Disseminated Adenovirus Infection Without Infecting Allograft in Recent Renal Transplant

NKF 2017 Spring Clinical Meetings Abstracts 1528 Steroid Combined Induced CT and Scleroderma Fluoroscopy Renal Guided Crisis Percutaneous Trans109 peritoneal Jaros, Nephrostomy Tube Insertion and Subsequent Antonin Christos Argyropoulos, Kamran Shaffi, DISSEMINATED ADENOVIRUS INFECTION WITHOUT Nephrolithotomy in a Patient withUniversity Left Ectopic Kidney Rawan Al-Odat, Edgar of Pelvic New Mexico, INFECTING ALLOGRAFT INFischer. RECENT RENAL TRANSPLANT: Albuquerque, Ishtiaq Ahmed, NM, Ebadur USA Alisa Rahman, Zahrani. Prince Darpan Gandhi, Kemi Oluwole, Caudell,Tarek Maria Salazar, Prince Mohan. Medical University of South Carolina, Charleston, SC, USA Sultan Military Medical City, Riyadh, Saudi Arabia 154 Acute Renal Failure from Supplement Induced Bile Cast Adenoviruses are increasingly recognized as contributors to 10morbidity Hemorrhagic Shock and solid-organ Hemoperitoneum a Fatal ManiSucessfully Treated with Apheresistransplant as and mortality among recipients. festation can ofJohnson, Granulomatosis with Polyangiitis Presentation be asymptomatic shedding to fatal Caroline Theresa Kinard, Jilldisseminated Adamski, Mira disease recipients. Mortality from disseminated Emadin transplant AlMayo Jaber,Clinic Gaurav Jain, Souheil Saddekni. University Keddis. Hospital, Phoenix, AZ, USA adenovirus disease is as high as 75% in immunocompromised host. of Alabama Hospital, Birmingham, AL, USA 156 ANon-HCV MPGNdominant with Cold Agglutinin 61 year old Cryoglobulinemic white female with autosomal polycystic 13kidney A Rare Case of ANCA Associated Vasculitis infrom a Patient disease (ADPKD) cadaveric transplant 8 –received Association orrenal Cause? Hemolytic Anemia year old Systemic female whoSclerosis died in motor vehicle accident. She received of with Ghassan Kabbach, Rahim Dhanani, Israel Kasago, George basiliximab induction with maintenance immunosuppression of Sadeem Ali, Austin Rice,and Romualdo Talento, Nauman Soryal, mycophenolate Vivek Bose, (MMF) Rafia Chaudhry, Mauricio Monrroy, tacrolimus, prednisone. 49 days postShahid. Carolina University andSheCollege, Vidant Medical Foulkeshe L,East Hongalgi Albany Medical Albany, transplant presented withK.cough and diarrhea. had neutropenia Center, Greenville, NC, (ANC) USA 0.77 K/CUMM; acute kidney with absolute neutrophil count NY, USA with serum creatinine (sCr) of 1.4 mg/dL from baseline sCr 0.9 14injury Atypical Hemolytic Uremic Syndrome Can Present as 159 Zeroelevated Tolerance Gap mg/dL, ASTon 549Anion U/L, and ALT 228 U/L. Chest CT scan Malignant Hypertension and Renal Dysfunction showed diffuse bronchiectasis. MMFCollazo-Maldonado. and tacrolimus were stopped. Sathish Karmegam, Roberto Methodist CMV PCR System, was negative. Colonoscopy showed active colitis Azmir, with Shehzad Ali, Farhang Ebrahimi, Mohammad El Health Dallas, TX, USA biopsy negative for CMV. AST and ALT peakedCenter, to 3515 Staten U/L andIsland, 555 Saadi. Richmond University Medical 160U/L Aldosteronism in Polycystic Kidney Disease: Hypertension respectively. Serum adenovirus PCR was 1.3 billion copies, and NY, USA respiratory panel. She was treated with intravenous was detectedininPlain Hiding Sight 20immunoglobulin An Unusual (IVIG) Causeand