The Experts below are selected from a list of 162 Experts worldwide ranked by ideXlab platform
Leslie Spry - One of the best experts on this subject based on the ideXlab platform.
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acute tubular necrosis associated with chromium picolinate containing dietary supplement
Annals of Pharmacotherapy, 2006Co-Authors: Sachin Wani, Celia Weskamp, Jeffrey Marple, Leslie SpryAbstract:OBJECTIVE: To report a case of acute tubular necrosis associated with the use of a chromium picolinate-containing dietary supplement. CASE SUMMARY: A 24-year-old white male who had been ingesting a dietary supplement (Arsenal X) for 2 weeks during his workout sessions developed acute renal failure. Radiologic investigation showed the presence of a solitary right kidney, and an open renal biopsy confirmed features of acute tubular necrosis. He developed significant renal impairment that required hemodialysis. He was also treated with plasmapheresis and steroids, as a diagnosis of Pulmonary-Renal Syndrome was entertained early in the disease course, which was subsequently ruled out. The patient ultimately recovered and, on outpatient visits, was noted to have normal renal function. DISCUSSION: The use of dietary supplements has become increasingly popular in the US, and these supplements are not subject to stringent premarketing testing or postmarketing surveillance. The main ingredients in the supplement discussed here were chromium picolinate, Sida cordifolia, synephrine, and guarana. An objective causality assessment using the Naranjo probability scale indicated a probable association between the use of this supplement and the development of acute renal failure in this patient. CONCLUSIONS: Current information regarding the beneficial effects of trivalent chromium is not very robust; therefore, use of this agent cannot be recommended at this time. This report serves as an important reminder to the public, as well as healthcare providers, of potential nephrotoxic reactions to dietary supplements.
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acute tubular necrosis associated with chromium picolinate containing dietary supplement
Annals of Pharmacotherapy, 2006Co-Authors: Sachin Wani, Celia Weskamp, Jeffrey Marple, Leslie SpryAbstract:Objective:To report a case of acute tubular necrosis associated with the use of a chromium picolinate–containing dietary supplement.Case Summary:A 24-year-old white male who had been ingesting a dietary supplement (Arsenal X) for 2 weeks during his workout sessions developed acute renal failure. Radiologic investigation showed the presence of a solitary right kidney, and an open renal biopsy confirmed features of acute tubular necrosis. He developed significant renal impairment that required hemodialysis. He was also treated with plasmapheresis and steroids, as a diagnosis of Pulmonary-Renal Syndrome was entertained early in the disease course, which was subsequently ruled out. The patient ultimately recovered and, on outpatient visits, was noted to have normal renal function.Discussion:The use of dietary supplements has become increasingly popular in the US, and these supplements are not subject to stringent premarketing testing or postmarketing surveillance. The main ingredients in the supplement discus...
Muhammad Adrish - One of the best experts on this subject based on the ideXlab platform.
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Pulmonary renal Syndrome: A case report of diffuse alveolar hemorrhage in association with ANCA negative pauci-immune glomerulonephritis.
Medicine, 2018Co-Authors: Lakshmi Saladi, Danial Shaikh, Muhammad Saad, Enny Cancio-rodriguez, Vivette D. D'agati, Boris Medvedovsky, Kalpana Uday, Muhammad AdrishAbstract:Rationale Pulmonary renal Syndrome (PRS) is a term most commonly used to describe a combination of glomerulonephritis and pulmonary hemorrhage as a manifestation of a multisystem autoimmune disease. It is usually associated with ANCA vasculitis and anti-GBM disease. Diffuse alveolar hemorrhage in a patient with ANCA and anti-GBM negative pauci-immune glomerulonephritis is rare and optimal management is unknown. Patient concerns An 85-year-old man with hypertension, diabetes mellitus, prostate cancer and recently diagnosed pauci-immune necrotizing glomerulonephritis presented to our emergency department with worsening dyspnea and pedal edema for several days. Clinical presentation and radiological studies were suggestive of fluid overload but he developed worsening respiratory failure despite hemodialysis. Diagnoses Bronchoscopy confirmed diffuse alveolar hemorrhage. ANCA and anti-GBM antibodies were negative. The patient was diagnosed with pulmonary renal Syndrome - diffuse alveolar hemorrhage in the setting of ANCA and anti-GBM negative pauci-immune glomerulonephritis. Interventions Patient was started on intravenous pulse steroids, cyclophosphamide and received seven sessions of plasmapheresis. Outcomes There was an improvement in patient's respiratory status and repeat bronchoscopy at the end of treatment did not show diffuse alveolar hemorrhage. Lessons Pauci-immune crescentic necrotizing glomerulonephritis is usually associated with the presence of ANCA, however, ANCA may be absent in 10% of these cases. Immunosuppression is the mainstay of treatment for ANCA and anti-GBM associated PRS. This case highlights the importance of immunosuppression and plasmapheresis in patients with ANCA negative vasculitis due to presence of unidentified serum antibodies. If left untreated, these patients can have a fulminant course with high mortality ranging from 25 to 50%.
Sachin Wani - One of the best experts on this subject based on the ideXlab platform.
