Immunotactoid glomerulopathy and tuberculosis: a novel association
Read
7354
Timeswas read the article
2164
Total PDF
5190
Total HTML
Share statistics
array:21 [ "pii" => "X201325141105185X" "issn" => "20132514" "doi" => "10.3265/Nefrologia.pre2011.Mar.10849" "estado" => "S300" "fechaPublicacion" => "2011-05-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2011;31:369-71" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4006 "formatos" => array:3 [ "EPUB" => 330 "HTML" => 3140 "PDF" => 536 ] ] "Traduccion" => array:1 [ "en" => array:17 [ "pii" => "X0211699511051852" "issn" => "02116995" "doi" => "10.3265/Nefrologia.pre2011.Mar.10849" "estado" => "S300" "fechaPublicacion" => "2011-05-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia. 2011;31:369-71" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4684 "formatos" => array:3 [ "EPUB" => 322 "HTML" => 3734 "PDF" => 628 ] ] "en" => array:9 [ "idiomaDefecto" => true "titulo" => "Immunotactoid glomerulopathy and tuberculosis: a novel association" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "369" "paginaFinal" => "371" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Immunotactoid glomerulopathy and tuberculosis: a novel association" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Gupta, A. Khaira" "autores" => array:2 [ 0 => array:2 [ "Iniciales" => "A." "apellidos" => "Gupta" ] 1 => array:2 [ "Iniciales" => "A." "apellidos" => "Khaira" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "X201325141105185X" "doi" => "10.3265/Nefrologia.pre2011.Mar.10849" "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/X201325141105185X?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699511051852?idApp=UINPBA000064" "url" => "/02116995/0000003100000003/v0_201502091414/X0211699511051852/v0_201502091415/en/main.assets" ] ] "itemSiguiente" => array:17 [ "pii" => "X2013251411051841" "issn" => "20132514" "doi" => "10.3265/Nefrologia.pre2011.Mar.10832" "estado" => "S300" "fechaPublicacion" => "2011-05-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2011;31:371-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4458 "formatos" => array:3 [ "EPUB" => 309 "HTML" => 3523 "PDF" => 626 ] ] "en" => array:9 [ "idiomaDefecto" => true "titulo" => "Sarcoidosis: diagnosis from the renal function and hypercalcaemia study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "371" "paginaFinal" => "372" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Sarcoidosis: diagnóstico a partir del estudio de insuficiencia renal e hipercalcemia" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "O. Ibrik, R. Samon, A. Roda, R. Roca, J.C. González, J. Viladoms, J. Vilaseca, M. Serrano" "autores" => array:8 [ 0 => array:2 [ "Iniciales" => "O." "apellidos" => "Ibrik" ] 1 => array:2 [ "Iniciales" => "R." "apellidos" => "Samon" ] 2 => array:2 [ "Iniciales" => "A." "apellidos" => "Roda" ] 3 => array:2 [ "Iniciales" => "R." "apellidos" => "Roca" ] 4 => array:2 [ "Iniciales" => "J.C." "apellidos" => "González" ] 5 => array:2 [ "Iniciales" => "J." "apellidos" => "Viladoms" ] 6 => array:2 [ "Iniciales" => "J." "apellidos" => "Vilaseca" ] 7 => array:2 [ "Iniciales" => "M." "apellidos" => "Serrano" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699511051844" "doi" => "10.3265/Nefrologia.pre2011.Mar.10832" "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/X0211699511051844?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251411051841?idApp=UINPBA000064" "url" => "/20132514/0000003100000003/v0_201502091638/X2013251411051841/v0_201502091639/en/main.assets" ] "itemAnterior" => array:17 [ "pii" => "X2013251411051868" "issn" => "20132514" "doi" => "10.3265/Nefrologia.pre2011.Feb.10784" "estado" => "S300" "fechaPublicacion" => "2011-05-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2011;31:368-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5393 "formatos" => array:3 [ "EPUB" => 325 "HTML" => 4540 "PDF" => 528 ] ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Spontaneous remission of nephrotic syndrome in a patient with diabetic nephropathy and Parkinson's disease" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "368" "paginaFinal" => "369" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Remisión espontánea de síndrome nefrótico en paciente con nefropatía diabética y enfermedad de Parkinson" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Tab. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "10784_108_17673_en_t1.10784.jpg" "Alto" => 229 "Ancho" => 600 "Tamanyo" => 102212 ] ] "descripcion" => array:1 [ "en" => "Follow-up of laboratory results" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Heras, A. Sáiz, M.J. Fernández-Reyes, R. Sánchez, A. Molina, M.A. Rodríguez, F. Álvarez-Ude" "autores" => array:7 [ 0 => array:2 [ "Iniciales" => "M." "apellidos" => "Heras" ] 1 => array:2 [ "Iniciales" => "A." "apellidos" => "Sáiz" ] 2 => array:2 [ "Iniciales" => "M.J." "apellidos" => "Fernández-Reyes" ] 3 => array:2 [ "Iniciales" => "R." "apellidos" => "Sánchez" ] 4 => array:2 [ "Iniciales" => "A." "apellidos" => "Molina" ] 5 => array:2 [ "Iniciales" => "M.A." "apellidos" => "Rodríguez" ] 6 => array:2 [ "Iniciales" => "F." "apellidos" => "Álvarez-Ude" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699511051860" "doi" => "10.3265/Nefrologia.pre2011.Feb.10784" "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/X0211699511051860?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251411051868?idApp=UINPBA000064" "url" => "/20132514/0000003100000003/v0_201502091638/X2013251411051868/v0_201502091639/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "titulo" => "Immunotactoid glomerulopathy and tuberculosis: a novel association" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "369" "paginaFinal" => "371" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "A. Gupta, A. Khaira" "autores" => array:2 [ 0 => array:4 [ "Iniciales" => "A." "apellidos" => "Gupta" "email" => array:1 [ 0 => "parthankur@yahoo.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:3 [ "Iniciales" => "A." "apellidos" => "Khaira" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Division of Nephrology, University of Ottawa, Ottawa, Ontario, Canada, " "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "10849_108_17674_en_10849_f1.jpg" "Alto" => 360 "Ancho" => 333 "Tamanyo" => 142879 ] ] ] ] "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">Dear Editor:</span></p><p class="elsevierStylePara">Tuberculosis is associated with a variety of glomerular manifestations. However, association with immunotactoid glomerulopathy has never been reported. We encountered a case of 37-year-old gentleman with such a novel presentation.</p><p class="elsevierStylePara">A 37-year-old gentleman presented with swelling all over the body for 6 weeks. His past history revealed recent history of pulmonary tuberculosis 9 weeks back. He was presently on 2 drug anti-tubercular treatment (ATT) (isoniazid and rifampicin) after first 8 weeks of 4 drugs, which additionally included pyrazinamide and ethambutol. At the time of diagnosis of tuberculosis, he was also found to have stage 1 hypertension and was started on hydrochlorthiazide 12.5 mg daily. There was no history of hematuria, past renal disease or any other systemic disorder. Physical examination revealed pitting edema and no other notable findings.</p><p class="elsevierStylePara">Laboratory data showed hemoglobin 10.1 g/dl, white cell counts of 6800, blood urea 68 mg/dl, serum creatinine 1.4 mg/dl, eGFR by MDRD formula 59 ml/min/1.73 m², protein 4.5 g/dl, albumin 1.7 g/dl, cholesterol 356 mg/dl, Hepatitis- B and C and HIV- 1 and 2 negative, ANA and cryoglobulins negative, normocomplementemia, urine – protein 3+, RBC 4-6 and WBC 1-2/hpf, casts-nil and 24-hr urine protein 4.8 g (non-selective). Liver functions tests were within normal limits. An ultrasound guided renal biopsy was performed.