Tubulointerstitial Nephritis and Uveitis Syndrome Associated with Renal Tryptaseand Chymase-positive Mast Cell Infiltration

We report the clinical course and immunohistochemical analysis of a patient who presented with tubulointerstitial nephritis and uveitis syndrome (TINU syndrome). The patient, a 40-year-old woman, was referred to our hospital with general fatigue and a slight fever from another hospital. Mast cells are closely related to the development of renal interstitial fibrosis in patients with glomerulonephritis. To determine the role of mast cells in renal interstitial injury in TINU patients, we performed immunohistochemical studies on renal biopsy specimens using anti-human tryptase and anti-human chymase antibodies specific for mast cells. Double immunostaining of tryptase and chymase was also performed in renal tissues. In double immunofluorescence, cells with both chymase and tryptase (MCtc) were marked in the regions of interstitial fibrosis in this patient. It appears that mast cells are one of the constitutive cells of interstitial fibrosis in patients with TINU syndrome

Usefulness of a Body Composition Analyzer, InBody 2.0, in Chronic Hemodialysis Patients

The objective of the present study was to investigate whether InBody 2.0 might be useful in measuring the dry weight of chronic hemodialysis (HD) patients. Thirty-five HD patients (22 males and 13 females; mean age 62.6 ± 14.0 years; mean HD duration 101.0 ± 118.06 months) were examined. Multifrequency bioelectric impedance analysis was used to estimate the ratio of extracellular water (ECW) to total body water (TBW). The body resistance was measured at frequencies ranging from 1 kHz to 1 MHz. The impedance index was determined at a low frequency (5 kHz) and correlated closely with ECW, using sodium bromide dilution as standard comparison. The levels of serum albumin, prealbumin, total cholesterol (TC), triglycerides (TG), transferrin, and human atrial natriuretic peptide (hANP) were measured by routine methods in our hospital. The ECW/TBW ratio was significantly associated with the levels of hANP (p < 0.05). However, no associations between the levels of serum albumin, TC, TG, or transferrin and the ECW/TBW were observed. It appears that the body composition analyzer, InBody 2.0, may be useful for estimating the dry weight in chronic HD patients

Transient Thyrotoxicosis After Parathyroidectomy in a Hemodialysis Patient with Secondary Hyperparathyroidism

A 51-year-old Japanese male had been maintaining hemodialysis for 20 years. He had advanced secondary hyperparathyroidism. He had total parathyroidectomy (PTX) and autotransplantation in 2003. After the operation, clinical and endocrinologic findings showed transient thyrotoxicosis. There was no immunologic finding compatible with Graves' disease and chronic thyroiditis. After PTX, radioisotope accumulation markedly decreased on 99mTcO4− thyroid gland scintigram and blood flow diminished on thyroid gland ultrasonogram. These findings absolutely recovered with the resolution of thyrotoxicosis within 1 month. It appears that disturbance of the microcirculation in the thyroid gland by manipulation during operation might be a cause of transient thyrotoxicosis after PTX. It is important to consider transient thyrotoxicosis as a complication of PTX in secondary hyperparathyroidism