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acute tubular necrosis associated with chromium picolinate containing dietary supplement
Annals of Pharmacotherapy, 2006Co-Authors: Sachin Wani, Celia Weskamp, Jeffrey Marple, Leslie SpryAbstract:OBJECTIVE: To report a case of acute tubular necrosis associated with the use of a chromium picolinate-containing dietary supplement. CASE SUMMARY: A 24-year-old white male who had been ingesting a dietary supplement (Arsenal X) for 2 weeks during his workout sessions developed acute renal failure. Radiologic investigation showed the presence of a solitary right kidney, and an open renal biopsy confirmed features of acute tubular necrosis. He developed significant renal impairment that required hemodialysis. He was also treated with plasmapheresis and steroids, as a diagnosis of Pulmonary-Renal Syndrome was entertained early in the disease course, which was subsequently ruled out. The patient ultimately recovered and, on outpatient visits, was noted to have normal renal function. DISCUSSION: The use of dietary supplements has become increasingly popular in the US, and these supplements are not subject to stringent premarketing testing or postmarketing surveillance. The main ingredients in the supplement discussed here were chromium picolinate, Sida cordifolia, synephrine, and guarana. An objective causality assessment using the Naranjo probability scale indicated a probable association between the use of this supplement and the development of acute renal failure in this patient. CONCLUSIONS: Current information regarding the beneficial effects of trivalent chromium is not very robust; therefore, use of this agent cannot be recommended at this time. This report serves as an important reminder to the public, as well as healthcare providers, of potential nephrotoxic reactions to dietary supplements.
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acute tubular necrosis associated with chromium picolinate containing dietary supplement
Annals of Pharmacotherapy, 2006Co-Authors: Sachin Wani, Celia Weskamp, Jeffrey Marple, Leslie SpryAbstract:Objective:To report a case of acute tubular necrosis associated with the use of a chromium picolinate–containing dietary supplement.Case Summary:A 24-year-old white male who had been ingesting a dietary supplement (Arsenal X) for 2 weeks during his workout sessions developed acute renal failure. Radiologic investigation showed the presence of a solitary right kidney, and an open renal biopsy confirmed features of acute tubular necrosis. He developed significant renal impairment that required hemodialysis. He was also treated with plasmapheresis and steroids, as a diagnosis of Pulmonary-Renal Syndrome was entertained early in the disease course, which was subsequently ruled out. The patient ultimately recovered and, on outpatient visits, was noted to have normal renal function.Discussion:The use of dietary supplements has become increasingly popular in the US, and these supplements are not subject to stringent premarketing testing or postmarketing surveillance. The main ingredients in the supplement discus...
Nikolaos M. Siafakas - One of the best experts on this subject based on the ideXlab platform.
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Pulmonary consolidation with fever is not always pneumonia: A case of microscopic polyangiitis and review of the literature
Respiratory Medicine CME, 2008Co-Authors: Katerina M. Antoniou, Foteini Economidou, Argiro Voloudaki, Charalambos Protopapadakis, Ioanna Mitrouska, Nikolaos M. SiafakasAbstract:Summary Microscopic polyangiitis is a non-granulomatous, systematic and small-vessel vasculitis in which necrotizing glomerulonephritis is very common and pulmonary capillaritis often occurs. We report a patient with fever, fatigue and dry cough who initially had been diagnosed as having pneumonia. A thoracic CT was performed showing widespread multiple nodular lesions, some with a central air-bronchogram and thickened bronchovascular bundles and some connected to nodules. No cavitation or ground glass opacities were observed. Fibreoptic bronchoscopy was normal and the cultures from the BAL were negative. Additionally, during his stay in the hospital his hematocrit was gradually falling, while the erythrocyte sedimentation rate increased. Urinanalysis revealed proteinuria and active urinary sediment. p-ANCA was positive and renal biopsy revealed focal pauci-immune necrotic glomerulonephritis. Pulmonary–renal Syndrome was suspected and renal biopsy was performed. The diagnosis of microscopic polyangiitis was established and the patient began treatment with pulse intravenous methylprednisolone and cyclophosphamide. After induction of remission, the patient received maintenance therapy. Finally, an extensive review of the literature on microscopic polyangiitis is presented.
Mary C Tobin - One of the best experts on this subject based on the ideXlab platform.
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neonatal microscopic polyangiitis secondary to transfer of maternal myeloperoxidase antineutrophil cytoplasmic antibody resulting in neonatal pulmonary hemorrhage and renal involvement
Annals of Allergy Asthma & Immunology, 2004Co-Authors: Priya J Bansal, Mary C TobinAbstract:Background Microscopic polyangiitis is a systemic vasculitis characterized by small vessel involvement. Studies suggest myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) is involved in its pathogenesis, and the titer may reflect disease activity. Objective To report a case of transplacental transfer of MPO-ANCA from a mother to a 33-week gestational age neonate that resulted in neonatal pulmonary hemorrhage and renal involvement that was successfully treated with high-dose steroid therapy and exchange transfusion. Methods MPO-ANCA titers from the cord blood and the neonate on the 8th, 15th, and 25th days of life (DOLs) were obtained. Metabolic panels and chest x-ray examinations were performed for the neonate and mother and the following values were measured: ANCA, erythrocyte sedimentation rate, C-reactive protein, antinuclear antibody, serial urinalysis, and complete blood cell count. Anti–glomerular basement membrane, quantitative immunoglobulins, anticardiolipin antibody, and rheumatoid factor were also measured for the neonate. Results The neonate had elevated MPO-ANCA titers at birth. Pulmonary hemorrhage and renal involvement were seen on DOL 2. High-dose steroid therapy decreased symptoms within 1.5 hours of initiation. Exchange transfusion performed on DOL 5 removed all of the remaining MPO-ANCA by DOL 25. The child remains asymptomatic to date. Conclusions To our knowledge, this is the first reported case of transplacental transfer of MPO-ANCA resulting in Pulmonary-Renal Syndrome that was successfully treated with high-dose steroid therapy and exchange transfusion.
