.

[Bourneville's syndrome: diagnostic and urologic implications]. / La sindrome di Bournerville: implicazioni diagnostiche ed urologiche.

Angiomyolipoma is a rare tumor frequently associated with tuberous sclerosis and it has a higher incidence of bilateral renal involvement in this case. Patients effected by Bourneville's Syndrome are often more symptomatic than patients with angiomyolipoma only, however it is necessary to examine the renal conditions in all of them because of the high risk for severe hemorrhage. Diagnostic evaluation is based on radiological findings as Ultrasonography and Computed Tomography. We present a case of bilateral and symptomatic angiomyolipoma is a young woman with Bourneville's Syndrome.

Severe primary IgA glomerulonephritis.

We describe the case of a 22-month-old girl who presented with a severe nephritic-nephrotic syndrome associated with arterial hypertension, remained symptomatic throughout the follow-up period and met advanced renal failure at 6 3/4 years of age. The initial renal biopsy revealed a mesangiocapillary glomerulonephritis with mesangial deposits of immunoglobulins (IgA, IgG, IgM), C3 and fibrin, extending into the capillary wall. Diffuse glomerular sclerosis was observed in the second biopsy. To our knowledge there are no reports of similar cases in the literature.

Primary nephrotic syndrome in Iran: clinicopathological study of 310 cases.

Three hundred and ten children with primary nephrotic syndrome were studied since 1972. 190 patients are classified as nephrosis (61%); including minimal glomerular lesions (22.9%), diffuse mesangial proliferation (6.77%) and focal and segmental sclerosis (31.6%). Corticoresponsivity was limited: 53.75% with a higher success rate in minimal glomerular lesions: 74% versus 38% of diffuse mesangial proliferation and 42.5% focal and segmental sclerosis. Immunosuppressive drugs were used for 96 patients corticodependent or resistant. They were more effective in dependent than resistant cases 94% versus 38%. A total of 149 cases were followed (mean: 3.9 years). In the last evaluation 67% were in remission, 8.10% in chronic renal failure and 24.8% with other abnormalities.