The Experts below are selected from a list of 267 Experts worldwide ranked by ideXlab platform
Samuel Navarro - One of the best experts on this subject based on the ideXlab platform.
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renal Malakoplakia as a pseudotumoral lesion in a renal transplant patient a case report
International Journal of Urology, 2007Co-Authors: Isidro Machado Puerto, Julia Cruz Mojarrieta, Israel Borrajero Martinez, Samuel NavarroAbstract:Malakoplakia is a rare chronic inflammatory disease associated with gram-negative bacterial infections frequently caused by Escherichia coli. Malakoplakia usually affects the lower urinary tract (bladder) but there are cases described in the kidney as well as in the respiratory and digestive organs. We report on a case with renal parenchymal Malakoplakia in a renal transplant patient and describe the pathological lesions of Malakoplakia: histiocytic proliferation with scarce inflammatory infiltrate, histiocytes with acidophilic cytoplasm and the presence of characteristic Michaelis-Gutmann bodies. The authors in this study review the updated reports related to the entity in this uncommon localization, the association with an immunocompromised patient, the macroscopic presentation as a pseudotumoral lesion and the possible relationship with the xanthogranulomatous pyelonephritis as a form of a histopathological spectrum in patients affected with gram negative urinary tract infection.
Hemant Kulkarni - One of the best experts on this subject based on the ideXlab platform.
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successful treatment of renal allograft and bladder Malakoplakia with minimization of immunosuppression and prolonged antibiotic therapy
Nephrology, 2014Co-Authors: Angela L Graves, Michael Texler, Laurens Manning, Hemant KulkarniAbstract:Malakoplakia is an unusual granulomatous inflammatory disorder associated with diminished bactericidal action of leucocytes that occurs in immunosuppressed hosts. Cases of renal allograft Malakoplakia are generally associated with a poor graft and patient survival. We present the case of a 56-year-old female with allograft and bladder Malakoplakia occurring two years after renal transplantation complicated by an early antibody mediated rejection. Following a number of symptomatic urinary tract infections caused by resistant Gram-negative bacilli, a diagnosis of Malakoplakia was made by biopsy of a new mass lesion of the renal allograft. Cystoscopy also revealed Malakoplakia of the bladder wall. Immunosuppressant regimen was modified. Mycophenolate mofetil was ceased, prednisolone reduced to 5 mg/day and tacrolimus concentrations were carefully monitored to maintain trough serum concentrations of 2–4 μg/L. Concurrently, she received a prolonged course of intravenous antibiotics followed by 13 months of dual oral antibiotic therapy with fosfomycin and faropenem. This joint approach resulted in almost complete resolution of allograft Malakoplakia lesions and sustained regression of bladder lesions on cystoscopy with histological resolution in bladder lesions. Her renal function has remained stable throughout the illness. If treated with sustained antimicrobial therapy and reduction of immunosuppression, cases of allograft Malakoplakia may not necessarily be associated with poor graft survival.
M G Coulthard - One of the best experts on this subject based on the ideXlab platform.
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end stage renal disease due to bilateral renal Malakoplakia
Archives of Disease in Childhood, 2004Co-Authors: S Hegde, M G CoulthardAbstract:Malakoplakia typically affects the bladders of immunocompromised adults who have defective intracellular killing of Escherichia coli . Renal Malakoplakia is rare in children and generally has a good outcome. In the case presented, however, it caused end stage renal failure in a 5 year old girl. The management dilemmas surrounding renal transplantation are highlighted.
Richard H. R. White - One of the best experts on this subject based on the ideXlab platform.
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Renal parenchymal Malakoplakia —a case report and review of the literature
Pediatric Nephrology, 1993Co-Authors: Moin A. Saleem, David V. Milford, Faro Raafat, Richard H. R. WhiteAbstract:Malakoplakia is an inflammatory condition associated with persisting bacterial antigen in macrophages and characterised histologically by the Michaelis-Gutmann body, containing bacterial fragments. We review the pathogenesis of Malakoplakia and report a novel form of treatment successfully used in an 8-week-old infant with bilateral renal Malakoplakia. The patient presented with an acute Escherichia coli urinary tract infection and enlarged kidneys. Antibiotic regimes were ineffective, but once the diagnosis was made treatment was changed to an immunosuppressive regime of prednisolone and azathioprine, to which she responded promptly. Renal Malakoplakia should be considered in any patient with a urinary tract infection unresponsive to antibiotics and enlarged kidneys. Although a large proportion of patients with Malakoplakia have an underlying systemic disorder, which may account for their abnormal macrophage function, the rest demonstrate either an isolated macrophage defect or no detectable anomaly at all. It is in this latter group we suggest that an immunomodulating regime can be curative.
L C Pierrotti - One of the best experts on this subject based on the ideXlab platform.
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Malakoplakia after renal transplantation in the current era of immunosuppressive therapy case report and literature review
Transplant Infectious Disease, 2012Co-Authors: C A Leao, Maria Irma Seixas Duarte, C Gamba, Jessica Fernandes Ramos, Flavia Rossi, M M Galvao, Elias Davidneto, W C Nahas, Maria Aparecida Shikanaiyasuda, L C PierrottiAbstract:: Malakoplakia is a rare chronic granulomatous disease of unknown cause. It is thought to be caused by an acquired bactericidal defect of macrophages. Malakoplakia is associated with chronic infections and immunosuppression. Although it occurs mainly in the urinary tract, it has already been reported in almost every organ system. The isolation of bacteria, especially Escherichia coli, is common in Malakoplakia patients. Here, we present a case of primary cutaneous Malakoplakia in a kidney transplant recipient who had been taking prednisone, tacrolimus, and mycophenolate. Culture of a lesion grew Burkholderia cepacia complex. Treatment with high doses of trimethoprim-sulfamethoxazole was successful. We also present a systematic review of the literature, identifying 4 previously reported cases of Malakoplakia after renal transplantation under similar immunosuppressive therapy, most occurring in the urinary tract or perineum and following benign courses to cure. Data in the literature suggest that Malakoplakia has become even rarer since changes were made in the immunosuppressive therapy employed after kidney transplantation.
