Ertapenem Related Neurotoxicity Presented with Visual Halusinations in Chronic Kidney Failure Patient

During the follow-up of patients with renal failure, many medications may be required due to the clinical condition and comorbidities. Care should be taken in terms of the nephrotoxic effect of these drugs used or the accumulation of renally excreted drugs in the body and causing toxic effects. One of the most important side effects of carbapenems is neurotoxicity. Although Imipenem is the most frequently mentioned in this respect, similar side effects can be seen due to other carbapenems. Even if the dose is adjusted according to the glomerular filtration rate, these side effects can be seen. When the literature is examined, it has been determined that neurotoxicity due to ertapenem is seen more frequently than expected. In this study, we wanted to draw attention to this issue by presenting our case of visual hallucination observed after the use of ertapenem in a patient with chronic renal failure

Mannose Binding Lectin Deficiency and Clinical Features

Innate immunity consists of macrophages, neutrophils, natural killer cells, mucosal immunuglobulins and the comlement system. Mannose binding lectin (MBL) takes part in innate immunity through opsonisation and complement activation. MBL deficiency is associated with some infections and autoimmune disorders. However some studies indicate that MBL deficiency alone is not essential for immunity but it may intensify the clinic picture of an immune deficiency that already exists. This article refers to clincal studies related to MBL and brings up the clinical importance of MBL deficiency. [Archives Medical Review Journal 2013; 22(4.000): 565-574

Watershed Cerebral Infarction in a Patient with Acute Renal Failure

Acute renal failure can cause neurologic manifestations such as mood swings, impaired concentration, tremor, stupor, coma, asterixis, dysarthria. Those findings can also be a sign of cerebral infarct. Here, we report a case of watershed cerebral infarction in a 70-year-old female patient with acute renal failure secondary to contrast administration and use of angiotensin converting enzyme inhibitor. Patient was evaluated with magnetic resonance imaging because of dysarthria. Magnetic resonance imaging revealed milimmetric acute ischemic lesion in the frontal and parietal deep white matter region of both cerebral hemisphere which clearly demonstrated watershed cerebral infarction affecting internal border zone. Her renal function returned to normal levels on fifth day of admission (BUN 32 mg/dl, creatinine 1.36 mg/dl) and she was discharged. Dysarthria continued for 20 days

MANNOSE BINDING LECTIN (MBL) GENE POLYMORPHISMS AND THEIR RELATIONS WITH CLINICAL FEATURES IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER (FMF)

WOS: 000424419500001Objective: Mannose-binding lectin (MBL), which takes part in the lectin pathway of the complement system as a component of innate immunity, is activated by the stimulation of various bacterial lectins. It is known that some of the MBL gene polymorphisms (eg, codon 52, codon 54) that may lead to alterations in MBL serum levels are responsible for the susceptibility to infectious diseases and contribute to the pathogenesis of various autoimmune and inflammatory diseases. In this study, we planned to investigate the frequencies of codon 52 and codon 54 polymorphisms of the MBL gene in FMF patients and their association with the clinical features of the disease. Materials and Methods: MBL gene polymorphisms of the R52C C>T and G54D G>A were investigated by sequencing in 157 FMF patients and 150 unrelated healthy controls. MEFV gene mutations in FMF patients were investigated by sequencing method. The clinical characteristics of the patients and the C-reactive protein (CRP) values in attack-free phase were recorded. Statistical analysis of the findings was performed with the SPSS version 18.0. Results: The MBL gene R52C C>T polymorphism was detected in 12.7% of the patients and 10.6% of the controls. G54D G>A polymorphism was detected in 26.7% of the patients and 26.6% of the controls. There was no significant difference between the two groups (p=0.794). No significant correlations between MBL gene polymorphisms and various clinical characteristics of patients (amyloidosis, fever, colchicine response) were found. Mean CRP level of the FMF patients was 4.90 +/- 6.72 mg/dL. In FMF patients with elevated serum CRP levels (>0.8 mg/L), codon 54 MBL polymorphism frequency was 14.8%, codon 52 polymorphism frequency was 25.2%. Codon 52 and codon 54 polymorphism frequencies were not different between the groups according to CRP level (p>0.05). In FMF patients, significant correlations were found between M694V and amyloidosis (p=0.002) as well as between M694I and colchicine resistance (p=0.016). Conclusion: The absence of a relationship between MBL polymorphisms and high CRP levels in attack-free phase of FMF patients suggests that the proinflammatory state in some FMF patients is not related to MBL mediated mechanisms. In our cases, the significant relationship between M694I and colchicine resistance is remarkable. Our finding of the significant relationship between M694V and amyloidosis is consistent with previous literature and demonstrating the importance of M694V in disease severity and prognosis

