Koseiren Sanjo General Hospital

Sanjō, Japan

Koseiren Sanjo General Hospital

Sanjō, Japan
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Iwafuchi Y.,Koseiren Sanjo General Hospital | Morita T.,Shinrakuen Hospital | Hata K.,Koseiren Sanjo General Hospital | Nakamura A.,Koseiren Sanjo General Hospital | Miyazaki S.,Shinrakuen Hospital
Clinical Nephrology | Year: 2012

Schnitzler syndrome is a rare clinical entity characterized by the association of chronic urticarial rash and monoclonal immunoglobulin M gammopathy. A 62-yearold male developed nephrotic syndrome with Schnitzler syndrome. A renal biopsy revealed mild thickening of the glomerular basement membrane with spikes and mild expansion of the mesangial matrix; prominent fine granular immunoglobulin G depositions were found along the capillary walls by immunofluorescence study and electron dense deposits were observed in the subepithelial spaces and in a part of mesangium by electron microscopically. The histological findings were compatible with secondary form of membranous nephropathy. To the best of our knowledge this is the first renal biopsy case of Schnitzler syndrome. With corticosteroid treatment chronic rash and proteinuria have disappeared, but immunoglobulin (IgM) paraprotein has been still present. © 2012 Dustri-Verlag Dr. K. Feistle.


Iwafuchi Y.,Koseiren Sanjo General Hospital | Okamoto K.,Niigata University | Oyama Y.,Koseiren Sanjo General Hospital | Narita I.,Niigata University
Internal Medicine | Year: 2016

A 28-year-old man was admitted to our hospital with nausea, headache and weakness of the left hand. He had severe uremia without hypertension due to recurrent/chronic pyelonephritis. Brain magnetic resonance imaging showed reversible vasogenic edema in the brainstem and bilateral frontal centrum semiovale. All of his neurological symptoms immediately improved after the introduction of hemodialysis. When a patient with uremia presents with neurological symptoms, posterior reversible encephalopathy syndrome should be considered in the differential diagnosis even if high blood pressure is not observed. Brain magnetic resonance imaging may be helpful in such a case, and an appropriate therapy could be subsequently initiated. © 2016 by The Japanese Society of Internal Medicine.


Iwafuchi Y.,Koseiren Sanjo General Hospital | Morioka T.,Kidney Center | Morita T.,Shinrakuen Hospital | Watanabe K.,Niigata University | And 2 more authors.
Case Reports in Nephrology and Dialysis | Year: 2016

Nephrotic syndrome without hematuria due to infection-related glomerulonephritis is uncommon. The present report describes a case of nephrotic syndrome due to infection-related glomerulonephritis without hematuria and hypertension in an older child. A 14-year-old boy was referred to our hospital because of a 5-day history of fever, nausea, weight gain and recent leg edema without hypertension. Laboratory data showed nephrotic-range proteinuria, hypoalbuminemia, mild hypocomplementemia and acute renal injury without hematuria. Although, due to the clinical presentation, minimal-change nephrotic syndrome was mostly suspected, a renal biopsy showed endocapillary hypercellularity mainly of mononuclear cells with segmental mesangiolytic changes. Fine granular IgG and C3 deposits were noted by an immunofluorescent study; many relatively small electron-dense deposits were observed electron-microscopically. These findings led to the diagnosis of nephrotic syndrome due to infection-related endocapillary proliferative glomerulonephritis, although the causative organism of his nephritis was not detected. He recovered with rest and dietary cure. When we examine an acute nephrotic child, infection-related glomerulonephritis should be considered as the differential diagnosis to avoid unnecessary use of corticosteroids. © 2016 The Author(s). Published by S. Karger AG, Basel.


PubMed | Koseiren Sanjo General Hospital
Type: Case Reports | Journal: Clinical nephrology | Year: 2012

Schnitzler syndrome is a rare clinical entity characterized by the association of chronic urticarial rash and monoclonal immunoglobulin M gammopathy. A 62-year old male developed nephrotic syndrome with Schnitzler syndrome. A renal biopsy revealed mild thickening of the glomerular basement membrane with spikes and mild expansion of the mesangial matrix; prominent fine granular immunoglobulin G depositions were found along the capillary walls by immunofluorescence study and electron dense deposits were observed in the subepithelial spaces and in a part of mesangium by electron microscopically. The histological findings were compatible with secondary form of membranous nephropathy. To the best of our knowledge this is the first renal biopsy case of Schnitzler syndrome. With corticosteroid treatment chronic rash and proteinuria have disappeared, but immunoglobulin (IgM) paraprotein has been still present.


PubMed | Kobe University, Niigata University, Koseiren Sanjo General Hospital and Shinrakuen Hospital
Type: Journal Article | Journal: Case reports in nephrology and dialysis | Year: 2016

Many types of inherited renal diseases have ocular features that occasionally support a diagnosis. The following study describes an unusual example of a 40-year-old woman with granular corneal dystrophy type II complicated by renal involvement. These two conditions may coincidentally coexist; however, there are some reports that demonstrate an association between renal involvement and granular corneal dystrophy type II. Granular corneal dystrophy type II is caused by a mutation in the


PubMed | Niigata University, Kidney Center, Koseiren Sanjo General Hospital and Shinrakuen Hospital
Type: Journal Article | Journal: Case reports in nephrology and dialysis | Year: 2016

Nephrotic syndrome without hematuria due to infection-related glomerulonephritis is uncommon. The present report describes a case of nephrotic syndrome due to infection-related glomerulonephritis without hematuria and hypertension in an older child. A 14-year-old boy was referred to our hospital because of a 5-day history of fever, nausea, weight gain and recent leg edema without hypertension. Laboratory data showed nephrotic-range proteinuria, hypoalbuminemia, mild hypocomplementemia and acute renal injury without hematuria. Although, due to the clinical presentation, minimal-change nephrotic syndrome was mostly suspected, a renal biopsy showed endocapillary hypercellularity mainly of mononuclear cells with segmental mesangiolytic changes. Fine granular IgG and C3 deposits were noted by an immunofluorescent study; many relatively small electron-dense deposits were observed electron-microscopically. These findings led to the diagnosis of nephrotic syndrome due to infection-related endocapillary proliferative glomerulonephritis, although the causative organism of his nephritis was not detected. He recovered with rest and dietary cure. When we examine an acute nephrotic child, infection-related glomerulonephritis should be considered as the differential diagnosis to avoid unnecessary use of corticosteroids.


PubMed | Koseiren Sanjo General Hospital
Type: Case Reports | Journal: Internal medicine (Tokyo, Japan) | Year: 2016

A 28-year-old man was admitted to our hospital with nausea, headache and weakness of the left hand. He had severe uremia without hypertension due to recurrent/chronic pyelonephritis. Brain magnetic resonance imaging showed reversible vasogenic edema in the brainstem and bilateral frontal centrum semiovale. All of his neurological symptoms immediately improved after the introduction of hemodialysis. When a patient with uremia presents with neurological symptoms, posterior reversible encephalopathy syndrome should be considered in the differential diagnosis even if high blood pressure is not observed. Brain magnetic resonance imaging may be helpful in such a case, and an appropriate therapy could be subsequently initiated.

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