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Biocompatibility in hemodialysis: artificial membrane and human blood interactions.

Hemodialysis, a cornerstone therapy for chronic kidney disease, represented a crucial advance in the evolution of artificial organs. While its success is largely due to its efficiency in removing uremic toxins, an equally important challenge is to uphold the primum non nocere principle by minimizing the harmful effects of membrane-blood interactions. This review examines the complex mechanisms and key interactions underlying membrane biocompatibility, including complement activation, inflammation, and coagulation disturbances, paving the way for their clinical implications. We also summarize r

Influenza A H1N1 Triggering Complement-Mediated Hemolytic Uremic Syndrome.

Complement-mediated hemolytic uremic syndrome (CM-HUS) is a condition characterized by hemolytic anemia, thrombocytopenia, and renal impairment, typically associated with a chronic dysregulation of the complement system. Few adult cases of CM-HUS triggered by influenza infection have been described. Here we present a case of a 56-year-old female with multiple myeloma receiving cancer treatment who presented with Influenza A H1N1-associated CM-HUS. She was treated with anti-complement therapy and at her 1-month follow-up had complete resolution of renal dysfunction and hemolytic anemia. This ca

Флюидные биомаркеры в демиелионирующих синдромах: прошлое, настоящее и перспективы.

По-прежнему продолжается работа над диагностическим алгоритмом демиелионирующих расстройств центральной нервной системы, а также поиск идеальных биомаркеров. Так называемый "идеальный" биомаркер должен обеспечивать точное различие между наиболее распространенными демиелионирующими патологиями ЦНС и подтипами одной и той же патологии (например, переход от релапсирующего многоразового склероза к вторичному прогрессивному фенотипу). Достижения в области технологии способствовали проведению этого исследования, и в нижеследующих разделах мы всесторонне проанализируем большинство из них, охарактериз

A prognostic model for patients with primary extramedullary multiple myeloma.

Background: Extramedullary disease is a manifestation of multiple myeloma, the prognosis of which remains poor even in the era of novel drugs. Therefore, we aimed to develop a predictive model for patients with primary extramedullary multiple myeloma (EMM). Methods: Clinical and laboratory data of patients diagnosed with primary EMM between July 2007 and July 2021 were collected and analyzed. Univariate and least absolute shrinkage and selection operation Cox regression analyses (LASSO) were used to select prognostic factors for overall survival (OS) to establish a nomogram prognostic model. T

Chronic recurrent wheals - If not chronic spontaneous urticaria, what else?

Chronic urticarial rash, mostly due to chronic spontaneous urticaria (CSU), is seen in up to 1 - 4% of the general population. Urticarial vasculitis (UV) and autoinflammatory syndromes, i.e., cryopyrin-associated periodic syndromes (CAPS) and Schnitzler syndrome (SchS), can mimic CSU-like rash but represent rare disorders with systemic symptoms including fever, headache, conjunctivitis, and arthralgia. Clinical and laboratory features can point to the presence of any of these diseases in patients initially presenting with chronic urticarial rash. These include long-lasting wheals (> 24 hours),

Thrombotic microangiopathy in untreated myeloma patients receiving carfilzomib, cyclophosphamide and dexamethasone on the CARDAMON study.

Proteasome inhibitors have been associated with thrombotic microangiopathy (TMA) - a group of disorders characterised by occlusive microvascular thrombosis causing microangiopathic haemolytic anaemia, thrombocytopenia and end-organ damage. To date, carfilzomib-associated TMA has predominantly been described in relapsed/refractory myeloma patients. We report eight patients with newly diagnosed myeloma who experienced TMA events while receiving carfilzomib on the phase II CARDAMON trial. The first three occurred during maintenance single-agent carfilzomib, two occurred at induction with carfilzo

An Updated Comprehensive Review on Diseases Associated with Nephrotic Syndromes.

There have been exciting advances in our knowledge of primary glomerular diseases and nephrotic syndromes in recent years. Beyond the histological pattern from renal biopsy, more precise phenotyping of the diseases and the use of modern nephrogenetics helps to improve treatment decisions and sometimes also avoid unnecessary exposure to potentially toxic immunosuppression. New biomarkers have led to easier and more accurate diagnoses and more targeted therapeutic decisions. The treatment landscape is becoming wider with a pipeline of promising new therapeutic agents with more sophisticated appr

Amyloidosis in the Context of Renal Cell Carcinoma: A Case Report and Literature Review.

