Notes

Killer-cell immunoglobulin-like receptor genotype and also haplotype mixtures in kids treated for acute lymphoblastic leukemia.
9; P = 0.25), incidence of re-bleeding during the 45-day follow-up (13 vs. 14; P = 0.84), need for endoscopic banding for varices (37/112 vs. 39/112, P = 0.99), mean hospital stay (days) (3.21 ± 2.78 vs. 2.73 ± 1.29; P = 0.10) were similar between the two groups.

Restrictive transfusion strategy is non-inferior to liberal transfusion strategy in patients with UGIB.
Restrictive transfusion strategy is non-inferior to liberal transfusion strategy in patients with UGIB.Rhabdomyolysis is a potentially life-threatening syndrome that causes acute kidney injury. Association of acute myeloid leukemia (AML) and myoglobin induced acute tubular necrosis (ATN) is rarely reported in the literature. Here, we report a young male who was admitted with fever of unknown origin. Diagnosed to have AML with renal failure and subsequently succumbed to illness, whose post mortem renal biopsy confirmed myoglobin induced ATN.Pellagra usually results from niacin deficiency and presents with the classic triad of dermatitis, diarrhea, and dementia. It is most commonly associated with malnutrition and poverty. We report a case of pellagra in a hemodialysis (HD) patient with breast neoplasia, aged 68-years, female, on HD unit for seven years. Her original nephropathy was indeterminate. The patient was followed up for homozygous beta-thalassemia and breast neoplasia with hepatic metastases on chemotherapy. The body mass index of the patient was 18.5 kg/m2. Physical examination showed a thickening of the epidermis with a scaly surface, pigmented, and atrophied areas. We noted neuropsychiatric signs (apathy, irritability, anorexia, and depression) and digestive symptomatology (diarrhea). The laboratory tests revealed hypoproteinemia at 55 g/L, hypoalbuminemia at 21 g/L, and hypocholesterolemia at 0.8 g/L. The diagnosis of pellagra disease was made. Vitamin and protein supplementation was initiated, but the patient committed suicide by puncture of her arteriovenous fistula, causing hemorrhagic shock. Pellagra is usually reported to be associated with malnutrition, chronic alcoholism, and some chemotherapeutic agents. In our patient, pellagra was caused by malnutrition and co-morbidities. Pellagra disease requires multidisciplinary care and can be frequently seen in HD patients due to the associated malnutrition.With the advent of potent immunosuppressive therapies, renal transplant recipients are more susceptible to a variety of infections with atypical pathogens and presentations. In the setting of many years post-renal transplant, weight loss may be due to occult systemic fungal infection and if left untreated it may evolve with multisystem involvement. We describe a case with significant weight loss who got admitted for the evaluation for post-transplant lympho- proliferative disorder. The 30-year-old male patient presented with weight loss eight years post- renal transplant and detailed evaluation revealed systemic fungal infection involving cutaneous, pulmonary, and hematopoietic systems.Epstein syndrome is characterized by sensorineural hearing impairment, macro- thrombocytopenia without neutrophil inclusion bodies, and hereditary nephritis which can progress to end-stage renal disease (ESRD) in adolescence. The prognosis of Epstein's syndrome depends on the severity of the hematological disorders and renal involvement that can lead to ESRD at an early age. Thrombocytopenia in Epstein syndrome is not an absolute contraindication for major surgical procedures like arteriovenous fistula formation or kidney transplantation. There are no set guidelines for preoperative prophylaxis in a patient with this pathology.Primary anti-phospholipid antibody (APLA) syndrome in males most commonly presents with clinical manifestations of venous thrombosis, thrombocytopenia, and pulmonary embolism. this website Although most present with acute symptoms following arterial thrombosis, diagnosis following evaluation for elevated renal function tests and hypertension is less common. We report here a case of a 22-year-old man who presented with acute nephritic syndrome following an acute febrile illness. He was detected to have altered renal function tests with serum creatinine of 1.6 mg/dL (141.4 μmol/L), microscopic hematuria, and proteinuria along with hypertension. His 24-h urine protein was 1700 g/day. He was planned for a kidney biopsy. Subsequent evaluations revealed an isolated elevation of activated partial thromboplastin time. Further evaluation revealed positive APLA syndrome. He underwent kidney biopsy later which showed mesangial hypercellularity with no involvement of the renal parenchymal vasculature. The reported case is an unusual presentation of primary APLA syndrome with acute nephritic syndrome.Sarcoidosis can present as acute kidney injury (AKI) due to granulomatous interstitial nephritis (GIN). AKI caused by sarcoid GIN without extra-renal manifestations is extremely rare. We report a case of a 42-year-old man with a history of unexplained weight loss admitted with progressively worsening kidney function. Physical examination did not show any abnormality. Laboratory investigations were normal except for high calcium level with no evidence of organ involvement of sarcoidosis. A renal biopsy showed GIN with non-caseating granulomata. Prednisolone was initiated and renal function improved. This is a case of an extremely rare AKI caused by sarcoid GIN without extra-renal manifestations which responded to prednisolone.In this part of world, nephrology data lack as there is no renal registry, and nephrology is still in its primitive stage. Multan Institute of kidney diseases started tertiary care renal services. We carried out an analysis of our renal biopsies performed here from August 2017 to May 2019. This was carried out to see the spectrum of renal diseases in this area. This is a retrospective analysis of renal biopsies performed at the Multan Institute of Kidney Diseases from August 2017 to May 2019. Renal biopsy was performed using real-time ultrasound. One hundred and seventy-five native renal biopsies were performed during this study period. One hundred and three male (59%) and 72 female (41%) patients underwent renal biopsy. The average age was 36 years, with a range of 16-70 years. Results from our study showed membranous glomerulo- nephritis (36%) as a leading cause of primary glomerular disease in this region. Lupus nephritis (30.3%) was a leading cause in secondary glomerular disease. Reviewing our study and published literature it's pellucid that lupus nephritis is a leading cause of secondary glomerulonephritis worldwide.
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