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prabakaran MD R, Gupta K, sharma A, Kohli H, Ramachandran R. SUN-293 LOW-DOSE VALGANCICLOVIR IS AS EFFECTIVE AS THE STANDARD DOSE PROPHYLAXIS FOR CYTOMEGALOVIRUS IN RENAL TRANSPLANT RECIPIENTS. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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NAYAK S, Prabhahar A, Bahuguna P, Gupta K, Kohli H, Ramachandran R. SUN-003 ONLINE HEMODIAFILTRATION (POST-DILUTION) AS COMPARED TO HIGH FLUX HEMODIALYSIS DOES NOT IMPROVE OUTCOMES IN COMMUNITY ACQUIRED AKI WITH SIRS- A RANDOMISED CONTROLLED TRIAL. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Ramachandran R, Bharati J, Kohli H. SUN-372 CD 19 targeted Rituximab is safe and effective in the management of Steroid dependent/resistant Podocytopathy. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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INAMDAR N, Prabhahar A, Tomer S, Bansal A, Gorsi U, Arora S, Gupta K, Kohli H, Ramachandran R. SAT-016 ENDOTHELIAL DYSFUNCTION REVERSES WITH RENAL FUNCTION RECOVERY IN PATIENTS WITH DIALYSIS REQUIRING COMMUNITY-ACQUIRED AKI WITH SIRS. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Gupta K, Girimaji N, Ramachandran R, Rathi M, Rakha A, Sharma A, Duseja R. SAT-402 STUDY OF T-REGULATORY CELLS AND B-REGULATORY CELLS IN LUPUS NEPHRITIS: A PROSPECTIVE CONTROLLED STUDY. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Murhekar M, Joshua V, Kanagasabai K, Shete V, Ravi M, Ramachandran R, Sabarinathan R, Kirubakaran B, Gupta N, Mehendale S. Epidemiology of dengue fever in India, based on laboratory surveillance data, 2014–2017. Int J Infect Dis 2019; 84S:S10-S14. [DOI: 10.1016/j.ijid.2019.01.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 01/05/2019] [Accepted: 01/07/2019] [Indexed: 11/17/2022] Open
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Prudenzano D, Lique F, Ramachandran R, Bizzocchi L, Caselli P. Collisional excitation of NH( 3Σ -) by Ar: A new ab initio 3D potential energy surface and scattering calculations. J Chem Phys 2019; 150:214302. [PMID: 31176333 DOI: 10.1063/1.5097651] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Collisional excitation of light hydrides is important to fully understand the complex chemical and physical processes of atmospheric and astrophysical environments. Here, we focus on the NH(X3Σ-)-Ar van der Waals system. First, we have calculated a new three-dimensional Potential Energy Surface (PES), which explicitly includes the NH bond vibration. We have carried out the ab initio calculations of the PES employing the open-shell single- and double-excitation couple cluster method with noniterative perturbational treatment of the triple excitations. To achieve a better accuracy, we have first obtained the energies using the augmented correlation-consistent aug-cc-pVXZ (X = T, Q, 5) basis sets and then we have extrapolated the final values to the complete basis set limit. We have also studied the collisional excitation of NH(X3Σ-)-Ar at the close-coupling level, employing our new PES. We calculated collisional excitation cross sections of the fine-structure levels of NH by Ar for energies up to 3000 cm-1. After thermal average of the cross sections, we have then obtained the rate coefficients for temperatures up to 350 K. The propensity rules between the fine-structure levels are in good agreement with those of similar collisional systems, even though they are not as strong and pronounced as for lighter systems, such as NH-He. The final theoretical values are also compared with the few available experimental data.
