A case of primary hypoparathyroidism presenting with acute kidney injury secondary to rhabdomyolysis

Hypoparathyroidism is the most common cause of symmetric calcification of the basal ganglia. Herein, a case of primary hypoparathyroidism with severe tetany, rhabdomyolysis, and acute kidney injury is presented. A 26-year-old male was admitted to the emergency clinic with leg pain and cramps, nausea, vomiting, and decreased amount of urine. He had been treated for epilepsy for the last 10 years. He was admitted to the emergency department for leg pain, cramping in the hands and legs, and agitation multiple times within the last six months. He was prescribed antidepressant and antipsychotic medications. He had a blood pressure of 150/90 mmHg, diffuse abdominal tenderness, and abdominal muscle rigidity on physical examination. Pathological laboratory findings were as follows: creatinine, 7.5 mg/dL, calcium, 3.7 mg/dL, alanine transaminase, 4349 U/L, aspartate transaminase, 5237 U/L, creatine phosphokinase, 262.000 U/L, and parathyroid hormone, 0 pg/mL.There were bilateral symmetrical calcifications in basal ganglia and the cerebellum on computerized tomography. He was diagnosed as primary hypoparathyroidism and acute kidney injury secondary to severe rhabdomyolysis. Brain calcifications, although rare, should be considered in dealing with patients with neurological symptoms, symmetrical cranial calcifications, and calcium metabolism abnormalities

Diagnosing latent tuberculosis in immunocompromised patients measuring blood IP-10 production capacity: An analysis of chronic renal faulire patients

WOS: 000451979404061Objective Patients undergoing haemodialysis for chronic renal failure-hemodialysis (CRF-HD) are at risk of latent tuberculosis infection (LTBI). The effectiveness of using blood IP-10 production capacity to diagnose LTBI in CRF-HD patients was analysed. Methods The study enrolled 50 CRF-HD patients. Interferon-γ release assay (IGRA) was done using QuantiFERON-TB Gold In Tube (QFG-IT) system. Blood IP-10 production capacity was measured using the QFG-IT system tubes. Tuberculin skin testing (TST) was performed on the same day and the test results were compared. Results TST turned out to be positive in 36.4% of the patients and QFG-IT in 54% of them. After stimulation with specific tuberculosis antigens, blood IP-10 levels increased noticeably. The antigen-stimulated blood IP-10 level was significantly higher in patients who were either TST or QFG-IT positive than in patients whose tests were negative (p=0.0001). Using 4.02 pg/mL as the threshold for stimulated blood logtransformed IP-10 level, good agreement was observed between IP-10 and QFG-IT results (κ=1). Conclusion Blood IP-10 level, which can be measured simply, provides results equivalent to IGRAs for the diagnosis of LTBI in CRF-HD patients

Otoimm�N Troid Hastal�K Ve B�Brek Yetmezli��i İLe Seyreden ÇöLiyak Hastal����

Celiac disease (CD) may coexist with another autoimmune disorders. We presented a woman with coeliac disease coexistent with autoimmune hypothyroidism, nephrosclerosis and severe hyperparathyroidism. Forty years-old hypertensive woman, who had diarrhea without tenesmus, blood and mucus for 20 years, was admitted to hospital. Parathyroid hormone level was very high. Creatinine clearance was 44.5 ml/minute, and protein was 596mg/day. Renal biopsy revealed immunofluorescence negative chronic changes mimicking nephrosclerosis. The clinical and biochemical presentation of CD maybe complicated or differed from in renal failure patient. Especially management of serum phosphorus and PTH levels may have great importance.Çöliyak hastalığı (ÇH) başka otoimmün hastalıklarla birlikte olabilir. Burada, ÇH ile birlikte otoimmün hipotiroidizm, nefroskleroz ve ciddi hipoparatiroidizmin birlikte olduğu bir kadın hasta sunulmuştur. Kırk yaşında kadın hasta, 20 yıldır süren tenezmin eşlik etmediği, kansız, mukussuz ishal nedeniyle hastaneye yatırıldı. Parathormon düzeyi çok yüksek idi. Kreatinin klirensi 44.5ml/dakika, proteinüri 596mg/gün idi. Böbrek biyopsisinde, nefroskleroz ile uyumlu immunofloresan negatif kronik değişiklikler saptandı. ÇH’nin klinik ve biyoşimik bulguları, renal yetersizlikli hastalarda komplike veya farklı olabilir. Özellikle serum fosfor ve parathormon düzeylerinin yönetimi büyük öneme sahiptir

