This case report describes a patient who presented with acute kidney injury (AKI) and nephrotic syndrome. Initial clinical manifestations mimicked rapidly progressive glomerulonephritis (RPGN) but a renal biopsy revealed collapsing focal segmental glomerulosclerosis (FSGS) with acute tubular necrosis (ATN). The AKI was likely caused by volume depletion from diarrhea exacerbating underlying renal abnormalities from nephrotic syndrome. This case highlights the challenges of differentiating various glomerular diseases based on clinical presentation alone and the importance of renal biopsy for accurate diagnosis.
Still’s Disease and Recurrent Complex Regional Pain Syndrome Type-I: The Firs...Samantha Adcock
Clinical Study
Still’s Disease and Recurrent Complex Regional Pain Syndrome
Type-I: The First Description
C´esar Faillace and Joz´elio Freire de Carvalho
Is your business Google-ized? This 3 hour class gives an overview of Inbound Marketing strategies that Google loves! We review on-site SEO, content creation, promotion through social media, lead generation, and the importance of mobile.
Still’s Disease and Recurrent Complex Regional Pain Syndrome Type-I: The Firs...Samantha Adcock
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Is your business Google-ized? This 3 hour class gives an overview of Inbound Marketing strategies that Google loves! We review on-site SEO, content creation, promotion through social media, lead generation, and the importance of mobile.
Implementing a Hyper-V Virtualization InfrastructureASPE, Inc.
Virtualization is a hot topic today and for good reason. Using virtualization technologies organizations can reduce costs while increasing service provision and technical capabilities. Hyper-V, Microsoft’s latest offering in the virtualization market, presents a whole new virtual machine technology in the Microsoft product line. Comparable to VMware’s ESX server solution, Hyper-V comes out-of-the-box with Windows 2008 Server systems and can integrate with other Microsoft management tools such as System Center and group policies.
In this webinar, we will introduce you to the features and benefits of Hyper-V and you will gain important knowledge including:
· Hardware requirements of Hyper-V
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Kidney damage is exceptionally reported during acute septicemic brucellosis. It can remain isolated or becomes part of a more severe picture of multisystemic bacterial involvement and usually progresses favorably under appropriate antibiotic therapy. We report an original case of reversible acute renal failure in a 50-year-old Tunisian woman associated to neurobrucellosis with diffuse cerebral vasculitis and syndrome of inappropriate secretion of antidiuretic hormone. This mechanism (brucellar renal vasculitis) was found only once in the medical literature.
Implementing a Hyper-V Virtualization InfrastructureASPE, Inc.
Virtualization is a hot topic today and for good reason. Using virtualization technologies organizations can reduce costs while increasing service provision and technical capabilities. Hyper-V, Microsoft’s latest offering in the virtualization market, presents a whole new virtual machine technology in the Microsoft product line. Comparable to VMware’s ESX server solution, Hyper-V comes out-of-the-box with Windows 2008 Server systems and can integrate with other Microsoft management tools such as System Center and group policies.
In this webinar, we will introduce you to the features and benefits of Hyper-V and you will gain important knowledge including:
· Hardware requirements of Hyper-V
· Benefits of Hyper-V over Virtual Server 2005
· Management options for large-scale implementations
· Deployment planning
· Keys to performance within virtual machines
Kidney damage is exceptionally reported during acute septicemic brucellosis. It can remain isolated or becomes part of a more severe picture of multisystemic bacterial involvement and usually progresses favorably under appropriate antibiotic therapy. We report an original case of reversible acute renal failure in a 50-year-old Tunisian woman associated to neurobrucellosis with diffuse cerebral vasculitis and syndrome of inappropriate secretion of antidiuretic hormone. This mechanism (brucellar renal vasculitis) was found only once in the medical literature.
Over the last decades, more than 35 different definitions have been used to describe acute kidney injury (AKI). Multiple definitions for AKI have obviously led to a great disparity in the reported incidence and mortality of AKI making it difficult or even impossible to compare the various published studies focusing on AKI. Therefore, it became crucial to establish a consensual and accurate definition of AKI that could desirably be used worldwide. Recent consensus criteria for AKI definition and classification [the Risk Injury Failure Loss of kidney function End-stage kidney disease (RIFLE) and the Acute Kidney Injury Network (AKIN) classifications] have led to more consistent estimates of its epidemiology. This review will present and critically discuss current literature about AKI diagnosis and epidemiology.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
2. 1006 M.F. Rodamilans et al.