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Agrawal P, Nada R, Ramachandran R, Rayat CS, Kumar A, Kohli HS. Loss of Subpodocytic Space Predicts Poor Response to Tacrolimus in Steroid-Resistant Calcineurin Inhibitor-Naïve Adult-Onset Primary Focal Segmental Glomerulosclerosis. Indian J Nephrol 2019; 29:90-94. [PMID: 30983748 PMCID: PMC6440328 DOI: 10.4103/ijn.ijn_422_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Focal segmental glomerulosclerosis (FSGS) is the most common cause of adult-onset nephrotic syndrome, but its pathophysiology is poorly understood. The question as to why only a subset of patients responds to treatment in unanswered. In the past few years, change of podocytic phenotype from stationary type in health to migratory type in disease has been described, of which loss of subpodocytic space is a surrogate marker. Diagnostic biopsies of adult-onset steroid-resistant calcineurin inhibitor-naïve primary FSGS cases, which were subsequently treated with tacrolimus were included in this retrospective study conducted from 2011 to 2013. The ultrastructure of all cases was studied in detail, especially in context to the presence or absence of subpodocytic space. In the present study, we have compared presence or absence of subpodocytic space in tacrolimus-responsive versus tacrolimus-resistant cases to identify potential electron microscopic features predictive of response to treatment, of which loss of subpodocytic space indicating migratory phenotype is the most important and consistent feature. The present series included 7 tacrolimus responsive cases (includes two cases with partial response) and seven tacrolimus-resistant cases. The tacrolimus-resistant patients were of older age, had a longer duration of illness, and a lower eGFR as compared to tacrolimus responsive cases. The subpodocytic space was preserved in patients on tacrolimus with complete remission and lost in patients with partial response and tacrolimus-resistant cases.
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Singh N, Pattanashetti N, Joshi K, Kohli HS, Gupta KL, Ramachandran R. Missed Monoclonal Disease Manifesting in Early Post-renal Transplant Period. Indian J Nephrol 2019; 29:65-69. [PMID: 30814798 PMCID: PMC6375021 DOI: 10.4103/ijn.ijn_384_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
A 63-year-old diabetic gentleman with microvascular complications presented with advanced azotemia and anemia. He was stabilized with blood transfusion and hemodialysis. With the probable diagnosis of diabetic nephropathy-related end-stage renal disease, he underwent kidney transplantation. He had delayed graft function. Graft biopsy done on the 2nd postoperative day showed acute tubular necrosis. Graft biopsy repeated after 2 weeks for persistent graft dysfunction showed myeloma cast nephropathy (MCN) and light chain proximal tubulopathy. Work-up for multiple myeloma was positive. He was started on plasmapheresis and chemotherapy. However, he suffered sudden cardiac death during dialysis after 1 week. The presence of MCN in the early graft biopsy implies that it must have been the cause for his native kidney failure. Thus, renal failure in a diabetic should not always be presumed to be due to diabetic nephropathy, and kidney biopsy should be done in diabetics with atypical features.
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Murhekar M, Kanagasabai K, Shete V, Joshua V, Ravi M, Kirubakaran BK, Ramachandran R, Sabarinathan R, Gupta N. Epidemiology of chikungunya based on laboratory surveillance data—India, 2016–2018. Trans R Soc Trop Med Hyg 2019; 113:259-262. [DOI: 10.1093/trstmh/try141] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/14/2018] [Accepted: 12/14/2018] [Indexed: 11/12/2022] Open
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Sankarganesh D, Ramachandran R, Suriyakalaa U, Ramesh Saravanakumar V, Archunan G, Akbarsha MA, Achiraman S. Assessment of urinary volatile compounds and proteins in the female goat Capra hircus: A pilot study to reveal potential indicators of oestrus. Reprod Domest Anim 2019; 54:646-651. [PMID: 30659685 DOI: 10.1111/rda.13407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 12/29/2018] [Indexed: 11/29/2022]
Abstract
Urine samples of female goats in pro-oestrus, oestrus and post-oestrus phases were analysed for finding oestrus-specific volatile compounds using gas chromatograph-mass spectrometry (GC-MS), and proteins using sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS). Fourteen urinary volatile were identified covering all three phases among which four compounds, 1-Tetradecanol, n-Pentadecanol, 3-Methylene tridecane and 2-Ethyl-1-dodecene, were unique to oestrus. Also, oestrus urine contained a 25 kDa protein, which was totally absent in pro-oestrus urine, and less-expressed in post-oestrus urine. This protein revealed to be complement C3 fragment. This pilot study, for the first time, reveals the difference in urinary volatile compounds and proteins in the female goat during the different phases of oestrous cycle. The four unique volatile compounds and a 25 kDa protein that appeared as oestrus-specific in this study warrant further investigation to consider them as urinary biomarkers of oestrus in goats.
