Heard a case in Renal Grand Rounds this morning regarding an elderly (72 year-old) 1st-time cadavaric renal transplant recipient who presented during his 3rd month post-transplant with fever, an elevated creatinine, and a CT scan showing mediastinal lymphadenopathy….
At the Brigham and Women’s Hospital & the Dana Farber Cancer Institute, there is an ongoing trial of using pneumonectomy and injected, heated cisplatin into the pleural space for patients with malignant mesothelioma, a condition with an overall…
One of the rare but serious side effects of recombinant erythropoietin therapy is the possibility of pure red cell aplasia, an autoimmune condition in which antibodies against erythropoietin result in T-cell-mediated destruction of erythroid precursors. It may be…
I saw a patient in the renal transplant clinic today for evaluation to get onto the kidney transplant list, as he is just around the corner to starting dialysis (actually, he may actually start tonight since his routine…
The M3 subtype of acute myelogenous leukemia–also known as acute promyelocytic leukemia–is one of the most responsive forms of leukemia, as the addition of all-trans retinoic acid (ATRA) is known to overcome the maturation block in affected lymphocytes. While…
Quick case summary as presented in Renal Grand Rounds today: A 54 year-old man presents with altered mental status, a sky-high ammonia level (>200) and anemia requiring blood transfusion. Other unusual lab values include hypophosphatemia and hypokalemia with…
Another oncologic medication with a specific renal side effect is gemcitabine (Gemzar), a nucleoside analogue used with frequency to treat cancer of the lung, pancreas, breast and colon to name a few. Gemcitabine can cause a thrombotic…
The case: a 50-ish yo woman, normal baseline renal function, and a history of nephrolithiasis x 2 episodes presented with gross, painless hematuria. She was initially thought to have another stone event, but she had no significant flank…
Welcome to Cytoxan (cyclophosphamide), one of the most versatile (albeit toxic) medications in the nephrology world. Its mechanism of action is as an alkylating agent; it induced alkylation of DNA in actively proliferating cells, which explains its use…
Post-transplant lymphoproliferative disorder (PTLD) occurs in < 1% of kidney transplant recipients, but can often be a serious complication. In essence, PTLD is a form of lymphoma which occurs due to decreased immune surveillance as a result of...