</p><p class="elsevierStylePara">On light microscopy, glomeruli exhibited varying degrees of mesangial expansion, negative silver staining and congo red staining and some thickening of peripheral capillary walls. Immunoflourescence was positive only for IgG in mesangium and peripheral capillary walls. Electron microscopy showed microtubules >30 nm arranged focally in parallel in mesangium suggesting immunotactoid glomerulopathy (ITG) (figure 1). Further work-up showed a negative serum and 24-hr urine immuno-fixation electrophoresis. Imaging studies done for lymphoproliferative disease as an etiology were negative too.</p><p class="elsevierStylePara">He was treated with ATT for a total of 6 months. His blood pressures were kept under control with ramipril 10 mg daily. His proteinuria decreased to 1.1g/day at 6 months. At 2 years of follow-up, his serum creatinine is 3 mg/dl with eGFR of 23. We offered a repeat renal biopsy during this period which the patent did not consent.</p><p class="elsevierStylePara">ITG is distinct rare morphologic entity characterized by microtubular glomerular deposits often ranging from 34 to 49 nm in diameter organized in parallel arrays. It usually occurs in older individuals presenting with nephrotic syndrome, hematuria and renal insufficiency. The term was introduced by Schwartz et al in 1980's, where they described this disease as a glomerular disease characterized by highly organized crystalline structure of immune deposits in absence of systemic diseases such as amyloidosis, cryoglobulinemia, paraproteinemia, and systemic lupus erythematosus<span class="elsevierStyleSup">1</span>. In most instances, an underlying lymphoproliferative disorder is found. Association with HIV, sickle cell disease, hypereosinophilic syndrome and recurrence in transplanted kidneys has been reported<span class="elsevierStyleSup">2-5</span>.</p><p class="elsevierStylePara">Our case showed a temporal association with tuberculosis. Though tuberculosis or its treatment is shown to be linked to a variety of glomerular diseases such as amyloidosis, minimal change disease, IgA nephropathy, and collapsing glomerulopathy<span class="elsevierStyleSup">6-9</span> but as causality with ITG has never been reported. It is difficult to prove whether tuberculosis per se caused ITG, however treatment of tuberculosis resulted in partial remission.</p><p class="elsevierStylePara">The exact pathogenesis of ITG remains to be elucidated. Like lymphoproliferative diseases, tuberculosis is also an inflammatory disorder. It might be possible that immune dysregulation in tuberculosis or systemic inflammatory mediators cause defects in critical podocyte cellular functions involved in clearance of filtered and retained immunoglobulins. This would end up in formation of immunotactoids.</p><p class="elsevierStylePara">The treatment strategies for ITG have been variable, though there has been a case of ITG exhibiting nephrotic syndrome successfully treated with corticosteroids and antihypertensive therapy<span class="elsevierStyleSup">10</span>. We did not subject our patient to steroids as there was a potential risk of flaring tuberculosis with high doses of corticosteroids. However, we did not try rituximab as data for this agent is limited at present<span class="elsevierStyleSup">5</span>.</p><p class="elsevierStylePara">Our patient was relatively young as compared to most other cases and progressed to chronic kidney disease stage 4 over a span of 2 years. The natural course of the disease is progression to end-stage renal disease (ESRD) within 7 months to 10 years. However, in a recent report a patient with a diagnosis of ITG developed acute kidney injury (AKI) and ESRD within 1 week of initial presentation<span class="elsevierStyleSup">11</span>.</p><p class="elsevierStylePara">To conclude, to the best of our knowledge, our case is the first report of an association of ITG with tuberculosis. There could be a possible causal relationship between mycobacterial infections and ITG. In addition to search for lymphoproliferative disorder and HIV, tuberculosis as an etiology should be kept in mind in a case of ITG.