Cryptococcosis in a patient with IgA nephropathy treated with corticosteroids
Criptococosis en paciente con GMN IgA tratado con esteroides
Read
6292
Timeswas read the article
2037
Total PDF
4255
Total HTML
Share statistics
array:21 [ "pii" => "X201325140800409X" "issn" => "20132514" "doi" => " " "estado" => "S300" "fechaPublicacion" => "2008-10-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2008;28:567-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3199 "formatos" => array:3 [ "EPUB" => 298 "HTML" => 2366 "PDF" => 535 ] ] "Traduccion" => array:1 [ "es" => array:17 [ "pii" => "X0211699508004092" "issn" => "02116995" "doi" => " " "estado" => "S300" "fechaPublicacion" => "2008-10-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia. 2008;28:567-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5498 "formatos" => array:3 [ "EPUB" => 272 "HTML" => 4848 "PDF" => 378 ] ] "es" => array:9 [ "idiomaDefecto" => true "titulo" => "Criptococosis en paciente con GMN IgA tratado con esteroides" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "567" "paginaFinal" => "568" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Cryptococcosis in a patient with IgA nephropathy treated with corticosteroids" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alejandra Rodriguez Garcia, Rita Guerra Rodriguez" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Alejandra" "apellidos" => "Rodriguez Garcia" ] 1 => array:2 [ "nombre" => "Rita" "apellidos" => "Guerra Rodriguez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "X201325140800409X" "doi" => " " "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X201325140800409X?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699508004092?idApp=UINPBA000064" "url" => "/02116995/0000002800000005/v0_201502091416/X0211699508004092/v0_201502091416/es/main.assets" ] ] "itemSiguiente" => array:17 [ "pii" => "X2013251408004073" "issn" => "20132514" "doi" => " " "estado" => "S300" "fechaPublicacion" => "2008-10-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2008;28:568-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3299 "formatos" => array:3 [ "EPUB" => 292 "HTML" => 2454 "PDF" => 553 ] ] "en" => array:11 [ "idiomaDefecto" => true "titulo" => "Intracranyal hypertension as presentation of neurobrucellosis in a patient on hemodialysis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "568" "paginaFinal" => "569" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hipertensión endocraneal como presentación de una neurobrucellosis en un paciente de hemodiálisis." ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jorge Roig, Felipe Sarró, Mercè Borras, Elvira Fernández" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Jorge" "apellidos" => "Roig" ] 1 => array:2 [ "nombre" => "Felipe" "apellidos" => "Sarró" ] 2 => array:2 [ "nombre" => "Mercè" "apellidos" => "Borras" ] 3 => array:2 [ "nombre" => "Elvira" "apellidos" => "Fernández" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699508004076" "doi" => " " "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699508004076?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251408004073?idApp=UINPBA000064" "url" => "/20132514/0000002800000005/v0_201502091635/X2013251408004073/v0_201502091635/en/main.assets" ] "itemAnterior" => array:17 [ "pii" => "X2013251408004104" "issn" => "20132514" "doi" => " " "estado" => "S300" "fechaPublicacion" => "2008-10-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2008;28:566-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3743 "formatos" => array:3 [ "EPUB" => 288 "HTML" => 2861 "PDF" => 594 ] ] "en" => array:11 [ "idiomaDefecto" => true "titulo" => "Metastatic pulmonary calcinosis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "566" "paginaFinal" => "567" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Calcinosis pulmonar metástasica" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Raquel Montoiro Allué, Alfonso Perez Trullen, Silvia Moreno Loshuertos" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Raquel" "apellidos" => "Montoiro Allué" ] 1 => array:2 [ "nombre" => "Alfonso" "apellidos" => "Perez Trullen" ] 2 => array:2 [ "nombre" => "Silvia" "apellidos" => "Moreno Loshuertos" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699508004107" "doi" => " " "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699508004107?