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001-es BibID:	BIBFORM061600
Első szerző:	Fülöp Tibor (kardiológus)
Cím:	Resolution of C1q deposition but not of the clinical nephrotic syndrome after immunomodulating therapy in focal sclerosis / Tibor Fülöp, Éva Csongrádi, Anna A. Lerant, Matthew Lewin, Jack R. Lewin
Dátum:	2015
Megjegyzések:	Background: The natural evolution of C1q nephropathy (C1qNP) during immunosuppressivetreatment is relatively little studied or understood.Case Presentation: A 30 year-old Caucasian female was referred to us for further managementof biopsy-proven C1qNP and severe nephrotic syndrome. Serologic work-up remainednegative, including complement C3 and C4 levels and repeated testing for antinuclearantibodies. A renal biopsy revealed minimal change nephropathy vs. focal sclerosis onlight microscopy and C1qNP on immunopathology. She has failed trials of high-dose oralprednisone, mycophenolate mofetil 1,500 mg twice a day and a subsequent regimen ofmonthly IV cyclophosphamide 750 mg ? 9 cycles. She also received the maximum toleratedangiotensin-converting enzyme inhibitor and spironolactone therapy. Random urine proteinto-creatinine (UPC) ratio predicted proteinuria in the range between 5-35 gm/day, whileserum creatinine rose progressively from 1.0 mg/dL to 1.4 mg/dL (to convert to ?mol/L,multiply by 88.4). A decision was made to repeat renal biopsy to reassess the underlyinghistology. The biopsy revealed focal sclerosis but no C1q deposition.Conclusions: Our case illustrates at least two points: first, an established pathologic diagnosisdoes not obviate the need for repeated renal biopsy later on, should diagnostic uncertaintypersist. Second, histological diagnoses may evolve over time, especially in a patient receivingactive and powerful immune-modulating treatment. In our case, the clinical nephrosis didnot change with immunosuppressive therapy while C1q deposition ceased, making this latterentity likely the immunologically mediated process.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Journal of Nephropathology. - 4 : 2 (2015), p. 54-58, -
További szerzők:	Csongrádi Éva (1969-) (szakorvos) Lerant, Anna (orvos) Lewin, Matthew (orvos) Lewin, Jack R.
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM068276
Első szerző:	Gharaibeh, Kamel A. (orvos)
Cím:	Pulmonary embolization with tunneled hemodialysis catheter-associated blood stream infection : the perils of systemic anticoagulation / Kamel A. Gharaibeh, Éva Csongrádi, Michael Shoemaker-Moyle, Anna Lerant, Mihály Tapolyai, Tibor Fülöp
Dátum:	2012
Megjegyzések:	A 35-year old African-American male withend-stage renal disease on hemodialysisthrough a tunneled dialysis catheter (TDC) presentedwith fever, diffuse aches and generalizeddistress. Blood cultures (BC) wereobtained and empirical broad-spectrum antibiotictherapy started. After urgent renal dialysis,TDC was pulled at the bedside. Chest computedtomography (CT) diagnosed pulmonaryembolism and systemic i.v. heparin was initiated.BC grew Gram positive cocci (methicillinsensitiveS. aureus) and cardiac echocardiogramconfirmed acute bacterial endocarditis.Due to declined mental status, CT imaging wasobtained revealing massive intracranial hemorrhageleading to the patient's death. Furtherchest CT review revealed only hemodynamicallynon-significant pulmonary emboli in somesegmental and subsegmental arteries.Pulmonary embolization may be an expectedoccurrence with removal of infected TDC; systemicanticoagulation may not be warranted insuch cases and may lead to catastrophicintracranial hemorrhage. This case draws ourattention to the perils of rigid adherence to protocoland the failure of considering the needs ofspecial patient cohorts and individualized care.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Nephrology Reviews. - 4 : 2 (2012), p. 73-75. -
További szerzők:	Csongrádi Éva (1969-) (szakorvos) Shoemaker-Moyle Michael (orvos) Lerant, Anna (orvos) Tapolyai Mihály (1968-) (nefrológus) Fülöp Tibor (1957-) (kardiológus)
Internet cím:	DOI Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM061590
Első szerző:	Gharaibeh, Kamel A. (orvos)
Cím:	Desmopression is an effective adjunct treatment for reversing excessive hyponatremia overcorrection / Kamel A. Gharaibeh, Matthew J. Craig, Christian A. Koch, Anna A. Lerant, Tibor Fülöp, Éva Csongrádi
Dátum:	2013
ISSN:	2307-8960
Megjegyzések:	We report a case of a 50-year-old malnourished AfricanAmerican male with hiccups, nausea and vomiting whowas brought to the Emergency Department after repeatedseizures at home. Laboratory evaluations revealedsodium (Na+) 107 mmol/L, unmeasurably low potassium,chloride < 60 mmol/L, bicarbonate of 38 mmol/Land serum osmolality 217 mOsm/kg. Seizures werecontrolled with 3% saline ?. Once nausea was controlledwith iv antiemetics, he developed large volumefree water diuresis with 6 L of dilute urine in 8 h (urineosmolality 40-60 mOsm/kg) and serum sodium rapidlyrose to 126 mmol/L in 12 h. Both intravenous desmopressinand 5% dextrose in water was given to achievea concentrated urine and to temporarily reverse theCASE REPORTWorld J Clin Cases 2013 August 16; 1(5): 155-158ISSN 2307-8960 (online)? 2013 Baishideng. All rights reserved.Online Submissions: http://www.wjgnet.com/esps/wjcc@wjgnet.comdoi:10.12998/wjcc.v1.i5.155WJCC\|www.wjgnet.com 55 August 16, 2013\|Volume 1\|Issue 5\|World Journal ofW J C C Clinical Casesacute rise of sodium, respectively. Serum Na+ was graduallyre-corrected in 2-3 mmol/L daily increments from118 mmol/L until 130 mmol/L. Hypokalemia was slowlycorrected with resultant auto-correction of metabolicalkalosis. The patient discharged home with no neurologicsequaele on the 11th hospital day. In euvolemichyponatremic patients controlling nausea may contributeto unpredictable free water diuresis. The addition ofan antidiuretic hormone analog, such as desmopressincan limit urine output and prevent an unpredictable riseof the serum sodium.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Hyponatremia Hypokalemia Overcorrection Polyuria Antidiuretic hormone Vasopressin Desmopressin Osmotic demyelination syndrome Central pontine myelinolysis
Megjelenés:	World Journal of Clinical Cases. - 1 : 5 (2013), p. 155-158. -
További szerzők:	Craig, Matthew J. (orvos) Koch, Christian A. Lerant, Anna (orvos) Fülöp Tibor (1957-) (kardiológus) Csongrádi Éva (1969-) (szakorvos)
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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