- |||||||||| Decadron (dexamethasone) / Merck (MSD)
Therapeutic Plasma Exchange for Severe Hypertriglyceridemia (Exhibit Hall, Orange County Convention Center, West Building) - Oct 13, 2022 - Abstract #KIDNEYWEEK2022KIDNEY_WEEK_2280;
Severe HTG was incidentally found due to workup of white effluent during TPE. It is reasonable to consider TPE as a therapy for severe hypertriglyceridemia pending evaluation and treatment to avoid complication from elevated triglycerides.
- |||||||||| methylprednisolone sodium succinate / Generic mfg.
Multisystem Inflammatory Syndrome in Adults: A Consequence of COVID-19 (Exhibit Hall, Orange County Convention Center, West Building) - Oct 13, 2022 - Abstract #KIDNEYWEEK2022KIDNEY_WEEK_1902;
The decision was made to treat with solumedrol and IVIG...The course and prognosis of renal injury in adults with MIS (MIS-A), however, have not been well described. Our case provides an important insight that even severe renal injury in MIS-A may carry a favorable prognosis with prompt immunomodulatory therapy.
- |||||||||| prednisone / Generic mfg., methylprednisolone sodium succinate / Generic mfg.
Started With the Kidneys, Followed by the Lungs: A Rare Case of Sarcoidosis (Exhibit Hall, Orange County Convention Center, West Building) - Oct 13, 2022 - Abstract #KIDNEYWEEK2022KIDNEY_WEEK_1898;
IV methylprednisolone was started and she underwent kidney biopsy for ARF...She was discharged on 60 mg prednisone daily for 2 weeks followed by a 3-month taper...Lung involvement was absent until steroids were tapered off 3 months later highlighting the importance of closely monitoring lung features if renal sarcoidosis is detected. Given the lack of treatment guidelines, a longer course of steroids for clinically significant renal sarcoidosis may be needed to prevent full-blown lung sarcoidosis.
- |||||||||| ANCA-Systemic Lupus Erythematosus Overlap Syndrome: Case Series (Exhibit Hall, Orange County Convention Center, West Building) - Oct 13, 2022 - Abstract #KIDNEYWEEK2022KIDNEY_WEEK_1545;
Treated with steroids & Cytoxan, followed by maintenance therapy with azathioprine & prednisone...Treated with solumedrol x3 followed by MMF...We recommend that ANCA testing be performed in all patients with lupus nephritis who have crescents on biopsy to test for overlap syndrome. Further studies are needed to identify the standard approach to treatment or if treatment should be tailored to individual patient presentation.
- |||||||||| Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
Outcomes of Idiopathic Membranous Nephropathy: A Single Centre Experience (Exhibit Hall, Orange County Convention Center, West Building) - Oct 13, 2022 - Abstract #KIDNEYWEEK2022KIDNEY_WEEK_1523;
Conclusion We have been unable to identify a difference in outcomes between C+P and Tac immunosuppression treatment regimens. Published literature suggest Rituximab is superior in patients who are PLA2R antibody positive and we are in the process of analysing this in our population.
- |||||||||| Soliris (eculizumab) / AstraZeneca
Bamboozled: Concomitant Lupus Nephritis and Systemic Thrombotic Microangiopathy (Exhibit Hall, Orange County Convention Center, West Building) - Oct 13, 2022 - Abstract #KIDNEYWEEK2022KIDNEY_WEEK_1498;
Definitive data for cessation of eculizumab is not available, but cessation has not resulted in a recurrent flare. Despite a biopsy without typical characteristic full-house staining for LN, the patient responded well to the Euro-lupus protocol and remains with stable kidney function and minimal proteinuria.
- |||||||||| hydralazine hydrochloride / Generic mfg.
A Case of Hydralazine-Induced ANCA-Associated Vasculitis (Exhibit Hall, Orange County Convention Center, West Building) - Oct 13, 2022 - Abstract #KIDNEYWEEK2022KIDNEY_WEEK_1485;
Discussion This case shows the importance of considering the diagnosis of hydralazine ANCA associated vasculitis when treating patients with nephritic syndrome. It also highlights the importance of reconsidering treatment with hydralazine for hypertension or heart failure and reserve it to certain groups of patients with few alternatives.
