Letter to the Editor
Acute interstitial nephritis in a patient with chronic idiopathic urticaria
Nefritis intersticial aguda en un paciente con urticaria crónica idiopática
Leído
5058
Vecesse ha leído el artículo
1932
Total PDF
3126
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S0211699520301727" "issn" => "02116995" "doi" => "10.1016/j.nefro.2020.08.009" "estado" => "S300" "fechaPublicacion" => "2022-01-01" "aid" => "792" "copyright" => "Sociedad Española de Nefrología" "copyrightAnyo" => "2020" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia. 2022;42:105-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:19 [ "pii" => "S0211699520301685" "issn" => "02116995" "doi" => "10.1016/j.nefro.2020.07.014" "estado" => "S300" "fechaPublicacion" => "2022-01-01" "aid" => "788" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia. 2022;42:108-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Mieloma múltiple con enfermedad renal crónica dependiente de diálisis peritoneal y trasplante autólogo de células stem" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "108" "paginaFinal" => "109" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Multiple myeloma with chronic kidney disease dependent on peritoneal dialysis and autologous stem cell transplant" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Anika Tyszkiewicz, Manuel Heras Benito, Giomar Urzola Rodriguez, Beatriz Rey Búa, Mónica Baile González, Miguel Sánchez-Jáuregui Castillo" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Anika" "apellidos" => "Tyszkiewicz" ] 1 => array:2 [ "nombre" => "Manuel" "apellidos" => "Heras Benito" ] 2 => array:2 [ "nombre" => "Giomar" "apellidos" => "Urzola Rodriguez" ] 3 => array:2 [ "nombre" => "Beatriz" "apellidos" => "Rey Búa" ] 4 => array:2 [ "nombre" => "Mónica" "apellidos" => "Baile González" ] 5 => array:2 [ "nombre" => "Miguel" "apellidos" => "Sánchez-Jáuregui Castillo" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699520301685?idApp=UINPBA000064" "url" => "/02116995/0000004200000001/v4_202211260552/S0211699520301685/v4_202211260552/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0211699520301739" "issn" => "02116995" "doi" => "10.1016/j.nefro.2020.08.010" "estado" => "S300" "fechaPublicacion" => "2022-01-01" "aid" => "793" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia. 2022;42:103-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "C3 glomerulopathy associated to B-cell chronic lymphocytic leukemia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "103" "paginaFinal" => "105" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Glomerulopatía C3 asociada a leucemia linfocítica crónica de células B" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 405 "Ancho" => 1750 "Tamanyo" => 159269 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Glomerulus showing moderate mesangial widening and thickening of capillary walls, as well as double contours. (Periodic acid-Schiff stain (PAS) stain, 200×), (B) Immunofluorescence microscopy showing small granular deposits of complement (C3), mainly in the glomerula mesangium (×200). (C) Electron microscopy revealing electron dense deposits in the mesangial matrix (×8000).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Filipa Silva, Joana Tavares, Rita Pinho Peixeiro, João Oliveira, Diana Fernandes, Ana Castro, Sofia Santos, Rita Coutinho, Cristina Freitas, Josefina Santos, João Pedro Pimentel, Jorge Coutinho, António Cabrita" "autores" => array:13 [ 0 => array:2 [ "nombre" => "Filipa" "apellidos" => "Silva" ] 1 => array:2 [ "nombre" => "Joana" "apellidos" => "Tavares" ] 2 => array:2 [ "nombre" => "Rita Pinho" "apellidos" => "Peixeiro" ] 3 => array:2 [ "nombre" => "João" "apellidos" => "Oliveira" ] 4 => array:2 [ "nombre" => "Diana" "apellidos" => "Fernandes" ] 5 => array:2 [ "nombre" => "Ana" "apellidos" => "Castro" ] 6 => array:2 [ "nombre" => "Sofia" "apellidos" => "Santos" ] 7 => array:2 [ "nombre" => "Rita" "apellidos" => "Coutinho" ] 8 => array:2 [ "nombre" => "Cristina" "apellidos" => "Freitas" ] 9 => array:2 [ "nombre" => "Josefina" "apellidos" => "Santos" ] 10 => array:2 [ "nombre" => "João Pedro" "apellidos" => "Pimentel" ] 11 => array:2 [ "nombre" => "Jorge" "apellidos" => "Coutinho" ] 12 => array:2 [ "nombre" => "António" "apellidos" => "Cabrita" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699520301739?idApp=UINPBA000064" "url" => "/02116995/0000004200000001/v4_202211260552/S0211699520301739/v4_202211260552/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Acute interstitial nephritis in a patient with chronic idiopathic urticaria" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">Dear Editor</span>," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "105" "paginaFinal" => "107" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Kubra Kaynar, Nejla Küçük, Sevdegül Mungan, Beyhan Güvercin, Şükrü Ulusoy" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Kubra" "apellidos" => "Kaynar" "email" => array:1 [ 0 => "kkaynar@yahoo.