This case study details an 86-year-old male with a history of hypertension, dyslipidemia, and bilateral blindness, who presented with recurrent vomiting and a progressive proteinuric acute kidney injury. Initial evaluations revealed nephrotic syndrome and acute kidney injury, alongside imaging findings consistent with a renal mass, later confirmed as grade 3 clear renal cell carcinoma (RCC) upon biopsy. Concurrently, systemic amyloid A (AA) amyloidosis was diagnosed based on the result of the kidney biopsy. Despite multidisciplinary management, the patient's renal function progressively deteri

Rare complication of a commonly used antihypertensive agent: A case of hydralazine-induced ANCA-associated vasculitis presenting as rapidly progressive glomerulonephritis.

Hydralazine-induced ANCA-associated vasculitis is a rare clinical entity, with complications including rapidly progressive glomerulonephritis, pulmonary hemorrhage, and pulmonary-renal syndrome. We present this case to highlight the clinical features that support this challenging diagnosis and to emphasize the importance of prompt recognition and aggressive intervention given its significant morbidity and mortality.

Rapid Recognition of Carfilzomib-Induced Thrombotic Microangiopathy and Early Application of Eculizumab Successfully Rescued Two Relapsed Myeloma Patients.

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… Complement C3 levels were within the reference range (0.76–0.93 g/L), whereas complement C4 decreased to a nadir of 0.05 g/L. Factor H (FH) and its autoantibodies were both within normal limits. … Complement C3 levels decreased from 1.81 g/L to 0.64 g/L (normal range: 0.76–0.93 g/L), as well as complement C4 reaching a minimum of 0.08 g/L. Other tests included FH at 231.05 ng/mL (reference range: 246.60–417.69 ng/mL) and Factor I at 10 ng/mL (reference range: 12.26–333.02 ng/mL). …

Carfilzomib Induced Microangiopathy due to Accumulation With Paxlovid.

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Carfilzomib-Induced Thrombotic Microangiopathy: A Case Report on a Rare Complication.

Thrombotic microangiopathy (TMA) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ injury due to microvascular thrombosis. Drug-induced TMA is a recognized subtype, but its diagnosis is challenging due to the absence of specific laboratory tests to identify the agent. Many chemotherapeutic agents are associated with TMA. Carfilzomib is a newer chemotherapeutic agent and is an uncommon cause of TMA. We report the case of a 71-year-old female patient undergoing treatment with carfilzomib for refractory multiple myeloma who developed suspected carfilzomib-induced

The potential of FCRL genes as targets for cancer treatment: insights from bioinformatics and immunology.

Cancer is a prevalent and dangerous disease that requires a multifaceted approach to treatment. The FCRL family gene has been linked to immune function and tumor progression. Bioinformatics may help unravel their role in cancer treatment. We conducted a comprehensive analysis of the FCRL family genes in pan-cancer using publicly available databases and online tools. Specifically, we examined gene expression, prognostic significance, mutation profiles, drug resistance, as well as biological and immunomodulatory roles. Our data were sourced from The Cancer Genome Atlas, Genotype-Tissue Expressio

Safety and efficacy of low-dose intravenous arsenic trioxide in systemic lupus erythematosus: an open-label phase IIa trial (Lupsenic).

BackgroundLupus animal model has shown that arsenic trioxide (ATO), a treatment of acute promyelocytic leukaemia, could be effective in SLE. This is the first clinical study to determine the safety and efficacy of a short course of intravenous ATO in patients with active SLE.MethodsThis phase IIa, open-label, dose-escalating study enrolled 11 adult SLE patients with a non-organ threatening disease, clinically active despite conventional therapy. Patients received 10 IV infusions of ATO within 24 days. The first group received 0.10 mg/kg per injection, with dose-escalating to 0.15 mg/kg in a se

Clinicopathologic Features of Antibrush Border Antibody Disease.