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251408004104?idApp=UINPBA000064" "url" => "/20132514/0000002800000005/v0_201502091635/X2013251408004104/v0_201502091635/en/main.assets" ] "en" => array:11 [ "idiomaDefecto" => true "titulo" => "Cryptococcosis in a patient with IgA nephropathy treated with corticosteroids" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "567" "paginaFinal" => "568" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Alejandra Rodriguez Garcia, Rita Guerra Rodriguez" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Alejandra" "apellidos" => "Rodriguez Garcia" "email" => array:1 [ 0 => "jairarodriguez@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:3 [ "nombre" => "Rita" "apellidos" => "Guerra Rodriguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => " Hospital General de Fuerteventura, Fuerteventura, Islas Canarias, España, " "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:3 [ "entidad" => " Hospital Universitario Insular de Gran Canaria, Gran Canaria, Islas Canarias, España, " "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Criptococosis en paciente con GMN IgA tratado con esteroides" ] ] "textoCompleto" => "To the editor: IgA glomerulonephritis (IgA GMN) is the leading cause of primary GMN in the world.1 Its natural course without treatment is a slow pro- gression to chronic renal failure in approximately 50% of patients.2 Because of  this  course,  use  of  corticosteroids has been postulated  in  recent years  in patients with  risk  factors  for  progression to chronic renal failure such as increased serum creatinine  levels  (SCr), proteinuria of approximately 500-1000 mg/day,  and  hypertension.1,3-5 We  report the case of a 60-year-old male patient  with  a  history  of  atrial  fibrillation,  type  2  diabetes  mellitus,  and dyslipidemia who was  referred  to our clinic  for  progressive  renal  function impairment from SCr 1.1 mg/dL to 2.7 mg/dL in three months with a creatinine clearance (ClCr) of 40mL/min, microhematuria, and proteinuria. A renal biopsy  allowed  for  diagnosing  IgA GMN  with  significant  tubulointerstitial  involvement. Treatment was  started with ACEIs (enalapril 10 mg/24 h) and  a  tapering  corticosteroid  regimen (80 mg/24 h). After two months of treatment,  the  patient  reported  fatigue, headache,  and  tinnitus,  and  showed renal  function  impairment  (SCr  4 mg/dL and ClCr  16 mL/min). A lumbar  puncture  was  performed,  and  the subsequent culture showed the presence of Cryptococcus neoformans. Imaging  tests  revealed  lesions  consistent with cryptococcoma  in  basal  ganglia and  the  left parasagittal  region. Corticosteroids were discontinued, and  treatment was  started with  amphotericin B and flucytosine for two weeks, plus oral  fluconazole  for  one  additional month.  Lesions  disappeared,  and  the patient  is  currently  asymptomatic, with  SCr  of  3.3 mL/min,  ClCr  of  31 mg/mL, and proteinuria of 1.0 g/24 h, and under  treatment with enalapril 10 mg/24 h. <br></br><br></br>In  summary,  corticosteroids  are  potent  immunosuppressants  of  both  humoral  and  cell-mediated  immunity,7 <br></br>which causes patients treated with them to have a 40-fold greater predisposition than  untreated  patients  to  suffer  infection by opportunistic or atypical microorganisms.8 Thus, since use of immunosuppressants  is  a  standard  therapeutic weapon in our routine clinical practice, we should not forget its potential harmful  effects  and  should watch  patients who receive them for the occurrence of symptoms  and  signs,  however  trivial they may appear, in order to be able to take any adequate diagnostic and therapeutic actions.  " "pdfFichero" => "P-E-S-A372-EN.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "Sr. Director, la glomerulonefritis IgA (GMN IgA) es la primera causa de GMN primaria en el mundo1. Su evolución natural sin tratamiento es hacia una lenta progresión a la insuficiencia renal crónica en aproximadamente un 50 % de los pacientes2." ] "en" => array:1 [ "resumen" => "To the editor: IgA glomerulonephritis (IgA GMN) is the leading cause of primary GMN in the world.1 Its natural course without treatment is a slow pro- gression to chronic renal failure in approximately 50% of patients." ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000002800000005/v0_201502091635/X201325140800409X/v0_201502091635/en/main.assets" "Apartado" => array:4 [ "identificador" => "35436" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000002800000005/v0_201502091635/X201325140800409X/v0_201502091635/en/P-E-S-A372-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X201325140800409X?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 8 | 13 | 21 |
| 2024 October | 35 | 32 | 67 |
| 2024 September | 48 | 23 | 71 |
| 2024 August | 68 | 63 | 131 |
| 2024 July | 30 | 20 | 50 |
| 2024 June | 56 | 35 | 91 |
| 2024 May | 42 | 30 | 72 |
| 2024 April | 32 | 26 | 58 |
| 2024 March | 37 | 23 | 60 |
| 2024 February | 24 | 33 | 57 |
| 2024 January | 27 | 31 | 58 |
| 2023 December | 26 | 24 | 50 |
| 2023 November | 33 | 29 | 62 |
| 2023 October | 31 | 33 | 64 |
| 2023 September | 23 | 29 | 52 |
| 2023 August | 30 | 25 | 55 |
| 2023 July | 39 | 27 | 66 |
| 2023 June | 38 | 16 | 54 |
| 2023 May | 33 | 25 | 58 |
| 2023 April | 29 | 17 | 46 |
| 2023 March | 24 | 14 | 38 |
| 2023 February | 31 | 17 | 48 |
| 2023 January | 20 | 21 | 41 |
| 2022 December | 39 | 21 | 60 |
| 2022 November | 46 | 24 | 70 |
| 2022 October | 30 | 42 | 72 |
| 2022 September | 41 | 31 | 72 |
| 2022 August | 43 | 33 | 76 |
| 2022 July | 25 | 54 | 79 |
| 2022 June | 34 | 27 | 61 |
| 2022 May | 26 | 34 | 60 |
| 2022 April | 30 | 36 | 66 |
| 2022 March | 47 | 29 | 76 |
| 2022 February | 36 | 34 | 70 |
| 2022 January | 27 | 30 | 57 |
| 2021 December | 40 | 30 | 70 |
| 2021 November | 40 | 31 | 71 |
| 2021 October | 33 | 41 | 74 |
| 2021 September | 35 | 36 | 71 |
| 2021 August | 41 | 35 | 76 |
| 2021 July | 60 | 42 | 102 |
| 2021 June | 56 | 25 | 81 |
| 2021 May | 31 | 32 | 63 |
| 2021 April | 30 | 34 | 64 |
| 2021 March | 38 | 23 | 61 |
| 2021 February | 30 | 21 | 51 |
| 2021 January | 35 | 21 | 56 |
| 2020 December | 17 | 9 | 26 |
| 2020 November | 29 | 11 | 40 |
| 2020 October | 16 | 22 | 38 |
| 2020 September | 16 | 9 | 25 |
| 2020 August | 31 | 8 | 39 |
| 2020 July | 27 | 11 | 38 |
| 2020 June | 10 | 13 | 23 |
| 2020 May | 26 | 11 | 37 |
| 2020 April | 21 | 18 | 39 |
| 2020 March | 28 | 12 | 40 |
| 2020 February | 20 | 18 | 38 |
| 2020 January | 32 | 17 | 49 |
| 2019 December | 27 | 21 | 48 |
| 2019 November | 36 | 18 | 54 |
| 2019 October | 11 | 10 | 21 |
| 2019 September | 17 | 12 | 29 |
| 2019 August | 17 | 10 | 27 |
| 2019 July | 19 | 21 | 40 |
| 2019 June | 10 | 15 | 25 |
| 2019 May | 22 | 13 | 35 |
| 2019 April | 32 | 30 | 62 |
| 2019 March | 21 | 13 | 34 |
| 2019 February | 18 | 12 | 30 |
| 2019 January | 25 | 15 | 40 |
| 2018 December | 78 | 36 | 114 |
| 2018 November | 62 | 13 | 75 |
| 2018 October | 59 | 15 | 74 |
| 2018 September | 44 | 19 | 63 |
| 2018 August | 35 | 15 | 50 |
| 2018 July | 45 | 17 | 62 |
| 2018 June | 30 | 15 | 45 |
| 2018 May | 22 | 14 | 36 |
| 2018 April | 42 | 10 | 52 |
| 2018 March | 27 | 8 | 35 |
| 2018 February | 24 | 6 | 30 |
| 2018 January | 27 | 8 | 35 |
| 2017 December | 40 | 11 | 51 |
| 2017 November | 22 | 4 | 26 |
| 2017 October | 25 | 5 | 30 |
| 2017 September | 40 | 9 | 49 |
| 2017 August | 26 | 4 | 30 |
| 2017 July | 32 | 11 | 43 |
| 2017 June | 15 | 10 | 25 |
| 2017 May | 29 | 14 | 43 |
| 2017 April | 28 | 11 | 39 |
| 2017 March | 20 | 7 | 27 |
| 2017 February | 14 | 5 | 19 |
| 2017 January | 17 | 8 | 25 |
| 2016 December | 40 | 14 | 54 |
| 2016 November | 35 | 10 | 45 |
| 2016 October | 63 | 7 | 70 |
| 2016 September | 93 | 2 | 95 |
| 2016 August | 92 | 2 | 94 |
| 2016 July | 133 | 6 | 139 |
| 2016 June | 68 | 0 | 68 |
| 2016 May | 98 | 0 | 98 |
| 2016 April | 58 | 0 | 58 |
| 2016 March | 47 | 0 | 47 |
| 2016 February | 60 | 0 | 60 |
| 2016 January | 54 | 0 | 54 |
| 2015 December | 78 | 0 | 78 |
| 2015 November | 54 | 0 | 54 |
| 2015 October | 56 | 0 | 56 |
| 2015 September | 49 | 0 | 49 |
| 2015 August | 49 | 0 | 49 |
| 2015 July | 54 | 0 | 54 |
| 2015 June | 28 | 0 | 28 |
| 2015 May | 53 | 0 | 53 |
| 2015 April | 5 | 0 | 5 |
Show all