IL-33 AND ST2 LEVELS IN CHRONIC KIDNEY DISEASE: ASSOCIATIONS WITH INFLAMMATION, VASCULAR ABNORMALITIES, CARDIOVASCULAR EVENTS AND SURVIVAL

WOS: 000469797100395

KILLER CELL IMMUNOGLOBULIN LIKE RECEPTOR GENOTYPE DISTRIBUTION IN FAMILIAL MEDITERRANEAN FEVER: NO ASSOCIATION WITH DISEASE PHENOTYPE AND RENAL AMYLOIDOSIS

52nd Congress of the European-Renal-Association-European-Dialysis-and-Transplant-Assocation -- MAY 28-31, 2015 -- London, ENGLANDWOS: 000361215101452…European Renal Assoc, European Dialysis & Transplant Asso

Assessment of myocardial repolarisation parameters in patients with familial Mediterranean fever

Background: Familial Mediterranean fever (FMF) is a chronic, recurrent auto-inflammatory disease characterised by self-terminating attacks of fever and sterile polyserositis. The main cause of death in auto-inflammatory diseases is cardiovascular events. Additionally, auto-inflammatory diseases have potential effects on the myocardial repolarisation parameters, including the T-wave peak-to-end (Tp-Te) interval, cTp-Te interval (corrected Tp-Te) and the cTp-Te/QT ratio. The aim of this study was to analyse the efficacy of myocardial repolarisation alterations in anticipation of cardiovascular risks in patients with FMF

IL-33 and ST2 levels in chronic kidney disease: Associations with inflammation, vascular abnormalities, cardiovascular events, and survival.

Increased inflammation, associated with the increase in chronic kidney disease (CKD) stage, has a very important influence in vascular injury and cardiovascular diseases. In this study, we aimed to investigate the levels of IL-33 and ST2 in the different stages of CKD and to determine their effect on vascular damage and cardiovascular events (CVE).This was an observational cohort study in which serum IL-33 and ST2 were obtained from 238 CKD (stages 1-5) patients. We examined the changes in IL-33/ST2 levels in CKD patients, as well as the association with a surrogate of endothelial dysfunction. Fatal and non-fatal CVE were recorded for a mean of 24 months. We also performed a COX regression analysis to determine the association of IL-33/ST2 levels with CVE and survival.IL-33 and ST2 levels were significantly increased and estimated glomerular filtration rates (eGFR) were decreased. Flow-mediated dilatation (FMD) was significantly decreased from stage 1 to stage 5 CKD. IL-33 and ST2 levels were associated with FMD, and ST2 was a predictor. Multivariate Cox analysis showed that the presence of diabetes mellitus, smoking, and proteinuria and haemoglobin, Hs-CRP, IL-33, and ST2 were associated with the risk of CVE. Kaplan-Meier survival curves showed that patients with IL-33 and ST2 levels below the median value (IL-33 = 132.6 ng/L, ST2 = 382.9 pg/mL) had a higher cumulative survival compared with patients who had IL-33 and ST2 levels above the median value (log-rank test, p = 0.000).This is the first study that demonstrates that serum IL-33 and ST2 are associated with vascular injury, cardiovascular events, and survival in CKD patients