</p><p class="elsevierStylePara"><a href="grande/10849_108_17674_en_10849_f1.jpg" class="elsevierStyleCrossRefs"><img src="10849_108_17674_en_10849_f1.jpg" alt="Microtubular deposits of >30 nm seen in mesangium (on electron microscopy magnification x15000)."></img></a></p><p class="elsevierStylePara">Figure 1. Microtubular deposits of >30 nm seen in mesangium (on electron microscopy magnification x15000).</p>" "pdfFichero" => "P1-E521-S2971-A10849-EN.pdf" "tienePdf" => true "PalabrasClave" => array:1 [ "en" => array:3 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec441194" "palabras" => array:1 [ 0 => "Renal failure" ] ] 1 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec441196" "palabras" => array:1 [ 0 => "Tuberculosis" ] ] 2 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec441198" "palabras" => array:1 [ 0 => "Immunotactoid glomerulopathy" ] ] ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "10849_108_17674_en_10849_f1.jpg" "Alto" => 360 "Ancho" => 333 "Tamanyo" => 142879 ] ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Korbet SM, Schwartz MM, Rosenberg BF, Sibley RK, Lewis EJ. Immunotactoid glomerulopathy. Medicine (Baltimore) 1985;64:228-43." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Chen C, Jhaveri KD, Hartono C, Seshan SV. An uncommon glomerular disease in an HIV patient: value of renal biopsy and review of the literature. Clin Nephrol 2011;75:80-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21176755" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Aviles DH, Craver R, Warrier RP. Immunotactoid glomerulopathy in sickle cell anemia. Pediatr Nephrol 2001;16:82-4. <a href="http://www.ncbi.nlm.nih.gov/pubmed/11198611" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Choi YJ, Lee JD, Yang KH, Woo JY, Kim BK, Bang BK, et al. Immunotactoid glomerulopathy associated with idiopathic hypereosinophilic syndrome. Am J Nephrol 1998;18:337-43. <a href="http://www.ncbi.nlm.nih.gov/pubmed/9653841" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Sathyan S, Khan FN, Ranga KV. A case of recurrent immunotactoid glomerulopathy in an allograft treated with rituximab. Transplant Proc 2009;41:3953-5. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19917422" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Krishnamurthy S, Samanta D, Yadav S. Renal amyloidosis secondary to childhood tuberculosis: a report of two cases. J Postgrad Med 2009;55:121-3. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19550057" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Mori S, Matsushita Y, Arizono K. Minimal-change nephrotic syndrome associated with isoniazid in anti-tuberculosis chemoprophylaxis for a patient with rheumatoid arthritis. Intern Med 2011;50:253-7. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21297330" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Ortmann J, Schiffl H, Lang SM. Partial clinical remission of chronic IgA nephropathy with therapy of tuberculosis. Dtsch Med Wochenschr 2010;135:1228-31. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20533156" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Rodrigues CE, Sette LH, Torritani J, Malheiros DM, Titan SM, Barros RT, et al. Tuberculosis-associated collapsing glomerulopathy: remission after treatment. Ren Fail 2010;32:143-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20113281" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Kinomura M, Maeshima Y, Kodera R, Morinaga H, Saito D, Nakao K, et al. A case of immunotactoid glomerulopathy exhibiting nephrotic syndrome successfully treated with corticosteroids and antihypertensive therapy. Clin Exp Nephrol 2009;13:378-84. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19367362" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Jain S, Chhabra D. A case of immunotactoid glomerulopathy with rapid progression to end-stage renal disease. Scientific World J 2009;9:1348-54." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003100000003/v0_201502091638/X201325141105185X/v0_201502091639/en/main.assets" "Apartado" => array:4 [ "identificador" => "35437" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor - Brief Case Reports" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003100000003/v0_201502091638/X201325141105185X/v0_201502091639/en/P1-E521-S2971-A10849-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X201325141105185X?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 9 | 16 |
