C4d deposition in the peritubular capillaries of native renal biopsies.
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Biopsy↗
Biomedical subjects
E Lerut
Publications and source records attributed to E Lerut.
Benefit of anti-TNFalpha treatment for nephrotic syndrome in a patient with juvenile inflammatory bowel disease associated spondyloarthropathy complicated with amyloidosis and glomerulonephritis.
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Adult↗
beta 2 M-amyloidosis and gastrointestinal bleeding after renal transplantation.
Dialysis-related amyloidosis is a disorder that commonly develops in long-term dialysis with an incidence that is linked to the duration of hemodialysis. The amyloid deposits are composed of the amyloid precursor beta 2 microglobulin, mainly affecting the osteoarticular system, but also involving extra-osteoarticular tissues. We present a patient with repeated rectal bleeding caused by a circumferential atone ulcer in the immediate posttransplantation period due to the use of a rectal canula after 27 years of treatment with hemodialysis. Histopathological examination of the rectal ulcer biopsy specimens revealed positive Congo red stain and additional immunohistochemical investigation showed the presence of beta 2-microglobulin in a blood vessel wall of the rectum. Although dialysis related amyloidosis may be partially prevented, it is important to remain alert for dialysis related amyloidosis complications after renal transplantation in patients with a longstanding history of dialysis.
Amyloidosis↗
Alkaline encrusted pyelitis.
Alkaline encrusted pyelitis is an infectious disease characterised by encrustations in the wall of the upper urinary tract, surrounded by severe inflammation. Destruction of native kidneys and kidney grafts may occur, resulting in end stage renal failure. Corynebacterium group D2, an urea splitting microorganism, is nearly exclusively associated with this disease. The most important predisposing factors are previous urological procedures and an immunosuppressed state. In a suggestive clinical context, diagnosis should be made with unenhanced computed tomography findings and bacteriologic isolation of the responsible microorganism. The treatment is threefold: appropriate antibiotic therapy, by preference with glycopeptides, acidification of urine and chemolysis, and if needed, surgical removal of encrustations. We report the case of a patient who was diagnosed with this rare condition and could escape maintenance dialysis after correct diagnosis was made and conservative treatment was started using antibiotics and combined oral and local acidification.
Aged↗