Recurrence of nephrotic syndrome in a patient after renal transplantation. Diagnostic difficulties

Kłębuszkowe zapalenia nerek stanowią częstą przyczynę dializoterapii w Polsce i dotyczą 0,1–0,7% populacji. Ważny problem kliniczny stanowią glomerulopatie, które pojawiają się w nerce przeszczepionej, ponieważ mogą one doprowadzić do utraty przeszczepu. Celem pracy było przedstawienie przypadku klinicznego 42-letniego pacjenta ze schyłkową niewydolnością nerek w przebiegu nefropatii IgM. Pierwsze objawy choroby pojawiły się w wieku około 19 lat. Pomimo stosowanego leczenia immunosupresyjnego w różnych schematach następowała progresja zmian patologicznych z nawrotowym białkomoczem i rozwojem nadciśnienia tętniczego. Pacjent wielokrotnie był hospitalizowany z powodu zaostrzenia procesu chorobowego. Z powodu schyłkowej niewydolności nerek był leczony hemodializami przez 15 miesięcy. Otrzymał przeszczep nerki od dawcy zmarłego. Około 2. tygodnia po przeszczepie stwierdzono nasilony białkomocz. Wykonano biopsję przeszczepu. Opis badania był niejednoznaczny, jednak nie stwierdzono ewidentnych cech odrzucania. Po 6 miesiącach od transplantacji rozwinął się zespół nerczycowy. Ponownie wykonano biopsję. Badanie histopatologiczne nerki przeszczepionej wykazało zmianę minimalną. Podano pulsy steroidowe. Uzyskano remisję zespołu nerczycowego. Biopsja powikłana była powstaniem przetoki tętniczo-żylnej. Z powodu stabilizacji nadciśnienia tętniczego zadecydowano o niezamykaniu przetoki. Chory pozostaje pod kontrolą Poradni Transplantacyjnej, aktualnie po ponad roku od nawrotu zespołu nerczycowego. Stwierdza się białkomocz dobowy poniżej 1 g oraz stabilną funkcję przeszczepu. Ze względu na nawrotowy charakter kłębuszkowych zapaleń nerek, a także możliwość rozwoju innej patologii przeszczepu w celu prowadzenia optymalnego leczenia konieczne jest niekiedy wykonywanie kilkakrotnej biopsji przeszczepianego narządu, pomimo możliwych powikłań.Glomerulonephritis is a common cause of dialysis in Poland and refers to 0.1–0.7% of the population. An important clinical problem are glomerulopathies which appear in the transplanted kidney, because they may lead to graft loss. The aim of this study was to present a clinical case of a 42-year old patient with end-stage renal disease in the course of IgM nephropathy. The first symptoms appeared when he was 19. Despite treatment with immunosuppressive regimens in various schemes, he developed recurrent proteinuria and hypertension. The patient was repeatedly hospitalized with an exacerbation of the disease. Due to end-stage renal failure he has been treated with hemodialysis for 15 months. He received a kidney transplant from a cadaver donor. About 2 weeks after transplantation severe proteinuria was developed. Biopsy of transplant was performed. Histopathological report was inconclusive, but there were no obvious features of glomerulonephritis. 6 months after transplantation he developed nephrotic syndrome. Repeated biopsy was done. Histopathological examination of the transplanted kidney showed minimal change disease. The patient was given steroid pulses and obtained remission of nephrotic syndrome. Biopsy was complicated by the creation of an arteriovenous fistula. Due to the stabilization of hypertension the fistula was unclosed. The patient remains under the control of Transplantation Clinic. Now after more than a year after the recurrence of nephrotic syndrome, the daily proteinuria is stated below 1g and graft function is stable. Because of the recurrent nature of glomerulonephritis, and the possibility of the development of other transplant pathology to guide the optimal treatment it is sometimes necessary to perform a biopsy of the transplanted organ several times despite possible complications

Anti-Gender Politics in the Populist Moment

This book charts the new phase of global struggles around gender equality and sexual democracy: the ultraconservative mobilization against "gender ideology" and feminist efforts to counteract it. It argues that anti-gender campaigns, which emerged around 2010 in Europe, are not a simple continuation of the anti-feminist backlash dating back to the 1970s, but part of a new political configuration. Opposition to "gender" has become a key element of the rise of right-wing populism, which successfully harnesses the anxiety, shame and anger caused by neoliberalism and threatens to destroy liberal democracy.　 Anti-Gender Politics in the Populist Moment offers a novel conceptualization of the relationship between the ultraconservative anti-gender movement and right-wing populist parties, examining the opportunistic synergy between these actors. The authors map the anti-gender campaigns as a global movement, putting the Polish case in a comparative perspective. They show that the anti-gender rhetoric is best understood as a reactionary critique of neoliberalism as a socio-cultural formation. The book also studies the recent wave of feminist mass mobilizations, viewing the transnational revolt of women as a left populist movement.　 　　 This is an important study for those doing research in politics, cultural studies, gender and sexuality studies and sociology. It will also be useful for activists and policy makers

Gender as ‘Ebola from Brussels’ : The Anti-colonial Frame and the Rise of Illiberal Populism