| 2024 October | 45 | 49 | 94 |
| 2024 September | 53 | 27 | 80 |
| 2024 August | 49 | 69 | 118 |
| 2024 July | 38 | 44 | 82 |
| 2024 June | 50 | 46 | 96 |
| 2024 May | 65 | 36 | 101 |
| 2024 April | 44 | 36 | 80 |
| 2024 March | 48 | 22 | 70 |
| 2024 February | 34 | 30 | 64 |
| 2024 January | 28 | 31 | 59 |
| 2023 December | 26 | 21 | 47 |
| 2023 November | 64 | 34 | 98 |
| 2023 October | 68 | 28 | 96 |
| 2023 September | 59 | 29 | 88 |
| 2023 August | 39 | 17 | 56 |
| 2023 July | 47 | 27 | 74 |
| 2023 June | 34 | 23 | 57 |
| 2023 May | 45 | 28 | 73 |
| 2023 April | 20 | 15 | 35 |
| 2023 March | 41 | 17 | 58 |
| 2023 February | 58 | 20 | 78 |
| 2023 January | 28 | 14 | 42 |
| 2022 December | 41 | 29 | 70 |
| 2022 November | 38 | 36 | 74 |
| 2022 October | 36 | 32 | 68 |
| 2022 September | 39 | 25 | 64 |
| 2022 August | 34 | 40 | 74 |
| 2022 July | 26 | 37 | 63 |
| 2022 June | 26 | 36 | 62 |
| 2022 May | 34 | 30 | 64 |
| 2022 April | 40 | 43 | 83 |
| 2022 March | 45 | 29 | 74 |
| 2022 February | 40 | 39 | 79 |
| 2022 January | 25 | 32 | 57 |
| 2021 December | 42 | 40 | 82 |
| 2021 November | 32 | 41 | 73 |
| 2021 October | 38 | 38 | 76 |
| 2021 September | 35 | 35 | 70 |
| 2021 August | 31 | 34 | 65 |
| 2021 July | 39 | 26 | 65 |
| 2021 June | 21 | 32 | 53 |
| 2021 May | 26 | 31 | 57 |
| 2021 April | 37 | 46 | 83 |
| 2021 March | 55 | 51 | 106 |
| 2021 February | 20 | 20 | 40 |
| 2021 January | 21 | 15 | 36 |
| 2020 December | 20 | 16 | 36 |
| 2020 November | 23 | 9 | 32 |
| 2020 October | 18 | 20 | 38 |
| 2020 September | 22 | 9 | 31 |
| 2020 August | 29 | 9 | 38 |
| 2020 July | 26 | 11 | 37 |
| 2020 June | 15 | 16 | 31 |
| 2020 May | 31 | 12 | 43 |
| 2020 April | 25 | 21 | 46 |
| 2020 March | 21 | 5 | 26 |
| 2020 February | 26 | 29 | 55 |
| 2020 January | 20 | 21 | 41 |
| 2019 December | 32 | 14 | 46 |
| 2019 November | 22 | 17 | 39 |
| 2019 October | 13 | 7 | 20 |
| 2019 September | 24 | 23 | 47 |
| 2019 August | 11 | 10 | 21 |
| 2019 July | 13 | 23 | 36 |
| 2019 June | 17 | 11 | 28 |
| 2019 May | 15 | 11 | 26 |
| 2019 April | 47 | 34 | 81 |
| 2019 March | 12 | 16 | 28 |
| 2019 February | 13 | 9 | 22 |
| 2019 January | 22 | 16 | 38 |
| 2018 December | 61 | 26 | 87 |
| 2018 November | 87 | 17 | 104 |
| 2018 October | 80 | 18 | 98 |
| 2018 September | 49 | 16 | 65 |
| 2018 August | 41 | 19 | 60 |
| 2018 July | 43 | 14 | 57 |
| 2018 June | 42 | 13 | 55 |
| 2018 May | 53 | 15 | 68 |
| 2018 April | 49 | 8 | 57 |
| 2018 March | 49 | 8 | 57 |
| 2018 February | 59 | 7 | 66 |
| 2018 January | 58 | 9 | 67 |
| 2017 December | 59 | 11 | 70 |
| 2017 November | 30 | 3 | 33 |
| 2017 October | 33 | 7 | 40 |
| 2017 September | 31 | 6 | 37 |
| 2017 August | 30 | 13 | 43 |
| 2017 July | 29 | 10 | 39 |
| 2017 June | 29 | 8 | 37 |
| 2017 May | 39 | 9 | 48 |
| 2017 April | 40 | 7 | 47 |
| 2017 March | 25 | 23 | 48 |
| 2017 February | 14 | 6 | 20 |
| 2017 January | 24 | 5 | 29 |
| 2016 December | 53 | 3 | 56 |
| 2016 November | 66 | 3 | 69 |
| 2016 October | 108 | 6 | 114 |
| 2016 September | 129 | 5 | 134 |
| 2016 August | 194 | 4 | 198 |
| 2016 July | 180 | 7 | 187 |
| 2016 June | 106 | 0 | 106 |
| 2016 May | 94 | 0 | 94 |
| 2016 April | 85 | 0 | 85 |
| 2016 March | 61 | 0 | 61 |
| 2016 February | 102 | 0 | 102 |
| 2016 January | 88 | 0 | 88 |
| 2015 December | 104 | 0 | 104 |
| 2015 November | 59 | 0 | 59 |
| 2015 October | 76 | 0 | 76 |
| 2015 September | 53 | 0 | 53 |
| 2015 August | 67 | 0 | 67 |
| 2015 July | 57 | 0 | 57 |
| 2015 June | 47 | 0 | 47 |
| 2015 May | 73 | 0 | 73 |
| 2015 April | 6 | 0 | 6 |
Show all