Acute Renal Failure due to Leukaemic Infiltration in Chronic Lymphocytic Leukaemia

Chronic lymphocytic leukemia (CLL) is a malignancy characterized by clonal proliferation and accumulation of B lymphocytes. Although leukaemic infiltration of the kidney is well recognized in CLL, acute renal failure (ARF) due to leukaemic infiltration is extremely rare. Here we present a case of ARF as the initial manifestation of CLL. The diagnosis was made by a kidney biopsy. Treatment with cyclophosphamide and prednisolone resulted in a completely improved renal function

Otozomal dominant polikistik böbrek hastalığında ürogenital kistlerin semen parametreleri üzerine etkisi var mı ?

WOS: 000374928100006OBJECTIVE: Autosomal dominant polycystic kidney disease (ADPKD) is a systemic disease with cysts in many organs including the urogenital tract. The aim of the study was to evaluate the relationship between urogenital cysts, semen pathologies and infertility in ADPKD. MATERIAL and METHODS: Male ADPKD patients aged 18-60 with creatinine clearance years higher than 60 ml/min were included. All patients had magnetic resonance imaging of the urinary system and pelvis, scrotal Doppler ultrasonography and sperm analysis. The results were compared with those of a healthy control group. RESULTS: 27 patients and 17 volunteers were included. Seminal vesicle and prostate cysts were detected in four (15%) and six (22%) patients, respectively. Five of the 23 married patients (21%) had infertility and this rate was higher than in the control group (p=0.044). The ratio of sperms with normal morphology and progressive motility was lower, and the rate of hypospermia, oligozoospermia, azospermia, asthenozoospermia and teratozoospermia were higher in the patient group. There was no significant difference between patients with/without urogenital cysts regarding seminal pathologies. CONCLUSION: Seminal abnormalities and infertility are more frequent in patients with ADPKD. Defects in spermatogenesis and sperm motility may be related to urogenital cysts as well as ciliary pathologies. There is a need for further studies evaluating the role of urogenital cysts in semen pathologies.AMAÇ: Otozomal dominant polikistik böbrek hastalığı (ODPBH) ürogenital sistemle birlikte birçok organda kist oluşumuna neden olabilen sistemik bir hastalıktır. Çalışmada, ODPBH olan bireylerde ürogenital kistler ile semen patolojileri ve infertilite ilişkisi değerlendirilmiştir. GEREÇ ve YÖNTEMLER: Çalışmaya 18-60 yaşları arasında, kreatinin klirensi 60 ml/dakika/1.73 m2’nin üzerinde, ODPBH olan erkekler dahil edildi. Tüm hastalara üriner sistem ve pelvik manyetik rezonans(MR) inceleme, skrotal Doppler ultrasonografi ve semen analizi yapıldı. Sonuçlar sağlıklı kontrol grubu ile karşılaştırıldı. BULGULAR: Yirmiyedi hasta ve 17 gönüllü çalışmaya dahil edildi. Seminal vezikül kisti 4(%15), prostat kisti 6 (%22) hastada tespit edildi. Kontrol grubundan daha sık olarak, evli olan 23 hastanın 5’inde (%21) infertilite mevcuttu (p=0.044). Normal morfolojili sperm oranları ve ileri motilite daha düşük, hipospermi, oligozoospermi, azospermi, asthenozoospermi ve teratozoospermi oranları hasta grubunda daha yüksekti. Ürogenital kisti olan/olmayan hastalarda semen patolojileri açısından anlamlı fark yoktu. SONUÇ: Seminal anormallikler ve infertilite ODPBH olanlarda daha sıktır. Spermatogenez ve sperm motilite defektleri siliar patolojiler gibi urogenital kistlerle ilişkili olabilir. Ürogenital kistlerin semen patolojilerindeki rolünü değerlendirmek için ileri çalışmalara ihtiyaç vardır

Evaluation of periodontal parameters in patients undergoing peritoneal dialysis or hemodialysis

OBJECTIVE: To analyze and compare periodontal parameters in chronic renal failure (CRF) patients undergoing peritoneal dialysis (PD) therapy with a group of patients on hemodialysis (HD) treatment and healthy controls (C)