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Pattanashetti N, Gupta S, Rana S, Dahiya D, Das A, Kumar V, Rathi M, Kohli HS, Gupta KL, Ramachandran R. Intestinal Tuberculosis: A Rare Case of Massive Gastrointestinal Bleed in a Post-Renal Transplant Recipient. Indian J Nephrol 2019; 29:132-134. [PMID: 30983756 PMCID: PMC6440334 DOI: 10.4103/ijn.ijn_360_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Massive rectal bleeding is an uncommon presentation of ileal tuberculosis (TB). We report an uncommon cause of anemia in a post-renal transplant patient due to massive lower gastrointestinal (LGI) bleed. The index case had a normal upper and LGI endoscopy, but the 99technetium labeled red blood cell scan showed active bleeding from terminal ileum and caecum. Microscopic examination of the resected specimen revealed tubercular granuloma with acid-fast bacilli. Intestinal TB should be a differential diagnosis for massive LGI bleed in immunosuppressed patients in developing country.
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Senanayake HM, Patabendige M, Ramachandran R. Piloting of WHO Safe Childbirth Checklist using a modified version in Sri Lanka. BMC Res Notes 2018; 11:896. [PMID: 30547838 PMCID: PMC6295046 DOI: 10.1186/s13104-018-4009-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 12/10/2018] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Data was gathered to study the impact of a context-specific modified WHO Safe Childbirth Checklist (mSCC) at two tertiary care settings in Sri Lanka, as a part of an implementation program. DATA DESCRIPTION We provide data sets of a prospective observational study which was conducted in the University Obstetrics Unit at De Soysa Hospital for Women (DSHW), Colombo and two Obstetric Units at Teaching Hospital, Mahamodara, Galle (THMG), Sri Lanka. These consist of demographic and checklist implementation details and data on the level of acceptance. The study was conducted over 8 weeks at DSHW and over 4 weeks at THMG. Checklists were kept attached to clinical records at admission and collected on discharge. Level of acceptance was assessed using a self-administered questionnaire. Outcome measures were adoption rate (percentage of deliveries where mSCC was used), adherence to practices (mean percentage of items checked in each checklist), response rate (percentage of staff members who responded to questionnaire) and level of acceptance (percentage of "strongly agree/agree" in Likert scale to five questions regarding acceptance of modified SCC).
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dos Santos M, Ramachandran R, Kiess A, Wamsley K, McDaniel C. The Impact of Dietary Yeast Fermentation Product Derived from Saccharomyces cerevisiae on Semen Quality and Semen Microbiota of Aged White Leghorn roosters. J APPL POULTRY RES 2018. [DOI: 10.3382/japr/pfy050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Sethi J, Bagai S, Ramachandran R, Kumar V, Rathi M, Kohli HS, Gupta KL. Time to Revisit the Use of Nontunneled Dialysis Vascular Catheters Even in Cost-Limited Setting. Indian J Nephrol 2018; 28:406-407. [PMID: 30271008 PMCID: PMC6146739 DOI: 10.4103/ijn.ijn_443_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ramachandran R, Nascimento Dos Santos M, Kawaoku AJT, McDaniel CD. Roles of the sire and dam quail in egg, yolk, albumen, and shell weight alterations due to the parthenogenetic trait. Theriogenology 2018; 118:103-109. [PMID: 29886356 DOI: 10.1016/j.theriogenology.2018.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 05/18/2018] [Accepted: 05/23/2018] [Indexed: 10/14/2022]
Abstract
Infertile eggs from Chinese Painted quail exhibit parthenogenesis, and the 1st egg in a clutch sequence is more likely to develop a parthenogenetic embryo. Also, hens that exhibit parthenogenesis have shorter clutches and heavier egg weights. These larger eggs may be a result of the egg residing in the oviduct longer, allowing more time for the parthenote to develop. However, it is unknown which components of the egg are altered due to the parthenogenetic trait or the role of dams and sires from the parthenogenetic line of quails in these alterations. Therefore, our objective was to determine if the parthenogenetic trait in dams, sires, or both contributes to alterations in egg components, such as yolk, albumen, and shell weights. Two selected lines of quail, 1 line selected for parthenogenesis and 1 line that was unselected for the parthenogenetic trait (control), were utilized in a 2 x 2 factorial arrangement of dam and sire lines to create 4 breeding treatments: control dams + control sires (CC), control dams + parthenogenetic sires (CP), parthenogenetic dams + control sires (PC), parthenogenetic dams + parthenogenetic sires (PP). Daily, fresh eggs were collected, labeled, weighed, and the germinal disc was classified as fertile, unfertilized without development, or parthenote. Yolk, albumen, and shell weights were obtained, and their weights were also calculated as percentage of total egg weight. A dam main effect revealed heavier weights for total egg, yolk, albumen, and shell as well as a larger percentage of albumen and ratio of albumen to yolk in parthenogenetic line dams versus control line dams. However, the percentage of yolk was higher for control than parthenogenetic line dams. The increase in total egg and egg component weights due to the parthenogenetic trait suggests that the transit time of the egg through the oviduct is altered. Perhaps transit through the magnum and uterus is delayed the most yielding greater albumen and shell weights, respectively.
