Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ureteral endometriosis is a rare yet important entity that can lead to renal failure due to silent obstruction of the ureter. Awareness of clinical and morphologic features can help in early detection and treatment. We analyzed the clinical, pathologic, and immunohistochemical findings of 7 cases of ureteral endometriosis. Mean age of patients was 51 years. All patients presented with hydroureter, accompanied in the most cases by hydronephrosis. Superimposed pyelonephritis was experienced by 2 of 7 patients. Most patients (4 of 7) had previously undergone total abdominal hysterectomy with bilateral salpingo-oophorectomy. In 6 of 7 cases, endometriosis involved the left ureter. The distal one third of the ureter was involved in 6 cases, whereas the middle third was involved in 1 case. In 4 cases, endometriosis was located extrinsic to the ureter, whereas in 3 cases, the ureter showed intrinsic involvement by endometriosis. One case showed simple endometrial hyperplasia. Surgical management included nephrectomy in 2 cases, distal ureterectomy with reimplantation in 3 cases, ureteral stent placement followed by ureteroureterostomy in 1 case, and relief of ureteral obstruction by resection of pelvic endometrioma in 1 case. Immunostains for cytokeratin-7 (CK7) and progesterone receptor (PR) were positive in all of the cases, whereas immunostains for estrogen receptor (ER) were positive in 83% of cases and immunostains for CK20 were negative in all cases. CA125 immunostains were positive in 67% of cases. The stromal cells were positive for CD10, ER, and PR immunostaining. Our findings suggest that the diagnosis of ureteral endometriosis is preceded in most cases by hysterectomy and bilateral salpingo-oophorectomy, possibly because of prior symptoms related to adenomyosis or pelvic endometriosis and that ureteral endometriosis has a strong predilection for involvement of the lower third of the left ureter. Ureteral endometriosis should be included in the differential diagnosis of obstructive ureteral lesions in women, particularly those involving the lower third of the left ureter, even in postmenopausal patients. Immunostains for ER, PR, CK7, CA125, and CD10 can be helpful in challenging cases.
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PMID:Ureteral endometriosis: clinicopathological and immunohistochemical study of 7 cases. 1853 72

BACKGROUND Urine pregnancy tests are usually performed by women at home and also by healthcare professionals. However, there are several conditions that may cause a false-positive urine pregnancy test, including trophoblast tumors, malignancy, nephrotic syndrome, adenomyosis, tubo-ovarian abscess, and paraneoplastic syndromes. A case is presented of a false-positive urine pregnancy test in a 28-year-old woman with a history of tubal ligation, who had a delayed diagnosis of obstructive pyelonephritis due to renal calculus. CASE REPORT A 28-year-old woman had previously been sterilized by tubal ligation. She presented with acute pyelonephritis associated with a left staghorn renal calculus and was found to have a false-positive urine pregnancy test, which delayed the diagnosis and management of her acute pyelonephritis. On follow-up, she had a negative serum pregnancy test. Abdominal computed tomography (CT) identified a left-sided staghorn calculus resulting in partial ureteric obstruction and hydronephrosis. She was treated with antibiotics, including cefazoline, and a left nephrostomy tube was sited to treat her hydronephrosis. Her pain was initially managed with acetaminophen and hydrocodone. Four days after her initial hospital admission, the patient was stable enough to go home on oral levofloxacin and pain medication. CONCLUSIONS This case of a false-positive urine pregnancy test in a 28-year-old woman with a history of tubal ligation highlights that this association may result in the delay in the diagnosis and treatment of acute pyelonephritis.
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PMID:A Case of a False-Positive Urine Pregnancy Test and Delayed Diagnosis of Obstructive Pyelonephritis. 3221 Feb 20