RESULTS cultures were not performed. Infectious diarrhea and
AKI were suspected and she was started on intravenous
A 49-year-old Brazilian female was transferred from a antibiotics and gentle volume expansion with crystal-
small community hospital to a tertiary care facility for loids. Three days later, diarrhea had resolved but BUN
emergent hemodialysis. Transfer papers indicated that and serum creatinine had risen to 70 and 7.9 mg/dL,
she had presented to the outside hospital with a respectively, and she was transferred to a tertiary care
1-week history of fever, abdominal pain, diarrhea, and facility for emergent hemodialysis. Further investiga-
oliguria. In addition, she admitted to a 4-month tion included normal serum complements, negative
history of lower extremity edema progressing to viral and auto-antibody panels, 24-hour urine protein
anasarca, for which she was evaluated 1 month prior to 1059 mg, serum albumin < 1.0 g/dL, total cholesterol
admission. At that time, she was found to have a 306 mg/dL, and triglycerides 208 mg/dL. Renal ultra-
normal blood pressure, facial and lower extremity sound revealed normal-sized kidneys. Given the
edema, BUN 32 mg/dL, serum creatinine 1.38 mg/dL, history of proteinuria, hematuria, and rapid loss of
and urinalysis with 3+ protein and a benign sediment. renal function, a diagnosis of RPGN was entertained.
She denied any further investigation or treatment for Treatment was started with pulse therapy with methyl-
Ren Fail Downloaded from informahealthcare.com by 189.105.143.226 on 08/19/10
this condition. Her medical history was otherwise prednisolone (1 g IV per day for 3 days) and cyclo-
unremarkable and she denied taking any medications. phosphamide (600 mg IV, single dose) followed by
Upon admission to the outside hospital, she was prednisone 1 mg/kg/day. A percutaneous renal biopsy
afebrile and normotensive; orthostatic changes were was performed without complications and revealed
not reported. Physical examination revealed anasarca collapsing FSGS with a component of ATN (Figure 1).
and bilateral pleural effusions; there was no jaundice. She experienced a quick recovery of renal function and
Laboratory studies showed urinalysis with 3+ protein, was able to discontinue dialysis after a single session
6 white blood cells, and too numerous to count red (Figure 2A). She was discharged 4 weeks later with a
serum creatinine of 1.2 mg/dL and 24-hour urine
For personal use only.
blood cells per high power field but no red cell casts;
there were no eosinophils in the urine; BUN 43 mg/ protein of 2670 mg. One month later, serum creati-
dL, serum creatinine 4.86 mg/dL, hematocrit 28%, nine was 0.9 mg/dL and 24-hour urine protein was
white blood cell count 15,700 without bandemia and down to 430 mg. Five months after discharge, 24-hour
platelet count 447,000; a peripheral blood smear was urine protein was down to 147 mg and a steroid taper
negative for schistocytes; stool studies or blood was begun. One year later, she remains in complete
FIGURE 1. Kidney histology showing focal segmental glomerular sclerosis. (A–D)
Most glomeruli and tubules are normal (A). Some glomeruli show segmental col-
lapse and overlying podocyte hypertrophy and hyperplasia (B and C). Patches of
injured tubules showing flattening and loss of tubule brush border; cellular debris are
seen in the lumen. The interstitium is edematous with a few leukocytes (D).
Renal Failure
4. 1008 M.F. Rodamilans et al.
serum albumin and more proteinuria than those Declaration of interest: The authors report no
without AKI; interestingly, AKI patients were more conflicts of interest. The authors alone are responsible
likely to have had resistance to steroids and to have for the content and writing of the paper.
FSGS on a repeat renal biopsy.10
In a review of the pathophysiology of AKI in patients
with idiopathic nephrotic syndrome, Koomans suggested REFERENCES
the following as potential mechanisms: decreased
perfusion pressure, decreased filtration coefficient, high [1] Koomans HA. Pathophysiology of acute renal failure in idio-
intra-tubular pressure, ATN, interstitial nephritis, and pathic nephrotic syndrome. Nephrol Dial Transplant. 2001;
16(2):221–224.
interstitial edema.1 Our patient had a very low albumin [2] Thadhani R, Pascual M, Bonventre JV. Acute renal failure. N
and anasarca; in this setting, the additional reduction in Engl J Med. 1996;334(22):1448–1460.
effective circulating arterial volume induced by the diar- [3] Tarr PI. Shiga toxin-associated hemolytic uremic syndrome and
rhea probably led to ischemic ATN. The ATN findings thrombotic thrombocytopenic purpura: Distinct mechanisms of
in our patient’s biopsy were patchy and mild despite pro- pathogenesis. Kidney Int Suppl. 2009 February(112):S29–S32.