- |||||||||| Azilva (azilsartan) / Takeda, Entresto (sacubitril/valsartan) / Novartis, ROVI Pharmaceuticals Laboratories
Glomerular Microangiopathy in a Patient With Takayasu Arteritis (Exhibit Hall, Orange County Convention Center, West Building) - Oct 13, 2022 - Abstract #KIDNEYWEEK2022KIDNEY_WEEK_1482;
Thus, while oral prednisolone was started to suppress TA-induced inflammation, azilsartan was replaced with sacubitril valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), for treating refractory hypertension...In the present case, ARNI significantly reduced sBP which might directly contribute to the improvement of proteinuria. ARNI can be potent to control hypertension more effectively than conventional hypertensive agents in TA patients.
- |||||||||| dexamethasone / Generic mfg.
Renally Targeted Nanoparticle Drug Therapy for Rhabdomyolysis-Induced AKI (Exhibit Hall, Orange County Convention Center, West Building) - Oct 13, 2022 - Abstract #KIDNEYWEEK2022KIDNEY_WEEK_1106;
To improve efficacy and specificity we tested the hypothesis that a kidney-specific nanoparticle complexed to cilastatin (Cil) and the renoprotective agent dexamethasone (Dex) would ameliorate RIAKI in mice...Complexing Cil and Dex to H-Dot nanoparticles ameliorates renal functional loss due to RIAKI in mice. Kidney-specific treatment of RIAKI with Cil/Dex/H-Dot may lead to effective, organ and mechanism-targeted therapy, with potential applications beyond RIAKI.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
Hypophysitis in a Patient on Pembrolizumab (Exhibit Hall, Orange County Convention Center, West Building) - Oct 13, 2022 - Abstract #KIDNEYWEEK2022KIDNEY_WEEK_1083;
In a meta-analysis of 31 clinical trials with 7551 patients, the incidence of hypophysitis was only 0.4% with PD-1 inhibitors compared to 3.2% with CTLA-4 inhibitors and 6.4% with combination therapy. Patients may present with nonspecific symptoms such as fatigue, dizziness, and appetite loss, so it is important to have high clinical suspicion for hypophysitis and hormonal deficiencies in patients treated with pembrolizumab.
- |||||||||| Monoclonal Immunoglobulin Deposition Disease in a Young Female (Exhibit Hall, Orange County Convention Center, West Building) - Oct 13, 2022 - Abstract #KIDNEYWEEK2022KIDNEY_WEEK_1082;
The sensitivity of abnormal serum FLC is very high in MIDD, hence is an important marker for both suspicion of disease and remission. Clockwise: IF IgG, LM – Silver - Diffuse mesangial and endocapillary proliferation with lobular accentuation, IF IgG lambda, EM X4000 – Powdery deposits along TBM
- |||||||||| Imlygic (talimogene laherparepvec) / Amgen, Opdivo (nivolumab) / Ono Pharma, BMS, Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
Immunotherapy-Induced Glomerulonephritis: Whodunit? (Exhibit Hall, Orange County Convention Center, West Building) - Oct 13, 2022 - Abstract #KIDNEYWEEK2022KIDNEY_WEEK_1073;
Nivolumab was stopped and he was started on prednisone 60 mg daily and lisinopril...He was treated with rituximab 1 g weekly for 4 weeks, methylprednisolone IV 1 g daily for 4 days...Delayed onset kidney injury from nivolumab cannot be excluded or these findings could be due to T-VEC. T-VEC should be considered a possible cause of immune adverse events.
- |||||||||| Avastin (bevacizumab) / Roche
A Rare Case of Membranoproliferative Glomerulonephritis (MPGN) With Bevacizumab (Exhibit Hall, Orange County Convention Center, West Building) - Oct 13, 2022 - Abstract #KIDNEYWEEK2022KIDNEY_WEEK_1071;
She was previously treated with carboplatin, paclitaxel, docetaxel, bevacizumab and dexamethasone...She was started on prednisone 40mg, tapered in 3 months with improvement in Cr, proteinuria and remained stable despite switching to pembrolizumab and lenvatinib...But her kidney injury was temporally related to bevacizumab and followed discontinuation of dexamethasone suggesting potential development of antibodies to bevacizumab. Therefore, clinicians should be vigilant and practice low threshold for biopsy with patients on bevacizumab for appropriate management.