of cidofovir. Cast Nephropathy She required hemodialysis, Chandrashekar 1Kashyap, James Lynch Bailey, Frederic 1 2 1 developed respiratory andAnwar septic shock requiring vasopressors. ,Emory Faisal , Nada BaderGA, . University Rawan Al-Odat failure Rahbari-Oskoui. University, Atlanta, USA Autopsy findings revealed extensive necrosis of liver; hepatocyte 2 University of New Mexico,basophilic Albuquerque, USA; of with smudged inclusionsNM, characteristic adenovirus of 161nuclei Recognition of Reverse Pseudohyperkalemia Missouri, Kansas City, adenovirus MO, USAimmunohistochemistry stain. cytopathic effect and positive Siddhartha L. Rein, Joseph A. kidneyKattamanchi, revealed isometricJoshua vacuolization 21Transplant Granulomatous Nephrotic Syndrome of tubular Secondary to Vassalotti. Medicine at Mount Sinai, New epithelium with Icahn tubularSchool necrosis of without viral inclusions. Sarcoidosis Adenovirus York, NY,should USAbe included in differential diagnosis of post Omer Alrawi,hepatitis, Walid hepatic Ibrahim, Nehal Altaie,Infection Nashat Imran, and colitis. 164kidney Hightransplant Anion Gap Metabolicfailure Acidosis Due to 5- Oxoproline occurred first two months of transplant donor kidney did not Yahyawithin Osman Malik.Wayne StateandUniversity, Detroit with Low Dosesuggesting Acetaminophen show viral inclusion novel infection or reactivation of latent Medical Center, Detroit, MI, USA infection poor and therapyOpeyemi remains Oladele, Sobia inNrecipient. Khan,Prognosis Arun isKottarathara, 23challenging A Rare Case reducing of Spontenous Tumor Lysis in a use ofSynrome IVIG, andBrook Sandeepdespite Mallipattu, immunosuppression, Nand K Wadhwa. Stony cidofovir. Patient with Poor-Risk Germ Cell Cancer Medicine, Stony Brook, NY, USA Mohammed Alzubaidi1, Bhavna Bhasin2. 1Medical Univer165 Thrombotic Thrombocytpopenic Purpura in a Patient with sity of South Carolina, Charleston, SC, USA; 2Medical Goodpasture’s Disease: An Uncommon Association 110College of Wisconsin, Milwaukee, WI, USA Aakanksha Khanna, Nicholas Matthew R (RVT) D’Costa, TREATMENT RENALTan, VEIN THROMBOSIS IN 24 DIAGNOSIS Type B AND Lactic AcidosisOF Due to Dialysis-Induced Thiamine Sandra MOF Herrmann. Mayo AND Clinic, Rochester, MN, USA THE SETTING LUPUS NEPHRITIS ANTIPHOSPHOLIPID Deficiency in a Patient with Seminoma Steve (APS):Case Pabloof Garcia, Felix Renneberg, Maanit Kohli, 167 SYNDROME An Unusual Proteinuria with Rapidly Progressive Brigani Amante, Teitelbaum. University ofSaint Colorado Bibu, Navya Kuchipudi,Isaac Anne Van Hoven, Shaunak Dwivedi, Renal Failure Peter’s University Hospital, Brunswick, NJ, USA Hospital, Aurora, CO,New USA Ravkiran Khurana,(RVT) Tushar Thakur,of aAndrew Herman, vein thrombosis is the presence thrombusPresenting in either 25 Renal Autosomal Dominant Polycystic Kidney Disease Natthavat Tanphaichitr. of Rupesh the major Raina, renal veins. Alterations in plasma levelsCleveland of proteins Clinic as a Spontaneous Acute Blood Loss Anemia and HemorAkroninGeneral Akron, OH, USAare considered predisposing involved coagulation and fibrinolysis rhagic forShock its development. is a systemic autoimmune 171 factors Prolonged KetoacidosisAPS Associated with SGLT-2 disorder Inhibition: Ahmad Anjak, K. orGaitonde, A. Malhotra, C.V. Thakar. characterized