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Nejla" "apellidos" => "Küçük" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Sevdegül" "apellidos" => "Mungan" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Beyhan" "apellidos" => "Güvercin" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Şükrü" "apellidos" => "Ulusoy" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Nephrology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Internal Medicine, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Department of Pathology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Nefritis intersticial aguda en un paciente con urticaria crónica idiopática" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 608 "Ancho" => 805 "Tamanyo" => 87604 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Severe interstitial lymphocytic (including eosinophylic lymphocytes, plasma cells and mostly mononuclear leukocytes) infiltration affected 60% of cortical area, and interstitial fibrosis with tubular atrophy involved 30% of the tissue, H.E. 100×.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Acute interstitial nephritis (AIN) which is characterized as inflammation and oedema around renal tubuli mostly due to hypersensitivity to drugs, has been reported to be underlying aetiology among 5–27% of acute kidney injury cases in hospitalized patients.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Chronic idiopathic urticaria (CIU), is an intrinsic immunological abnormality independent of external causes without a triggering stimulus like stress, physical factor, drug and food. It usually affects females with a prevalence of 1% and mostly begins at the age of 30–50 years.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> Diagnosis mostly depend on chronic recurrent itching persisting at least six weeks with exclusion of diseases like infections, malignities, auto-immune and auto-inflammatory diseases.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,3</span></a> Treatment is needed for cumbersome symptom of pruritis and life-threatening medical emergency of angioedema. Omalizumab, which is recombinant humanized monoclonal antibody for immunoglobulin (Ig) E is advised for treatment of CIU as the third or fourth line of therapy after histamine receptor type 1 (H<span class="elsevierStyleInf">1</span>) antihistamines and leukotriene receptor antagonists are unsuccessful.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3,4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A 53-year-old female patient with diabetes mellitus, hysterectomy and CIU had symptoms of nausea and fatigue. In her medical history, she has been taking bilastine (20<span class="elsevierStyleHsp" style=""></span>mg/day) for 1 year, methylprednisolone was prescribed to the patient due to angioedema which affected tongue and larynx for 30 days until 5 months ago, diclofenac was given for pain relief after hysterectomy, she had taken dexketoprofen (25<span class="elsevierStyleHsp" style=""></span>mg/every 3 day) for 3 months until 2 months ago and she was injected the fifth monthly dose of 150<span class="elsevierStyleHsp" style=""></span>mg omalizumab 15 days ago. Laboratory evaluation revealed increased serum creatinine level (1.64<span class="elsevierStyleHsp" style=""></span>mg/dL) with respect to basal levels (0.65<span class="elsevierStyleHsp" style=""></span>mg/dL) of 6 months earlier, decreased glomerular filtration rate (GFR) (estimated GFR using Chronic Kidney Disease Epidemiology Collaboration, CKD-EPI equation was 34<span class="elsevierStyleHsp" style=""></span>mL/min/1.73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>, creatinine clearance using 24-h urine collection was 37.4<span class="elsevierStyleHsp" style=""></span>mL/min), microalbuminuria (98<span class="elsevierStyleHsp" style=""></span>mg/d), increased proteinuria (1.3<span class="elsevierStyleHsp" style=""></span>g/d), and increased beta-2 microglobulinuria (21,300<span class="elsevierStyleHsp" style=""></span>μg/L, normal value <300<span class="elsevierStyleHsp" style=""></span>μg/L<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a>). Her urinary beta-2 microglobulin: creatinine ratio was 76071 (μg/g) (normal<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>300<span