- |||||||||| Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
Anti-PR3 Positive Pauci-Immune Glomerulonephritis Associated With Immune Checkpoint Inhibitor Therapy and Responsive to Corticosteroid and Rituximab (Exhibit Hall, Orange County Convention Center, West Building) - Oct 13, 2022 - Abstract #KIDNEYWEEK2022KIDNEY_WEEK_1052;
Case Description A 73 year old man was admitted with hemoptysis, nausea and fatigue 5 days after his first cycle of carboplatin, paclitaxel & pembrolizumab for non-squamous cell lung cancer...IV Methylprednisolone 2mg/kg was administered for 5 days followed by rituximab infusions (2 x 1g, 2 weeks apart) and oral prednisolone taper...This case illustrates the importance of kidney biopsy in assessing and managing renal impairment associated with combined chemotherapy/immunotherapy regimens. H&E and trichrome stain showing necrotising crescent.
- |||||||||| Darzalex (daratumumab) / J&J
Looking Beyond the Proteinuria (Exhibit Hall, Orange County Convention Center, West Building) - Oct 13, 2022 - Abstract #KIDNEYWEEK2022KIDNEY_WEEK_1049;
After starting MM treatment, his proteinuria, edema and neuropathy resolved. This case illustrates the need to assess the patient as a whole and not just focus on one organ or syndrome.
- |||||||||| Spikevax (elasomeran) / Moderna, Xevudy (sotrovimab) / GSK, National Institutes of Health, Vir Biotech, National Institute of Allergy and Infectious Diseases
IgA Vasculitis After COVID-19 Vaccination: A Rare but Significant Complication (Exhibit Hall, Orange County Convention Center, West Building) - Oct 13, 2022 - Abstract #KIDNEYWEEK2022KIDNEY_WEEK_911;
Cyclophosphamide was initiated but then stopped due to cytopenias...The course was further complicated by positive COVID testing prior to discharge- he was asymptomatic and received sotrovimab...Thus even in those with known glomerular disease, vaccination should still be recommended. Studies are needed to determine if patients with off-target glomerulopathies can be safely rechallenged with COVID vaccine, whether the course of COVID vaccine-associated disease glomerular lesions mimic the primary glomerular disease and how to optimally manage these patients.
- |||||||||| dexamethasone / Generic mfg.
Review, Journal: New insights on Effects of Glucocorticoids in SARS-CoV-2 infection. (Pubmed Central) - Oct 13, 2022
Alox5 is a regulator and drug target for muscle atrophy, and malotilate is an attractive compound for repurposing studies to treat this disease. For clinical endocrinologists prescribing GCs for their patients, a precise understanding of both the molecular- and cellular-level mechanisms of endogenous and exogenous GCs is imperative, including timing of administration, dosage, duration of treatment, and specific formulations of GCs.
- |||||||||| carfilzomib / Generic mfg., pomalidomide / Generic mfg.
Enrollment closed, Trial primary completion date: Carfilzomib, Pomalidomide, and Dexamethasone in Treating Patients With High-Risk Multiple Myeloma (clinicaltrials.gov) - Oct 13, 2022
P2, N=29, Active, not recruiting,
Not yet recruiting --> Recruiting | Trial completion date: Jan 2030 --> Nov 2033 Recruiting --> Active, not recruiting | Trial primary completion date: Aug 2022 --> Aug 2023
- |||||||||| dexamethasone / Generic mfg.
Journal: Quassinoids from Eurycoma longifolia and their bone formation evaluation in zebrafish, C3H10 cells and silico. (Pubmed Central) - Oct 13, 2022
The current study performed a chemical investigation on the roots of EL, which resulted in the isolation and identification of ten quassinoids (EL-1-EL-10), and then conducted their osteogenic activity evaluations in vivo zebrafish model with or without dexamethasone (Dex) and in vitro C3H10 cell model...The structure-based virtual screening based on the pharmacophores in ePharmaLib, as well as the molecular docking study, implied that the effects of the quassinoids (EL-1-EL-5) on the enhancement of bone formation might be related with improving the content and the activity of androgen through binding with CYP19A, SHBG and AKR1C2, and activating bone metabolism-related ANDR target genes and signal pathways by combining with ANDR directly. Although the assumptions are in silico model-based and further in vitro and in vivo validations are still necessary, we provided a new perspective to explore the potential of EL to be used as an alternative treatment for not only androgen-deficient osteoporosis, but also estrogen-deficient bone loss, by combining with SHBG.