by venous arterial thrombosis in the presence of A Case Report antiphospholipid antibodies.. Cincinnati VA Medical Center, Cincinnati, OH, USA Jatinder Kohli, Stanley Goldfarb. Hospital of University A 29-year-old female with Systemic for of 3 29 Hypoaldosteronism PresentingLupus withErythematosus Renal Salt (SLE) Wasting Pennsylvania, Philadelphia, years presented with left flank painPA, and USA tenderness. The initial Diseaseof RVT andmade Absence ofandHyperkalemic Hypercholremic clinically confirmed with a CTinscan of the 173 diagnosis An “Atypical” Case of Exit Site Infection Peritoneal Acidosis abdomen. Heparin and warfarin was started. Was found positive for Dialysis Huda Arif, David Leehey. Loyola University Medical APS, her creatinine was 0.59 mg/dl, CRP 42.0 mg/L, ESR 105 mm/hr, Abhilash Koratala, Chornyy, Amir C3Centre, 54mg/dL,Chicago, and C4 9mg/dL. The initial urinalysis showed a Kazory. IL, Volodymyr USA University of Florida, Gainesville, FL, USAkidney biopsy to of 2.6 g/g. We performed 32 protein/creatinine Hypokalemic ratio Metabolic Alkalosis and a Hypertension in the diagnosis as well as to determinate the optimal therapy, 175 establish Severe Acute Kidney Injury from TURP-Associated Heme Blacks which showed diffuse segmental endocapillary and focal extracapillary Pigment Nephropathy 1 1 1 , Huzaif Qaisarglomerulopathy, , Vikas Singhconsistent , Mayurwith K. Patel Arif Asif1and proliferative membranous lupus , 1 Anubhav Behdad Besharatian, Sidney nephritis Class Kumar, IV-S1,and Class V. Therefore, started her on 1Kobrin, Suhsil Mehandru ,weAwais Masud , Loay Indu Sharma 2 Palmer, Matthew Jonathan Hogan. University ofstarted Pennsylmethylprednisolone mg IV University for three days. She was also on Salman . 1Jersey500Shore Medical Center, Seton vania, Philadelphia, PA, USA mycophenolate 500 mg BID as induction therapy. Posteriorly Neptune, the Hall-Hackensack-Meridian School of Medicine, 2 was discharged, on warfarinCollege, indefinitely, prednisone 178 patient A Rare Case of Macrophage Activating Syndrome Albany Medical Albany, NY, 1mg/kg USAwith NJ, USA; daily, hydroxychloroquine, lisinopril and mycophenolate. Renal Failure 33 Management Ischemic Monomelic AtoLong-Term Follow representedNeuropathy: a challenge due the concomitant lupusof Franklin Katherine Chaudhry, Krishna 2 Patients Without Fistula Wang, Ligation nephritis andLam, APS. The treatment of lupusRafia nephritis Class IV-S and 1 1with warfarin Hongalgi, Medical College, Class V requires prompt intervention. Anticoagulation VikasMehta. SinghAlbany , Huzaif Quaisar , NinaAlbany, Jubein2, Arif Asif1,Swati 1 should be initiated 1 to prevent 1 NY, USA symptomatic patients Mayur K. Patel , Indu Sharma , Suhsil Mehandru , Awais In this case to the proteinuria and APS we will 2 due 180 thromboembolism. A Rare1, Case Fibrillary Glomerulonephritis Presenting Loay of Salman . 1Jersey Shore University Medical Masud optwith for lifelong anticoagulation. In addition to the treatment these Hemoptysis Center, Seton Hall-Hackensack-Meridian School of Medipatients require close follow up2to assess response to treatment cine, Neptune, NJ, USA; Albany Medical College, Swathi Lavudi, Chris Webster, Saleha Rizwan, JamesAlbany, Reilly, measuring protein in urine, complement levels, kidney function and NY, Tina USA Ko. Allegheny inflammatory markers ESRHealth and CRP.Network, Pittsburgh, PA, USA A2 A4 A44