IntroductionAntibrush border antibody disease (ABBA) is an autoimmune tubulointerstitial kidney disease that primarily affects older individuals and results in progressive kidney failure. It is rare with only 20 reported cases. Here, we describe a case series to further define the clinicopathologic spectrum and natural history, and to inform management.MethodsWe identified 67 patients with ABBA who underwent kidney biopsy, including 65 native and 2 transplants. Demographics, clinical findings, and laboratory data were obtained. Histopathologic data included light microscopy, immunofluorescence

Необычный Строук-Вроде Презентации Множественного Склероза в 27-летнем человеке.

Трубоактивный множественный склероз (TMS) является редким подтипом множественного склероза с различными клиническими представлениями, что часто приводит к задержкам с диагностикой и началом лечения. В ходе исследования она имеет большое (>2 см) демиелинирующее массово похожее повреждение и может сопровождаться кольцевым улучшением, опасным отёком и массовым эффектом. Мы сообщаем о случае с 27-летним мужчиной, у которого была правая слабость и онемение. Год назад он выступил с аналогичной презентацией без окончательного диагноза. Вычисленная томография (CT) мозга выявила многочисленные двусторо

Cryoglobulinemia: An update on classification, pathophysiology, clinical presentation, and management.

Cryoglobulinemia (CG) is defined by the presence of serum immunoglobulins that precipitate below 37°C and redissolve upon rewarming. It is classified into three types based on immunoglobulin composition. Type I, a rare form, involves monoclonal IgM or IgG and is linked to lymphoproliferative disorders. Types II and III are known as mixed CG (MC): Type II consists of polyclonal IgG and monoclonal IgM with rheumatoid factor (RF) activity, whereas Type III includes polyclonal IgG and polyclonal IgM with RF activity. MC is predominantly associated with hepatitis C virus (HCV) infection and involve

Переход на Ublituximab из предыдущих anti-CD20 моноклонная антителная терапия: серия отчетов.

ВВЕДЕНИЕ: Anti-CD20 Моноклональные антитела (mAb) методы лечения множественных склерозов (MS) различаются в молекулярных структурах, распознавании эпитопов и механизмах CD20-positive (CD20+) клеточный лизис, который может повлиять на клиническую эффективность и терпимость и поддержку в рамках класса для пациентов с неоптимальной реакцией на предыдущий anti-CD20 Мэб. И МЕТОДЫ: Это серия ретроспективных дел 7 :: лица с псевдонимами, лечащимися в частной практике или в клинике, которая перешла на ublituximab из другой anti-CD20 mAb-терапия по соображениям эффективности или терпимости.ОПИСАНИЕ СЛУ

Idiopathic Fibrillary Glomerulonephritis: A Case Report Highlighting Diagnostic and Management Challenges.

Fibrillary glomerulonephritis (FGN) is a rare glomerular disease characterized by non-branching fibrils within the glomerular basement membrane, often leading to progressive renal dysfunction. Despite advances in diagnostic methods, including DNA-J heat shock protein family member B9 (DNAJB9) immunostaining, the pathogenesis and optimal treatment strategies remain poorly defined. We present the case of a 55-year-old woman with longstanding microscopic hematuria and subnephrotic proteinuria who was diagnosed with idiopathic fibrillary glomerulonephritis (IFGN) following a renal biopsy. Histopat

Характеристика воздействия генетической ответственности на аутоиммунные условия на результаты беременности с использованием менделийской случайности.

КОЛИЧЕСТВО: Аутоиммунные условия характерны для женщин репродуктивного возраста. Они связаны с повышенным риском неблагоприятных последствий беременности; неясно, является ли это причиной. Наша цель заключалась в изучении причинно-следственных последствий генетической ответственности для аутоиммунных заболеваний с точки зрения последствий беременности. МЕТОДЫ: Мы проводили two- выборка менделийской случайности (MR) для оценки воздействия генетической ответственности на ten Аутоиммунные условия на nine начальное и начальное seven последствия вторичной беременности. Мы использовали данные, получ

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… Increased varicella zoster virus antibodies Reduced complement C4 and factor B, increased complement C2 Reduced BMI Increased aspartate aminotransferase. Increased glomerular disorders. Reduced bilirubin Increased SHBG levels No evidence for causal effects of BMI on preterm birth [ 60 ]. … Increased varicella zoster virus antibodies Reduced complement C4 and factor B, increased complement C2 Reduced BMI Increased aspartate aminotransferase. Increased glomerular disorders. …