class="elsevierStyleHsp" style=""></span>μg/g<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a>). Biochemically her serum creatinine level was increased to 2.21<span class="elsevierStyleHsp" style=""></span>mg/dL within 8 days (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Presence of high amount of low molecular weight proteins (beta-2 microglobulin) in her urine analysis indicated tubular type consisting majority of proteinuria. Kidney biopsy showed acute interstitial nephritis accompanied with chronic interstitial injury related findings without immune deposition (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). In addition, early stage of diabetic nephropathy was observed due to diffuse basal membrane thickening. Oral methylprednisolone was given to the patient at the dose of 1<span class="elsevierStyleHsp" style=""></span>mg/kg/d for treatment of AIN.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> Dose was slowly tapered to 5<span class="elsevierStyleHsp" style=""></span>mg/day after a month and prescribed for another 3 months. Her serum creatinine level was decreased from 2.24<span class="elsevierStyleHsp" style=""></span>mg/dL to 1.58<span class="elsevierStyleHsp" style=""></span>mg/dL in 10 days of treatment, and after 4 months her serum creatinine level was 0.82<span class="elsevierStyleHsp" style=""></span>mg/dL.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The cause of AIN in majority of the patients was known as hypersensitivity towards drugs (75% of the cases).<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> Practically, every drug may have a potential for causing AIN, yet mostly reported drugs are antibiotics, NSAID, proton pump inhibitors and allupurinol.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> The time interval between drug intake and onset of AIN can vary from 1 week to 9 months (10–11 weeks being the commonest) among the patients.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> The most possible offending agent for AIN of the patient was thought as diclofenac since absence of any report regarding the other medications that our patient had taken (methylprednisolone, dexketoprofen, gliclazide, metformin, bilastine, and omalizumab). It is known that NSAID induced AIN does not generally response to glucocorticoid therapy.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> Conflicting with this information, our patient responded well to corticosteroid treatment which made us suspect some other drug she used might have led to AIN other than NSAID. The association of CIU with AIN has not been reported yet. It might be possible but needs to be clarified that AIN of our patient may result from one of the hypersensitivity reaction and manifestation of CIU. However, her itching symptoms completely abolished by omalizumab and this AIN developed during omalizumab treatment of 5 months duration. Omalizumab has been shown to decrease serum eosinophil levels and effective in treatment of CIU through its functions against eosinophils.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> In theory, omalizumab might have been protective for development of AIN via these eosinophil depleting effects. However, even though 5 months of omalizumab treatment, our patient had AIN which was treated successfully with methylprednisolone.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In conclusion, AIN of our case most probably was secondary to diclofenac intake 5 months earlier even though presence of response to glucocorticoids. Whether presence of CIU increase the tendency of patients to development of AIN secondary to offending drugs has not been known yet. Renal functions especially tubular proteinuria should be evaluated and searched thoroughly in order to diagnose early and treat appropriately for AIN among individuals with CIU before and during prescription of any drug.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Authors’ contributions</span><p id="par0025" class="elsevierStylePara elsevierViewall">Kubra Kaynar: Conception, design, drafting the article.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Nejla Küçük: Drafting the article.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Sevdegül Mungan: Drafting the pathological data of the case.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Beyhan Güvercin: Drafting the article.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Şükrü Ulusoy: Drafting the article.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Authors’ contributions" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflicts of interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 608 "Ancho" => 805 "Tamanyo" => 87604 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Severe interstitial lymphocytic (including eosinophylic lymphocytes, plasma cells and mostly mononuclear leukocytes) infiltration affected 60% of cortical area, and interstitial fibrosis with tubular atrophy involved 30% of the tissue, H.E. 100×.