Volume 4 Issue 2, February 2008

The authors proffer their response to the question previously posed by Joanne Bargman inNature Clinical Practice Nephrology: “Why are rheumatologists treating lupus nephritis?” They argue that rheumatologists are often the first point of call for patients presenting with systemic lupus erythematosus, and that they are also more adept than nephrologists at assessing certain extrarenal manifestations of the disease. Thus, the rheumatologist is ideally placed to design and monitor treatment, with the aid of a nephrologist.

Magnesium ions are essential to all living cells. As the second most abundant intracellular cation, magnesium has a crucial role in fundamental metabolic processes such as DNA and protein synthesis, oxidative phosphorylation, enzyme function, ion channel regulation, and neuromuscular excitability. After presenting an overview of magnesium homeostasis, the authors review the etiologies of hypomagnesemia, with an emphasis on hereditary causes.

It is important that clinicians from both developed and developing countries are familiar with the symptoms of tropical diseases. These conditions are endemic in many regions of the world, and immigration and travel are increasing the frequency with which patients present for care in the developed world. As malaria and leptospirosis are the most widely studied tropical diseases, Visith Sitprija from Thailand frames his presentation around these conditions.

In this article, Segal describes the case of an 89-year-old man with a history of prostate cancer who presented with hyperkalemia and kidney failure. The patient was ultimately diagnosed with acute kidney injury due to both upper and lower urinary tract obstruction. A series of schematic diagrams illustrating an interpretation of the events that occurred in the patient is presented.

Diffuse infiltrative lymphocytosis syndrome (DILS) is an autoimmune syndrome characterized by the oligoclonal expansion of CD8⁺ lymphocytes in response to HIV antigens. Izzedine et al. describe the case of an HIV-infected patient who developed acute granulomatous interstitial nephritis secondary to DILS. The pathogenesis of DILS is unclear, but the clinical spectrum of the disease and its diagnosis and treatment are discussed in detail.