37 Amyloidosis Treatment of Presenting Intracardiacwith Mycetoma a Post Renal 181 Nephroticin Syndrome and Transplant Patient of Systemic Nocardiosis with the ComVentricular Hypertrophy SCLERODERMA RENAL CRISIS (SRC) IN THE SETTING OF SYSTEMIC bination Imipenem and Trimethoprim-Sulfamethoxazol Terry Le,ofSCLERODERMA Vittal Chundru, Phani Morisetti. Louisiana SCLEROSIS SINE (ssSSc) IN PREGNANCY: Pablo Garcia,State University Health Sciences Center, Shreveport, LA, USA Shaylika Chauhan, Kohli, Navya Kuchipudi, Shaunak Dwivedi. Ashraf Attia,Maanit Ebadur Rahman, Muddassar Mahboob; Prince SaintSultan Peter’s Military University Hospital, New Brunswick, NJ, USA City, Riyadh, Saudi Arabia 182 Preeclampsia inMedical Association with Mirror Syndrome and A patient with Systemic Sclerosis Sine Scleroderma (ssSSc) must Fetalis Associated with Hypertonic 40 Nonimmune Desalination Hydrops and Polyuria present with Raynaud’s phenomenon, positive ANA, any end organ Saline andLeddy, Vasopressin in Govindasamy, 3 (SRC). Hypervolemic Children Julia Rajesh Jamie A. Green. damage eg.L. Scleroderma Renal Crisis SRC is a rare complication Geisinger Medical Center, Danville, PA, USA of SSc that Scott presents as new-onset hypertension (HTN) and rapidly John Baird. Columbia University College of Physideteriorating function. Corticosteroid may precipitate SCR. cians & renal Surgeons, New York, NY, USA 190 Pancreatic Adenocarcinoma Mimicking Granulomatous with A 27-year-old female initially presented with preeclampsia. She was 43 Polyangitis A Unique Case of Renal Failure in a Patient with Hepatitis C given betamethasone and had premature delivery. She was Sadichhya Lohani, Christopher Iuliana medications Niculescu, Sami Krishna Girgis.and University ofWilliam Okladischarged withBaradhi, anti-hypertensive herZarouk. proteinuria Hospital, Royal Oak,she MI, USA with colitis, homa, Tulsa, OK, USA was Beaumont resolving. Two weeks post-delivery, presented anemia, AKI, andANCA thrombocytopenia. Clinically resembled HUS/TTPGN 193 Irrelevant Pauci Immune Crescentic 44 ‘Calcinosis Cutis’:Negative A Marker of Systemic Calcification inina and was started onRheumatoid plasmapheresis and subsequently prednisone. She aDialysis Man with Arthritis Patient deteriorated, was intubated and started on HD. Since this patient had Dipesh Maan, Mark Bunker, Mary Chester Krishna Baradhi, Girgis. University ofBarbara OklaRaynaud phenomenon andChristopher positive ANA we started herWasko, on captopril Clark. General Hospital, PA, Her USA homa, Tulsa, OK,biopsy USA which for SRC. SheAllegheny had a renal showedPittsburgh, findings of TMA. clinical status improved andInfarction she was discharged on dialysis. 