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dos Santos M, Ramachandran R, Kiess A, Wamsley K, McDaniel C. Impact of in vitro inoculation and dietary supplementation with Bacillus subtilis on sperm quality of aged White Leghorn roosters. J APPL POULTRY RES 2018. [DOI: 10.3382/japr/pfx072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Wierzbicki A, Kohli M, Patel K, McMahon Z, Ramachandran R, Crook M, Reynolds T. Pro-protein subtilisin kexin-9 (PCSK9) inhibition in practice: Lipid clinic experience in 2 contrasting UK centres. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ramachandran R, Prakash G, Viswanathamurthi P, Malecki J. Ruthenium(II) complexes containing phosphino hydrazone/thiosemicarbazone ligand: An efficient catalyst for regioselective N-alkylation of amine via borrowing hydrogen methodology. Inorganica Chim Acta 2018. [DOI: 10.1016/j.ica.2018.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ramachandran R, McDaniel CD. Parthenogenesis in birds: a review. Reproduction 2018; 155:R245-R257. [PMID: 29559496 DOI: 10.1530/rep-17-0728] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 03/19/2018] [Indexed: 01/20/2023]
Abstract
Parthenogenesis or 'virgin birth' is embryonic development in unfertilized eggs. It is a routine means of reproduction in many invertebrates. However, even though parthenogenesis occurs naturally in even more advanced vertebrates, like birds, it is mostly abortive in nature. In fact, multiple limiting factors, such as delayed and unorganized development as well as unfavorable conditions developing within the unfertilized egg upon incubation, are associated with termination of progressive development of parthenogenetic embryos. In birds, diploid parthenogenesis is automictic and facultative producing only males. However, the mechanisms controlling parthenogenesis in birds are not clearly elucidated. Additionally, it appears from even very recent research that these mechanisms may hinder the normal fertilization process and subsequent embryonic development. For instance, virgin quail and turkey hens exhibiting parthenogenesis have reduced reproductive performance following mating. Also, genetic selection and environmental factors, such as live virus vaccinations, are known to trigger the process of parthenogenesis in birds. Therefore, parthenogenesis has a plausible negative impact on the poultry industry. Hence, a better understanding of parthenogenesis and the mechanisms that control it could benefit commercial poultry production. In this context, the aim of this review is to provide a complete overview of the process of parthenogenesis in birds.
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Muthu V, Ramachandran R, Nada R, Kumar V, Rathi M, Kohli HS, Jha V, Gupta KL, Sakhuja V. Clinicopathological Spectrum of Glomerular Diseases in Adolescents: A Single-center Experience over 4 Years. Indian J Nephrol 2018. [PMID: 29515296 PMCID: PMC5830804 DOI: 10.4103/ijn.ijn_239_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The spectrum of biopsy-proven glomerular disease was studied from a single center in Northwestern India, among adolescents aged 13–19 years. From January 2009 to December 2012, a total of 177 patients with biopsy-proven glomerular disease were studied. The same pathologist reported all the biopsy specimens after subjecting to light, immunofluorescence, and electron microscopy. The clinical profile and laboratory findings of the patients were correlated with the histopathological spectrum of glomerular diseases. Males formed 71.19% (n = 126) and the remaining 28.81% (n = 51) were females. Lupus nephritis had a strong female predominance, whereas minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) had a male predominance. Nephrotic syndrome was the indication for biopsy in 65% of the cases. Rapidly progressive renal failure and acute nephritis were the next common indications accounting for 14% and 7%, respectively. FSGS was the most common glomerular disease in adolescents (n = 45, 25.4%). The next common were MCD and lupus nephritis each contributing 21.6% and 10.7%, respectively. Primary glomerular diseases accounted for 84.75% (n = 150) of the total. The remaining 15.25% (n = 27) were attributed to secondary glomerular diseases, of which lupus nephritis was the most common, i.e., in 70.4% patients (n = 19). FSGS was the most common histology in adolescent nephrotic participants (37%). MCD was the next common, found in 31% of nephrotic patients. Electron microscopy changed the diagnosis made by light microscopy and immunofluorescence in 5.6% cases only, and it confirmed the diagnosis in another 21.6%. Kidney biopsy in adolescents is a safe procedure. The spectrum of glomerular diseases in adolescents is different from that seen in adults and smaller children.
