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  1. Article ; Online: Hepatocardiorenal syndrome in liver cirrhosis: Recognition of a new entity?

    Wu, Henry H L / Rakisheva, Amina / Ponnusamy, Arvind / Chinnadurai, Rajkumar

    World journal of gastroenterology

    2024  Volume 30, Issue 2, Page(s) 128–136

    Abstract: Emerging evidence and perspectives have pointed towards the heart playing an important role in hepatorenal syndrome (HRS), outside of conventional understanding that liver cirrhosis is traditionally considered the sole origin of a cascade of ... ...

    Abstract Emerging evidence and perspectives have pointed towards the heart playing an important role in hepatorenal syndrome (HRS), outside of conventional understanding that liver cirrhosis is traditionally considered the sole origin of a cascade of pathophysiological mechanisms directly affecting the kidneys in this context. In the absence of established heart disease, cirrhotic cardiomyopathy may occur more frequently in those with liver cirrhosis and kidney disease. It is a specific form of cardiac dysfunction characterized by blunted contractile responsiveness to stress stimuli and altered diastolic relaxation with electrophysiological abnormalities. Despite the clinical description of these potential cardiac-related complications of the liver, the role of the heart has traditionally been an overlooked aspect of circulatory dysfunction in HRS. Yet from a physiological sense, temporality (prior onset) of cardiorenal interactions in HRS and positive effects stemming from portosystemic shunting demonstrated an important role of the heart in the development and progression of kidney dysfunction in cirrhotic patients. In this review, we discuss current concepts surrounding how the heart may influence the development and progression of HRS, and the role of systemic inflammation and endothelial dysfunction causing circulatory dysfunction within this setting. The temporality of heart and kidney dysfunction in HRS will be discussed. For a subgroup of patients who receive portosystemic shunting, the dynamics of cardiorenal interactions following treatment is reviewed. Continued research to determine the unknowns in this topic is anticipated, hopefully to further clarify the intricacies surrounding the liver-heart-kidney connection and improve strategies for management.
    MeSH term(s) Humans ; Liver Cirrhosis/complications ; Heart ; Cardiomyopathies/etiology ; Cardiomyopathies/therapy ; Hepatorenal Syndrome/etiology ; Hepatorenal Syndrome/therapy
    Language English
    Publishing date 2024-01-30
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2185929-2
    ISSN 2219-2840 ; 1007-9327
    ISSN (online) 2219-2840
    ISSN 1007-9327
    DOI 10.3748/wjg.v30.i2.128
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6039: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Using Digital Health Interventions to Promote Prehabilitation Prior to Kidney Transplantation.

    Wu, Henry H L / Leung, Wing-Yin / Ponnusamy, Arvind / Woywodt, Alexander

    Progress in transplantation (Aliso Viejo, Calif.)

    2024  , Page(s) 15269248241237824

    Language English
    Publishing date 2024-03-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2864264-8
    ISSN 2164-6708 ; 1526-9248
    ISSN (online) 2164-6708
    ISSN 1526-9248
    DOI 10.1177/15269248241237824
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Is home dialysis an optimal option during pregnancy?

    Moore, Louise / Wu, Henry H L / Ponnusamy, Arvind

    Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy

    2023  Volume 28, Issue 3, Page(s) 467–468

    MeSH term(s) Humans ; Pregnancy ; Female ; Hemodialysis, Home/methods ; Pregnancy Complications/therapy ; Adult ; Kidney Failure, Chronic/therapy ; Pregnancy Outcome
    Language English
    Publishing date 2023-12-12
    Publishing country Australia
    Document type Letter
    ZDB-ID 2119809-3
    ISSN 1744-9987 ; 1091-6660 ; 1744-9979
    ISSN (online) 1744-9987
    ISSN 1091-6660 ; 1744-9979
    DOI 10.1111/1744-9987.14095
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5208: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article: Prophylactic ultra-low dose rituximab to maintain remission in relapsing adult minimal change disease.