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Parameter \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Patient \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Complain \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nausea \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Blood pressure (mmHg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">120/80 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Serum creatinine level (mg/dL)6 months earlier/at admission/during AKI/last visit \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.65/1.64/2.21/0.82 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Proteinuria level (g/d)At admission \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Albuminuria (mg/d)At admission \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">98 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Beta-2 microglobulinuria level (μg/L)At admission \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21,300 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Past drug history for the last 6 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Methylprednisolone, diclofenac, dexketoprofen, and omalizumab \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Serum ANA, anti dsDNA, and ANCA test results \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Negative \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Present drug history \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gliclazide, metformin, bilastine, and omalizumab \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diagnosis based on \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Clinical and histopathological data \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Comorbid diseases \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diabetes mellitus, chronic idiopathic urticaria \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Renal pathology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Acute interstitial nephritis accompanied with chronic interstitial injury and early stage of diabetic nephropathy \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Clinical and laboratory findings of the patient.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute kidney injury in interstitial nephritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. Caravaca-Fontan" 1 => "G. Fernandez-Juarez" 2 => "M. Praga" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MCC.0000000000000654" "Revista" => array:5 [ "tituloSerie" => "Curr Opin Crit Care" "fecha" => "2019" "volumen" => "25" "paginaInicial" => "558" "paginaFinal" => "564" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic urticaria: an overview of treatment and recent patents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K.L. Hon" 1 => "A.K.C. Leung" 2 => "W.G.G. Ng" 3 => "S.K. Loo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2174/1872213X13666190328164931" "Revista" => array:6 [ "tituloSerie" => "Recent Pat Inflamm Allergy Drug Discov" "fecha" => "2019" "volumen" => "13" "paginaInicial" => "27" "paginaFinal" => "37" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30924425" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute and chronic urticaria: evaluation and treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P. Schaefer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am Fam Physician" "fecha" => "2017" "volumen" => "95" "paginaInicial" => "717" "paginaFinal" => "724" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28671445" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Omalizumab for the treatment of chronic idiopathic urticaria: systematic review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Tonacci" 1 => "L. Billeci" 2 => "G. Pioggia" 3 => "M. Navarra" 4 => "S. Gangemi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/phar.1915" "Revista" => array:6 [ "tituloSerie" => "Pharmacotherapy" "fecha" => "2017" "volumen" => "37" "paginaInicial" => "464" "paginaFinal" => "480" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28226418" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Beta 2-microglobulinuria and lysozyme-uria. Their role as diagnostic and therapeutic indicators in dilatation of the upper urinary tract during pregnancy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H. Heidegger" 1 => "A. Hümfner" 2 => "R. Corradini" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Minerva