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Ramachandran R, Kłos J, Lique F. A new ab initio potential energy surface for the NH-He complex. J Chem Phys 2018; 148:084311. [PMID: 29495767 DOI: 10.1063/1.5023311] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We present a new three-dimensional potential energy surface (PES) for the NH(X3Σ-)-He van der Waals system, which explicitly takes into account the NH vibrational motion. The NH-He PES was obtained using the open-shell single- and double-excitation coupled cluster approach with non-iterative perturbational treatment of triple excitations. The augmented correlation-consistent aug-cc-pVXZ (X = Q, 5, 6) basis sets were employed, and the energies obtained were then extrapolated to the complete basis set limit. Using this new PES, we have studied the spectroscopy of the NH-He complex and we have determined a new rotational constant that agrees well with the available experimental data. Collisional excitation of NH(X3Σ-) by He was also studied at the close-coupling level. Calculations of the collisional excitation cross sections of the fine-structure levels of NH by He were performed for energies up to 3500 cm-1, which yield, after thermal average, rate coefficients up to 350 K. The calculated rate coefficients are compared with available experimental measurements at room temperature, and a reasonably good agreement is found between experimental and theoretical data.
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Maguire CA, Chong H, Ramachandran R, Popoola J, Akhras V, Singh M. Acrodermatitis acidaemica. Clin Exp Dermatol 2018; 43:315-318. [DOI: 10.1111/ced.13369] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2017] [Indexed: 11/29/2022]
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Singh N, Nada R, Rawat A, Sharma A, Sinha SK, Ramachandran R, Kumar V, Kohli HS, Gupta KL, Rathi M. Spectrum of IgG4-related Kidney Disease at a Tertiary Care Center. Indian J Nephrol 2018; 28:209-214. [PMID: 29962671 PMCID: PMC5998721 DOI: 10.4103/ijn.ijn_146_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IgG4-related kidney disease (IgG4 RKD) is increasingly reported with varied manifestations. The present study was carried out to study the spectrum of IgG4 RKD. All patients with renal manifestation associated with conditions known to be associated with IgG4-related diseases (IgG4 RDs), or renal imaging or histology suggestive of IgG4 RKD were included and evaluated further. Patients with known extrarenal IgG4RD were also screened for renal involvement. Out of 40 patients screened over a period of 15 months, IgG4 RKD was diagnosed in 8. Majority were male (87.5%) with mean age being 56 years. Disease spectrum ranged from normal renal function in one to renal failure requiring dialysis in another two patients. Significant proteinuria was uncommon (12.5%) while hematuria was not seen in any patient. Tubulointerstitial nephritis was seen in all four patients who underwent kidney biopsy. Two patients had associated glomerular lesions in the form of immune complex crescentic glomerulonephritis. The most common imaging abnormality was hypodense renal lesions seen in 2 patients. Elevated IgG4 levels had 87.5% sensitivity and 78.3% specificity for IgG4 RKD and levels did not correlate with disease severity. Of 4 patients treated with steroids, 3 showed improvement in renal function. IgG4 RKD is an uncommon disease even at a referral tertiary care center. Elevated IgG4 levels alone are neither sensitive nor specific for the diagnosis of IgG4 RKD, and a combination of clinical, imaging, serological, and histological features are required for diagnosis.
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Sethi J, Ramachandran R, Malhotra P, Nada R, Pinnamaneni VST, Kumar V, Rathi M, Kohli HS, Gupta KL. Plasma exchange in the management of new onset multiple myeloma with cast nephropathy treated with bortezomib based chemotherapy. Nephrology (Carlton) 2017; 22:1035-1036. [DOI: 10.1111/nep.12979] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 12/05/2016] [Indexed: 11/29/2022]
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