    Leung, Wing Yin / Wu, Henry H L / Woywodt, Alexander / Ponnusamy, Arvind

    Clinical kidney journal

    2023  Volume 17, Issue 1, Page(s) sfad270

    Language English
    Publishing date 2023-10-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 2655800-2
    ISSN 2048-8513 ; 2048-8505
    ISSN (online) 2048-8513
    ISSN 2048-8505
    DOI 10.1093/ckj/sfad270
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6587: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  5. Article: COVID-19 Infection and Vaccination and Its Relation to Amyloidosis: What Do We Know Currently?

    Leung, Wing-Yin / Wu, Henry H L / Floyd, Lauren / Ponnusamy, Arvind / Chinnadurai, Rajkumar

    Vaccines

    2023  Volume 11, Issue 7

    Abstract: Amyloidosis is a complex disorder characterized by deposited insoluble fibrillar proteins which misfold into β-pleated sheets. The pathogenesis of amyloidosis can vary but can be the result of immune dysregulation that occurs from sustained high ... ...

    Abstract Amyloidosis is a complex disorder characterized by deposited insoluble fibrillar proteins which misfold into β-pleated sheets. The pathogenesis of amyloidosis can vary but can be the result of immune dysregulation that occurs from sustained high inflammatory states, often known as AA amyloidosis. Multi-organ involvement including hepatic, gastrointestinal, renal, cardiac and immunological pathological manifestations has been observed amongst individuals presenting with amyloidosis. The recent global pandemic of severe acute respiratory syndrome coronavirus 2, also referred to as coronavirus 2019 (COVID-19), has been shown to be associated with multiple health complications, many of which are similar to those seen in amyloidosis. Though COVID-19 is recognized primarily as a respiratory disease, it has since been found to have a range of extra-pulmonary manifestations, many of which are observed in patients with amyloidosis. These include features of oxidative stress, chronic inflammation and thrombotic risks. It is well known that viral illnesses have been associated with the triggering of autoimmune conditions of which amyloidosis is no different. Over the recent months, reports of new-onset and relapsed disease following COVID-19 infection and vaccination have been published. Despite this, the exact pathophysiological associations of COVID-19 and amyloidosis remain unclear. We present a scoping review based on our systematic search of available evidence relating to amyloidosis, COVID-19 infection and COVID-19 vaccination, evaluating current perspectives and providing insight into knowledge gaps that still needs to be addressed going forward.
    Language English
    Publishing date 2023-06-24
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2703319-3
    ISSN 2076-393X
    ISSN 2076-393X
    DOI 10.3390/vaccines11071139
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  6. Article ; Online: An Unusual Cause of AKI in a Kidney Transplant Patient with Merkel Cell Cancer.

    Wu, Henry H L / Jeyalan, Vishnu / Ponnusamy, Arvind

    Kidney360

    2021  Volume 2, Issue 12, Page(s) 2040–2041

    MeSH term(s) Acute Kidney Injury/diagnosis ; Carcinoma, Merkel Cell/complications ; Female ; Humans ; Immunosuppressive Agents ; Kidney Transplantation/adverse effects ; Male ; Skin Neoplasms/complications
    Chemical Substances Immunosuppressive Agents
    Language English
    Publishing date 2021-12-30
    Publishing country United States
    Document type Journal Article
    ISSN 2641-7650
    ISSN (online) 2641-7650
    DOI 10.34067/KID.0004472021
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  7. Article ; Online: Concurrent presentation of IgG4-related tubulointerstitial nephritis and ANCA MPO crescentic glomerulonephritis.

    Wu, Henry H L / Wang, Claire C Y / Woywodt, Alexander / Ponnusamy, Arvind

    Clinical nephrology. Case studies

    2022  Volume 10, Page(s) 47–53

    Abstract: Concurrent IgG4-related tubulointerstitial nephritis and anti-neutrophil cytoplasmic antibodies (ANCA) myeloperoxidase (MPO) crescentic glomerulonephritis is an uncommon scenario, and the link between the two conditions, if any, is incompletely ... ...