- |||||||||| dexamethasone / Generic mfg., hydrocortisone / Generic mfg.
Retrospective data, Journal, Real-world evidence: Real-world effectiveness of steroids in severe COVID-19: a retrospective cohort study. (Pubmed Central) - Oct 13, 2022
To the best of our knowledge, this is the first case of a child having a paradoxical upgrading reaction following treatment for TB-HLH.Abbreviations ATT: anti-tuberculous therapy; CB-NAAT: cartridge-based nucleic acid amplification test; CECT: contrast-enhanced computed tomography; HLH: haemophagocytic lymphohistiocytosis; NK: natural killer, PUR: paradoxical upgrading reaction; sHLH: secondary HLH. The protective effect of steroid treatment for severe COVID-19 reported in randomised clinical trials was replicated in this retrospective study of a large real-world cohort.
- |||||||||| Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
A RARE CASE OF SERONEGATIVE PULMONARY RENAL SYNDROME () - Oct 12, 2022 - Abstract #CHEST2022CHEST_4996;
The absence of specific markers often leads to delay in diagnosis. It should be considered in cases where you have a high clinical suspicion for vasculitis despite negative auto-immune work-up.
- |||||||||| MYXEDEMA COMA: A LIFE-THREATENING DIFFERENTIAL OF ALTERED MENTAL STATUS () - Oct 12, 2022 - Abstract #CHEST2022CHEST_4994;
CASE PRESENTATION: Patient is a 61 year old female with seizure disorder on sodium valproate who presented to the ED with two weeks of progressively worsening mental status...A diagnosis of myxedema coma was made and treated with IV levothyroxine and IV hydrocortisone... Thyroid studies should be performed in all patients with new-onset psychiatric symptoms, especially those with a history of hypothyroidism.
- |||||||||| methylprednisolone oral / Generic mfg.
Journal: Development and Validation of a UPLC-MS/MS Method for Ultra-Trace Level Determination of Acyl Chloride Potential Genotoxic Impurity in Mezlocillin. (Pubmed Central) - Oct 12, 2022
Thus, we explored a simple esterification approach, which converts CMI into methyl 3-(methylonyl)-2-oxoimidazolidine-1-carboxylate completely by optimizing the reaction temperature and time...The limit of detection and limit of quantification of the method were reached 0.014 and 0.02 ppm, respectively, in the following validation study. A sensitive and specific ultra-performance liquid chromatography tandem mass spectrometry method for ultra-trace level determination of acyl chloride potential genotoxic impurity in mezlocillin drug substance has been successfully established in this study, which will provide a practical quality control tool of mezlocillin.
- |||||||||| Journal: Long-term outcomes and central nervous system relapse in extranodal natural killer/T-cell lymphoma. (Pubmed Central) - Oct 12, 2022
At a median follow-up of 8.4 years, the 5-year overall survival (OS) and progression-free survival (PFS) were 71% and 64%, respectively, in 140 localized ENKTL patients who received radiotherapy-dexamethasone, etoposide, ifosfamide, and carboplatin (RT-DeVIC) in clinical practice...In 80 advanced ENKTL patients, 18 received steroid (dexamethasone), methotrexate, ifosfamide, L-asparaginase, and etoposide (SMILE) chemotherapy as first-line treatment...Our 8-year follow-up revealed the long-term efficacy and safety of RT-DeVIC and SMILE. The risk of CNS relapse is an important consideration in advanced ENKTL.
- |||||||||| dexamethasone / Generic mfg.
Journal: Dexamethasone for Pediatric Critical Asthma: A Multicenter Descriptive Study. (Pubmed Central) - Oct 12, 2022
In this multicenter retrospective study from 49 children's hospitals, dexamethasone prescribing rates appear increasing for pediatric critical asthma. Observed variability in corticosteroid prescribing implies a continued need for controlled prospective comparative analyses to define ideal corticosteroid regimens for pediatric critical asthma.
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