Ginecol" "fecha" => "1990" "volumen" => "42" "paginaInicial" => "243" "paginaFinal" => "250" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The impact of renal tubular damage, as assessed by urinary β2-microglobulin–creatinine ratio, on cardiac prognosis in patients with chronic heart failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Otaki" 1 => "T. Watanabe" 2 => "T. Shishido" 3 => "H. Takahashi" 4 => "A. Funayama" 5 => "T. Narumi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCHEARTFAILURE.112.000089" "Revista" => array:6 [ "tituloSerie" => "Circ Heart Fail" "fecha" => "2013" "volumen" => "6" "paginaInicial" => "662" "paginaFinal" => "668" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23674363" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Kshirsagar AV, Falk RJ. Treatment of acute interstitial nephritis. 2020 May. UpToDate.com. Available at <a target="_blank" href="https://www.uptodate.com/contents/treatment-of-acute-interstitial-nephritis">https://www.uptodate.com/contents/treatment-of-acute-interstitial-nephritis</a>? [accessed 25.06.20]." ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Praga M, Appel GB. Clinical manifestations and diagnosis of acute interstitial nephritis. 2020 May. UpToDate.com. Available at <a target="_blank" href="https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-acute-interstitial-nephritis">https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-acute-interstitial-nephritis</a>? [accessed 25.06.20]." ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Changes in the aetiology, clinical presentation and management of acute interstitial nephritis, an increasingly common cause of acute kidney injury" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Praga" 1 => "A. Sevillano" 2 => "P. Aunon" 3 => "E. Gonzalez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ndt/gfu326" "Revista" => array:6 [ "tituloSerie" => "Nephrol Dial Transplant" "fecha" => "2015" "volumen" => "30" "paginaInicial" => "1472" "paginaFinal" => "1479" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25324356" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy of omalizumab in patients with chronic spontaneous urticaria and its association with serum IgE levels and eosinophil count" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "F. Tamer" 1 => "F. Gulru Erdogan" 2 => "D. Dincer Rota" 3 => "D. Yildirim" 4 => "Y. Akpinar Kara" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Dermatovenerol Croat" "fecha" => "2019" "volumen" => "27" "paginaInicial" => "101" "paginaFinal" => "106" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31351504" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/02116995/0000004200000001/v4_202211260552/S0211699520301727/v4_202211260552/en/main.assets" "Apartado" => array:4 [ "identificador" => "48186" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Cartas al Director" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/02116995/0000004200000001/v4_202211260552/S0211699520301727/v4_202211260552/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699520301727?idApp=UINPBA000064" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 10 | 14 | 24 |
| 2024 Octubre | 60 | 39 | 99 |
| 2024 Septiembre | 92 | 35 | 127 |
| 2024 Agosto | 102 | 70 | 172 |
| 2024 Julio | 78 | 36 | 114 |
| 2024 Junio | 82 | 48 | 130 |
| 2024 Mayo | 89 | 75 | 164 |
| 2024 Abril | 81 | 51 | 132 |
| 2024 Marzo | 66 | 30 | 96 |
| 2024 Febrero | 55 | 37 | 92 |
| 2024 Enero | 49 | 27 | 76 |
| 2023 Diciembre | 42 | 29 | 71 |
| 2023 Noviembre | 88 | 38 | 126 |
| 2023 Octubre | 108 | 32 | 140 |
| 2023 Septiembre | 97 | 28 | 125 |
| 2023 Agosto | 72 | 14 | 86 |
| 2023 Julio | 60 | 24 | 84 |
| 2023 Junio | 61 | 25 | 86 |
| 2023 Mayo | 68 | 44 | 112 |
| 2023 Abril | 50 | 21 | 71 |
| 2023 Marzo | 80 | 28 | 108 |
| 2023 Febrero | 45 | 18 | 63 |
| 2023 Enero | 41 | 40 | 81 |
| 2022 Diciembre | 61 | 29 | 90 |
| 2022 Noviembre | 68 | 47 | 115 |
| 2022 Octubre | 68 | 59 | 127 |
| 2022 Septiembre | 42 | 38 | 80 |
| 2022 Agosto | 48 | 43 | 91 |
| 2022 Julio | 68 | 62 | 130 |
| 2022 Junio | 67 | 47 | 114 |
| 2022 Mayo | 65 | 35 | 100 |
| 2022 Abril | 69 | 64 | 133 |
| 2022 Marzo | 71 | 68 | 139 |
| 2022 Febrero | 91 | 50 | 141 |
| 2022 Enero | 113 | 59 | 172 |
| 2021 Diciembre | 69 | 44 | 113 |
| 2021 Noviembre | 97 | 28 | 125 |
| 2021 Octubre | 71 | 44 | 115 |
| 2021 Septiembre | 47 | 49 | 96 |
| 2021 Agosto | 49 | 42 | 91 |
| 2021 Julio | 55 | 41 | 96 |
| 2021 Junio | 46 | 29 | 75 |
| 2021 Mayo | 48 | 49 | 97 |
| 2021 Abril | 90 | 84 | 174 |
| 2021 Marzo | 49 | 40 | 89 |
| 2021 Febrero | 28 | 39 | 67 |
| 2021 Enero | 45 | 30 | 75 |
| 2020 Diciembre | 25 | 9 | 34 |
Mostrar todo