    Abstract Concurrent IgG4-related tubulointerstitial nephritis and anti-neutrophil cytoplasmic antibodies (ANCA) myeloperoxidase (MPO) crescentic glomerulonephritis is an uncommon scenario, and the link between the two conditions, if any, is incompletely understood. We report the case of a 58-year-old woman who presented with a 2-month history of malaise and joint pain and was found to have acute kidney injury and hemato-proteinuria. Initial immunological tests revealed positive anti-neutrophil cytoplasmic antibodies with a peri-nuclear pattern (pANCA). An enzyme-linked immunoassay (ELISA) for anti-MPO antibodies was also positive, leading to a tentative diagnosis of ANCA-associated small vessel vasculitis with renal involvement. Steroid treatment was commenced, and an urgent kidney biopsy was performed. This showed crescentic glomerulonephritis, but also demonstrated concurrent tubulointerstitial nephritis with a dominance of IgG4-producing plasma cells. Serum IgG4 levels were also elevated. The patient was initially treated with intravenous cyclophosphamide and steroids and then switched to rituximab. When last seen, she was well after 1 dose of rituximab, with kidney function, inflammatory parameters, and serum IgG4 levels returning to normal levels. The concurrent presentation of ANCA-associated vasculitis and IgG4 renal disease is rare with only few cases reported in the literature. More work is needed to understand pathophysiology, outcomes, and management options for this complex scenario.
    Language English
    Publishing date 2022-07-04
    Publishing country Germany
    Document type Case Reports
    ISSN 2196-5293
    ISSN (online) 2196-5293
    DOI 10.5414/CNCS110852
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Thrombotic microangiopathy secondary to recurrent prostate cancer.

    Newton, Joseph / Floyd, Lauren / Ponnusamy, Arvind / Anderton, John

    Clinical nephrology. Case studies

    2021  Volume 9, Page(s) 105–109

    Abstract: An 86-year-old man returned to the UK from Spain with symptoms suggestive of gastrointestinal bleeding. He was found to have an acute kidney injury and thrombocytopenia. Further investigations identified the presence of a microangiopathic hemolytic ... ...

    Abstract An 86-year-old man returned to the UK from Spain with symptoms suggestive of gastrointestinal bleeding. He was found to have an acute kidney injury and thrombocytopenia. Further investigations identified the presence of a microangiopathic hemolytic anemia, supporting the diagnosis of a thrombotic microangiopathy. Differentials included atypical hemolytic uremic syndrome and secondary thrombotic microangiopathy. Thrombotic thrombocytopenic purpura (TTP) and STEC (Shiga toxin-producing
    Language English
    Publishing date 2021-09-10
    Publishing country Germany
    Document type Case Reports
    ISSN 2196-5293
    ISSN (online) 2196-5293
    DOI 10.5414/CNCS110609
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: ​

    James, Joel / Stauss, Madelena / Ponnusamy, Arvind / Myers, Martin

    BMJ case reports

    2020  Volume 13, Issue 6

    Abstract: Serum concentrations of paracetamol are measured to investigate the cause of acute hepatitis, monitor the clearance of paracetamol from the body and to determine if supratherapeutic levels warrant treatment with N-acetylcysteine (NAC). ​A 49-year-old ... ...