8 on 199 Refractory Hyponatremia in ina a Patient with After Fungating 45 Spontaneous Renal Middle Aged Female months, creatinine stabilized at and we were able to stop dialysis. Metastatic Melanoma Oralthe Contraceptives (OCs) The challenge in this case was differentiating between 2 processes Rui Mao, Thao P Tran, Krishna Baradhi. University of Bashir, Chamberlain Nnamdi Nwaohiri. that Khalid look clinically and pathologically theObialo, same. HUS/TTP is more School ofofInMedicine, Community Tulsa, OK, Morehouse School USA likelyOklahoma, to occur in pregnancy. this patientAtlanta, withMedicine, sine GA, scleroderma USA ssSSc, there wasSurprises: little clinicalDrug clues toRelated point towards The therapy in 46 Colorful UrineSRC. Pigmentation withLow plasmapheresis, eculizamab, steroids are unique to 201 on ‘Lytes: A aRare for captopril Proteinuria Outpatient Clinic, CaseEtiology Series and the specific disease they are treating and may be detrimental to the Kirea Mazzolini, ElieAl Saber, Samaya Qureshi, Sheryl Jaime Baynes-Fields, Lee, Poorvanshi Alag, contradictory diagnosis. Prognosis Jonathan for SRC, according to one Caberto, Rajeev Raghavan. Baylor College of are Medicine, Irfan Ahmed, Sandeep Aggarwal. Drexel University College international study, showed 36% mortality by one year. ACEIs the TX, USA oftreatment Medicine, Philadelphia, PA, USA irrespective of the mainHouston, for SCR and should be prescribed renalParadoxical function. HUS Short acting ACEIsNephritis iswith recommended and should beDisease 204 Interstitial in a Patient with Crohn 48 Atypical in a Patient Inflammatory Bowel titrated up aggressively. The goal is BP control. ESRD is not considered Disease Kelly Beers, Kevin Zarrabi, Yezina Nigatu, Lea until 2 years after onset of SCR and transplant should be deferred tillBaer, Chaitanya Mishra, Maria Dominick Santoriello, Lieberthal. StonyJ. Thomas, Brook Medical Center, Stony that Wilfred time. Ron Lawrence S. Weisberg. Cooper University Brook,Zanger, NY, USA USA Complex Glomerulonephritis 49 Hospital, P-ANCA Camden, Positive NJ, Immune 209 Role of Dialysis in Acute Toxic Associated with Levamisole UseEncephalopathy Secondary to Hyperammonemia 112 Kelly Beers, Arun Kottarathara, Wilfred Lieberthal, Rajeev Gayatri Nair, Rebecca Blonsky, Sevag Demirjian. The Rohatgi.SCLEROSIS Northport VAACUTE Medical Center, Northport, NY, MULTIPLE AND KIDNEY INJURY: Cleveland Clinic Foundation, Cleveland, USA USA CROSS-TALK: ANTIBODY Jason C George, KevinOH, Ho, Geisinger Medical Center,Pneumoperitoneum Danville, PA, USA.asina aRare 212 Massive Patient On CCPD,ofTreated 52 Granulomatous Prostatitis Presentation GranAnti-neutrophil cytoplasmic antibodies (ANCA) are known to exist with CT Guided Needle Aspiration ulomatosis with Polyangiitis in association with inflammatory demyelinating diseases (IDD), such as 1 1 1 Charles Neustein, Patricia Izuchukwu , Rafia Chaudhry Richard Blinkhorn , Loay Anum Bilal multiple sclerosis (MS), optic neuritis,Kachur, and, neuromyelitis opticaNwakoby. 1 positivity 1,2 1 in 3-7% of MS patients. Ocala Health, Ocala, FL, USA (NMO). ANCA has been observed Salman , Elvira Gosmanova . Albany Medical College, 2renal disease has not been previously However, ANCA-associated 213 Relapse of IgA Nephropathy Following an Episode of Albany, NY, USA; Albany Stratton VA Medical Center, reported in the context of IDD. We present a case of ANCA-associated, Rhabdomyolysis Albany, NY, USA crescentic glomerulonephritis in the setting of MS/optic neuritis. Thu-Cuc Nguyen, Izuchukwu Nwakoby. University of 53A 55 Skin Rash:female A Rare Presentation of optic Post-Transplant year-old with history of MS and neuritis in her LymusualCentral state of health developed subacuteOcala, kidney injury as seen on Florida/Ocala