This article examines the recent wave of grassroots mobilizations opposing gender equality, LGBT rights and sex education, which vilify the term gender in public debates and policy document. The anti-gender movement emerged simultaneously in various locations after 2010. We argue that it is not just another wave of anti-feminist backlash, or a new tactic of the Vatican in its ongoing efforts to undermine gender equality, but a new ideological and political configuration, which emerged in response to global economic crisis of 2008 and the ongoing crisis of liberal democracy. The backlash of the 80s and 90s combined neo-conservatism with market fundamentalism (which is to some extent still the case with neoconservative Christian fundamentalists in the US and elsewhere), while the new movement – though in many ways a continuation of earlier trends – tends to combine  gender conservatism with a critique of neoliberalism and globalization. Liberal elites are presented as “colonizers”; “genderism” is demonized as an ideology imposed by the world’s rich on the poor. Thanks to the anti-colonial frame, anti-genderism has remarkable ideological coherence and great mobilizing power: right-wing populists have captured the imagination and hearts of large portions of local populations more effectively than progressive movements have managed to do. The article examines the basic tenets of anti-genderism, shedding light on how this ideological construct contributes to the contemporary transnational resurgence of illiberal populism. We argue that today’s global right, while selectively borrowing from liberal-left and feminist discourses, is in fact constructing a new universalism, an illiberal one. While the examples discussed are mostly from Poland, the pattern is transnational, and our conclusions may have serious implications for feminist theory and activism.

Anti-Gender Politics in the Populist Moment (Edition 1)

This book charts the new phase of global struggles around gender equality and sexual democracy: the ultraconservative mobilization against "gender ideology" and feminist efforts to counteract it. It argues that anti-gender campaigns, which emerged around 2010 in Europe, are not a simple continuation of the anti-feminist backlash dating back to the 1970s, but part of a new political configuration. Opposition to "gender" has become a key element of the rise of right-wing populism, which successfully harnesses the anxiety, shame and anger caused by neoliberalism and threatens to destroy liberal democracy. Anti-Gender Politics in the Populist Moment offers a novel conceptualization of the relationship between the ultraconservative anti-gender movement and right-wing populist parties, examining the opportunistic synergy between these actors. The authors map the anti-gender campaigns as a global movement, putting the Polish case in a comparative perspective. They show that the anti-gender rhetoric is best understood as a reactionary critique of neoliberalism as a socio-cultural formation. The book also studies the recent wave of feminist mass mobilizations, viewing the transnational revolt of women as a left populist movement. This is an important study for those doing research in politics, cultural studies, gender and sexuality studies and sociology. It will also be useful for activists and policy makers.　

Anti-Gender Politics in the Populist Moment

This book charts the new phase of global struggles around gender equality and sexual democracy: the ultraconservative mobilization against "gender ideology" and feminist efforts to counteract it. It argues that anti-gender campaigns, which emerged around 2010 in Europe, are not a simple continuation of the anti-feminist backlash dating back to the 1970s, but part of a new political configuration. Opposition to "gender" has become a key element of the rise of right-wing populism, which successfully harnesses the anxiety, shame and anger caused by neoliberalism and threatens to destroy liberal democracy.　 Anti-Gender Politics in the Populist Moment offers a novel conceptualization of the relationship between the ultraconservative anti-gender movement and right-wing populist parties, examining the opportunistic synergy between these actors. The authors map the anti-gender campaigns as a global movement, putting the Polish case in a comparative perspective. They show that the anti-gender rhetoric is best understood as a reactionary critique of neoliberalism as a socio-cultural formation. The book also studies the recent wave of feminist mass mobilizations, viewing the transnational revolt of women as a left populist movement.　 　　 This is an important study for those doing research in politics, cultural studies, gender and sexuality studies and sociology. It will also be useful for activists and policy makers

Oxidative Stress and Liver Morphology in Experimental Cyclosporine A-Induced Hepatotoxicity

Cyclosporine A is an immunosuppressive drug used after organ’s transplantation. The adverse effects on such organs as kidney or liver may limit its use. Oxidative stress is proposed as one of the mechanisms of organs injury. The study was designed to elucidate CsA-induced changes in liver function, morphology, oxidative stress parameters, and mitochondria in rat’s hepatocytes. Male Wistar rats were used: group A (control) receiving physiological saline, group B cyclosporine A in a dose of 15 mg/kg/day subcutaneously, and group C the CsA-vehicle (olive oil). On the 28th day rats were anesthetized. The following biochemical changes were observed in CsA-treated animals: increased levels of ALT, AST, and bilirubin in the serum, statistically significant changes in oxidative stress parameters, and lipid peroxidation products in the liver supernatants: MDA+4HAE, GSH, GSSG, caspase 3 activity, and ADP/ATP, NAD+/NADH, and NADP+/NADPH ratios. Microscopy of the liver revealed congestion, sinusoidal dilatation, and focal hepatocytes necrosis with mononuclear cell infiltration. Electron microscope revealed marked mitochondrial damage. Biochemical studies indicated that CsA treatment impairs liver function and triggers oxidative stress and redox imbalance in rats hepatocytes. Changes of oxidative stress markers parallel with mitochondrial damage suggest that these mechanisms play a crucial role in the course of CsA hepatotoxicity