[4] Nasr SH, Said SM, Valeri AM, et al. Membranous glomeru-
found renal dysfunction; this physiologic and pathologic lonephritis with ANCA-associated necrotizing and crescen-
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dissociation has been previously described.11 tic glomerulonephritis. Clin J Am Soc Nephrol. 2009;4(2):
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proteinuria < 3.5 g and presence of hematuria are still [5] Futrakul N, Siriviriyakul P, Deekajorndej T, Futrakul P.
left unexplained. We posit that the first 24-hour urine Hemodynamic maladjustment and disease progression in
nephrosis with FSGS. Ren Fail. 2004;26(3):231–236.
collection was performed during oliguric AKI (serum [6] Tanaka H, Tateyama T, Waga S. Acute renal failure at the
creatinine of 4.3 mg/dL), which may have impaired pro- onset of idiopathic nephrotic syndrome in two children. Clin
tein excretion; nevertheless, a laboratory error cannot Exp Nephrol. 2001;5:47–49.
be excluded. A second 24-hour urine collection per- [7] Polaina Rusillo M, Borrego Utiel FJ, Ruiz Ávila I, Perez
formed 1 month later, while the serum creatinine was Bañasco V. Acute renal failure in a case of nephrotic syndrome
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secondary to focal and segmental glomerulosclerosis. Nefrologia
1.2 mg/dL, also revealed sub-nephrotic proteinuria but 2008;28(1):106–107.
this can be simply attributed to a response to therapy. [8] Jennette JC, Falk RJ. Adult minimal change glomerulopathy
In our opinion, the presentation with anasarca and with acute renal failure. Am J Kidney Dis. 1990;16(5):432–437.
serum albumin level < 1.0 g/dL leaves no doubt as to [9] Smith JD, Hayslett JP. Reversible renal failure in the nephrotic
the severity of our patient’s proteinuria. Although syndrome. Am J Kidney Dis. 1992;19(3):201–213.
[10] Waldman M, Crew RJ, Valeri A, et al. Adult minimal-change
FSGS typically presents with “pure” nephrotic disease: Clinical characteristics, treatment, and outcomes. Clin
syndrome, the presence of microscopic hematuria is not J Am Soc Nephrol. 2007;2(3):445–453.
that uncommon. Indeed, in one study, some degree of [11] Rosen S, Stillman IE. Acute tubular necrosis is a syndrome of
hematuria was detected in the majority of FSGS physiologic and pathologic dissociation. J Am Soc Nephrol.
patients.12 Other authors have shown that 12–19% of 2008;19(5):871–875.
[12] Mitwalli AH, Al WJ, bu-Aisha H, et al. Prevalence of glomeru-
patients with FSGS may actually present with a lar diseases: King khalid university hospital, saudi arabia. Saudi
nephritic picture.13–15 At least in children with FSGS, J Kidney Dis Transpl. 2000;11(3):442–448.
the presence of hematuria has been linked to a higher [13] Covic A, Schiller A, Volovat C, et al. Epidemiology of renal
risk of progression to chronic kidney disease.16 disease in Romania: A 10 year review of two regional renal
This report is a reminder of how AKI may compli- biopsy databases. Nephrol Dial Transpl. 2006;21(2):419–424.
[14] Rychlik I, Jancova E, Tesar V, et al. The Czech registry of renal
cate the course of nephrotic syndrome and create a biopsies. Occurrence of renal diseases in the years 1994–2000.
diagnostic challenge. In our case, the combined pres- Nephrol Dial Transpl. 2004;19(12):3040–3049.
ence of AKI and hematuria in a patient with collapsing [15] Naini AE, Harandi AA, Ossareh S, Ghods A, Bastani B.
FSGS mimicked an RPGN and prompted aggressive Prevalence and Clinical Findings of Biopsy-Proven Glomeru-
therapy with steroids and cyclophosphamide. Neverthe- lonephritidis in Iran. Saudi J Kidney Dis Transpl. 2007;18(4):
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less, careful interpretation of the history and laboratory [16] Abrantes MM, Cardoso LS, Lima EM, et al. Predictive factors
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in complex cases, with blending of pathologies. losclerosis. Pediatr Nephrol. 2006;21(7):1003–1012.
Renal Failure