Health, FL, USA phoproloferative Disorder routine labs (creatinine 3.0mg/dL, baseline 0.6mg/dL nine months 214 Fibrillary Glomerulopathy and Renal Cell Cancer in a Situs Anum Bilal, Llewellyn Foulke, Suzanne prior). She denied fevers, chills, gross hematuria, rash,Homan, cough or Sungeun Inversus Totalis Patient Kim, David Conti, Loay Rafia Chaudhry. Albany hemoptysis. Additional labs showedSalman, BUN of 26mg/dL, serum albumin Medicaland Center, NY, USA of 3.6mg/dL normalAlbany, electrolytes. Urinalysis microscopic Dmitri Nikolaenko, Mony Fraer. showed University of Iowa hematuria within urine protein/creatinine ratioIA, 3.34. Serology showed Hospital and Clinics, Iowa USA 54 It Runs The Family: A City, Case of Hyperkalemic Periodic perinuclear ANCA (p-ANCA) positivity with a confirmative antiParalysis titer of 32.4. – 12/26 An glomeruli Unfriendly 215 Staphylococcus Pseudintermedius myeloperoxidase Renal biopsy showed Companion withRebecca cellular or Blonsky, fibro-cellular crescents, interstitialThe inflammation, Georges Nakhoul. Clevelandmild Clinic tubular atrophy/interstitial fibrosis andFernandes, paucity of immune on Lee Foundation, Cleveland OH, USA Dmitri Nikolaenko, Shaun Dilek deposits Ince, M. immunofluorescence. She was treated with methylprednisolone 1g IV University of Iowa, Iowa USA – City, Related Peritonitis: First 55 Peritoneal Dialysis Pet BITE for 3Sanders. days followed by oral and prednisone 1mg/kg daily.IA, She was 2 Reportedtreated Casewith ofDisease Rhizobium Infection from subsequently rituximab IVwith weekly x 4 weeks. 218 Minimal Change in375mg/m a Radiobacter Patient Systemic Lupusa LabsErythematosus: 2 months showed a creatinine of 1.8mg/dL. Cat Bite after presentation A Case Report ANCA are known markers of autoimmunity in patients with IDD. Benjamin Bluen, Lukasz Kiljanek, Hans Schlecht, Michelle Odianosen Obadan, Rula Pace, Rajbir However, the clinical significance ofAbdulrahman, their associationJose with such Fuentes, Kyle LarryThe Krevolin. Drexel University Chopra. Saint John’s Episcopal Hospital, Far Rockaway, disorders has yet to beKrevolin, fully elucidated. present case provides a College of PA, USA novelNY, example of Medicine, the potentialPhiladelphia, antibody “cross-talk” that may occur in USA patients with known IDDGlobulin -- an interaction thatAcute can result in clinically 56 Anti-Thymocyte Induced Injury in a 220 Blood Pressure Control After Removal of Kidney Reninin Secreting relevant renal manifestations. Genetic variants of both disorders have Patient with Aplastic Anemia Atrophied Kidney previously been described. Given the association of autoantibodies with bothEshetu ANCA disease and IDD, an increased understanding of the role of Chandrashekar Bohra, Sean Verma, Claude Bassil. UniverObole, Robin Shah, Jason Prosek. Ohio State risk factors, genetic predisposition, toColumbus, clinically defined sity of including South Florida, Tampa,Center, FL, USA University Wexner Medical OH, USA autoimmune disease may aid in identifying the best treatment 57 Immune Complex Glomerulonephritis with Persistently – A Case 221 A Severe but Nonfatal Case of Hypermagnesemia approaches in such patients. Negative ANA Assay Report

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Am J Kidney Dis. 2017;69(4):A1-A105