Rapidly progressive glomerulonephritis: A wild card manifestation of lupus nephritis.

A significant proportion of individuals with systemic lupus erythematosus (SLE) will have clinical or laboratory evidence of renal involvement at some point in the course of their disease. Lupus nephritis (LN) is one of the more important systemic manifestations of SLE and although progression to end-stage renal disease (ESRD) is not usually the norm, a significant minority of patients will do so, some in a rather dramatic fashion. It is in such instances that LN constitutes a true nephrologic emergency. Gratifyingly, it is rarely a silent emergency and heightened awareness amongst clinicians about its unpredictable course should lead to earlier recognition and intervention. For this reason, a case of LN presenting with historical and histologic evidence of chronic kidney disease and superimposed, acute acceleration of renal function decline, leading rapidly to ESRD is reported here. A brief review of the literature surrounding the pathophysiologic mechanisms, clinicopathologic characteristics and current therapeutic approaches to LN is subsequently explored.

Ocular Manifestations in HIV-AIDS Patients in a Nigerian Community

Background: The aim of this study was to determine the ocular manifestations of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) among the study population.Method: A cross-sectional descriptive study was conducted among HIV-AIDS patients at the Federal Medical Centre; Owo; Nigeria. Ethics clearance was obtained from the ethics review committee of the hospital. Informed consent was obtained from all the respondents. This study was conducted over a period of nine months; from October 2010-June 2011; at the medical outpatient centre and the eye clinic of the hospital. The obtained information included the socio-demographics of the respondents; World Health Organization clinical stage of AIDS; CD4 count; duration of HIV-positive status; history of ocular problems and the treatment sought.Results: A total of 112 consenting respondents participated in this study. Not many respondents (36; 32.1) were aware of eye complications that relate to HIV-AIDS. Most informed respondents had been enlightened by health workers (20; 55.6). Few respondents (16; 14.3) had HIV-AIDS ocular manifestations. Squamous cell carcinoma was the most common ocular manifestation.Conclusion: Efforts should be made to promote the ocular health of HIV-AIDS patients to prevent blinding ocular manifestation

Distribution pattern of lens opacity among a rural population in South Western Nigeria.

PURPOSE: To determine prevalence of the morphological types of age-related lens opacity in Southwestern Nigeria as part of need assessment survey towards planning an eye health care service. METHOD: Multistage cluster sampling was used in selecting a representative cross-sectional sample of persons 50 years of age or older among the residents of the rural wards in Akinyele Local Government Area in southwestern Nigeria. Lens opacity was graded using the World Health Organization cataract grading system. RESULTS: One thousand two-hundred persons were recruited for the survey and 1031 (85.9%) had grading of lens opacity. The mean age of the participants was 64.9 years and 51.1% were male. Five hundred and ninety persons had definite lens opacity (crude prevalence rate 57.2%; 95% Confidence interval [CI] 54.1-60.3) (standardized prevalence 47.0%; 95% confidence interval 46.7-47.3). The prevalence for participants aged 70 years and above (82.5%; 95% CI 78.2-86.3) was three times more than for participants aged 50-59 years (29.2%; 95% CI 24.2-34.6). Nuclear opacity was the most prevalent type of lens opacity (20.9%; 95% CI 18.4-23.5). Sixty percent of the grade 3 lens opacity was found among participants aged 70 years and above. CONCLUSION: This is the first population-based survey on prevalence of lens opacity subtype in this West Africa subregion. The prevalence of lens opacity in the rural Akinyele local government is high. Nuclear sclerosis was the most prevalent form among this rural population.

Visual impairment from fibrous dysplasia in a middle-aged African man: a case report.

INTRODUCTION: Fibrous dysplasia is a benign tumour of the bones and is a disease of unknown aetiology. This report discusses a case of proptosis and visual deterioration with associated bony mass involving the right orbit. CASE PRESENTATION: A 32-year-old Nigerian man of Yoruba ethnic origin presented to the eye clinic of our hospital with right-eye proptosis and visual deterioration of 7-year duration. Presentation was preceded by a history of trauma. Proptosis was preceded by trauma but was non-pulsatile with no thrill or bruit but was associated with bony orbital mass. The patient reported no weight loss. Examination of his right eye showed visual acuity of 6/60 with relative afferent pupillary defect. Fundal examination revealed optic atrophy. Computed tomography showed an expansile bony mass involving all the walls of the orbit. The bony orbital mass was diagnosed histologically as fibrous dysplasia. Treatment included orbital exploration and orbital shaping to create room for the globe and relieve pressure on the optic nerve. CONCLUSION: Fibrous dysplasia should be considered in the differential diagnosis of slowly developing proptosis with associated visual loss in young adults.