    Abstract ​Serum concentrations of paracetamol are measured to investigate the cause of acute hepatitis, monitor the clearance of paracetamol from the body and to determine if supratherapeutic levels warrant treatment with N-acetylcysteine (NAC). ​A 49-year-old man treated for ischaemic colitis developed worsening renal and liver function tests. As part of the investigation of hepatorenal failure, paracetamol levels were requested, which were elevated at 14 mg/L (normal <4 mg/L) resulting in treatment with NAC. Despite treatment, levels of paracetamol remained elevated and the link between hyperbilirubinemia and false-positive paracetamol levels was identified. ​Bilirubin and its by-products have intense absorbance in the ultraviolet and visible regions of the electromagnetic spectrum, causing interference in the enzymatic colorimetric assay most commonly used to measure paracetamol concentration, resulting in false-positive paracetamol levels. Laboratories correct for this interference above a predetermined bilirubin concentration, termed the Icteric Index; however, in our case this interference occurred at a lower level of hyperbilirubinaemia than previously identified as significant. This interaction was found to be more significant at lower bilirubin levels when low or no paracetamol levels were present in the serum, resulting in a change to laboratory practice and development of a 'Sliding Scale' approach to analysis. ​Concurrent bilirubin or Icteric Index measurement is recommended for all laboratories that use the enzymatic colorimetric assay for paracetamol measurement. Lower Icteric Index or bilirubin thresholds are required when low or no paracetamol levels are present in the serum to prevent false-positive paracetamol results. We describe a new 'Sliding Scale' approach to analysis, and highlight an important interaction for clinicians to be aware of.
    MeSH term(s) Acetaminophen/administration & dosage ; Acetaminophen/blood ; Acetylcysteine/administration & dosage ; Analgesics, Non-Narcotic/administration & dosage ; Analgesics, Non-Narcotic/blood ; Colitis, Ischemic/drug therapy ; Colorimetry/methods ; Dimensional Measurement Accuracy ; False Positive Reactions ; Free Radical Scavengers/administration & dosage ; Humans ; Hyperbilirubinemia/blood ; Liver Failure/blood ; Liver Failure/chemically induced ; Liver Failure/diagnosis ; Liver Function Tests/methods ; Male ; Middle Aged ; Reproducibility of Results
    Chemical Substances Analgesics, Non-Narcotic ; Free Radical Scavengers ; Acetaminophen (362O9ITL9D) ; Acetylcysteine (WYQ7N0BPYC)
    Language English
    Publishing date 2020-06-30
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2020-234702
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Etanercept-Induced Anti-Glomerular Basement Membrane Disease.

    Al-Chalabi, Saif / Wu, Henry H L / Chinnadurai, Rajkumar / Ponnusamy, Arvind

    Case reports in nephrology and dialysis

    2021  Volume 11, Issue 3, Page(s) 292–300

    Abstract: Anti-glomerular basement membrane (anti-GBM) disease is a rare form of small-vessel vasculitis that typically causes rapidly progressive glomerulonephritis with or without alveolar haemorrhage. Previously, there has only been one reported case of tumour ... ...

    Abstract Anti-glomerular basement membrane (anti-GBM) disease is a rare form of small-vessel vasculitis that typically causes rapidly progressive glomerulonephritis with or without alveolar haemorrhage. Previously, there has only been one reported case of tumour necrosis factor-α (TNF-α) antagonist-induced anti-GBM disease. Here, we describe the first reported case of etanercept-induced anti-GBM disease. A 55-year-old Caucasian man was referred to our tertiary specialist renal centre with a history of painless macroscopic haematuria. The patient has been receiving weekly etanercept injections over the past 12 months for psoriatic arthropathy. The serum immunology panel results highlighted a significantly raised anti-GBM titre (370.1 U). Etanercept was stopped, and the patient was empirically commenced on pulsed methylprednisolone, cyclophosphamide, and plasma exchange. A renal biopsy showed crescentic glomerulonephritis. Few days after admission, he tested positive for coronavirus disease 2019 (COVID-19), and a decision was made to withhold cyclophosphamide. There was further decline in renal function with hyperkalaemia for which he received 2 sessions of haemodialysis. He was restarted on cyclophosphamide upon discharge. The patient was switched to rituximab treatment afterwards as he developed leucopenia 2 weeks following the commencement of cyclophosphamide. The serum creatinine level continued to improve and remained dialysis-independent. In conclusion, with the increased use of etanercept and other TNF-α antagonists, the prescribing clinician must be aware of the rare but life-threatening drug-induced vasculitis. We recommend careful monitoring of renal indices with the use of this class of medications.
    Language English
    Publishing date 2021-09-21
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2809879-1
    ISSN 2296-9705
    ISSN 2296-9705
    DOI 10.1159/000518984
    Database MEDical Literature Analysis and Retrieval System OnLINE

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