Browsing by Author "Alves, R"
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- Collagen type IV-related nephropathies in Portugal: pathogenic COL4A5 mutations and clinical characterization of 22 familiesPublication . Sá, MJ; Storey, H; Flinter, F; Nagel, M; Sampaio, S; Castro, R; Araújo, JA; Gaspar, MA; Soares, C; Oliveira, A; Henriques, AC; Costa, AG; Abreu, CP; Ponce, P; Alves, R; Pinho, L; Silva, SE; Moura, CP; Mendonça, L; Carvalho, FPathogenic mutations in genes COL4A3/COL4A4 are responsible for autosomal Alport syndrome (AS) and thin basement membrane nephropathy (TBMN). We used Sanger sequencing to analyze all exons and splice site regions of COL4A3/COL4A4, in 40 unrelated Portuguese probands with clinical suspicion of AS/TBMN. To assess genotype-phenotype correlations, we compared clinically relevant phenotypes/outcomes between homozygous/compound heterozygous and apparently heterozygous patients. Seventeen novel and four reportedly pathogenic COL4A3/COL4A4 mutations were identified in 62.5% (25/40) of the probands. Regardless of the mutated gene, all patients with ARAS manifested chronic renal failure (CRF) and hearing loss, whereas a minority of the apparently heterozygous patients had CRF or extrarenal symptoms. CRF was diagnosed at a significantly younger age in patients with ARAS. In our families, the occurrence of COL4A3/COL4A4 mutations was higher, while the prevalence of XLAS was lower than expected. Overall, a pathogenic COL4A3/COL4A4/COL4A5 mutation was identified in >50% of patients with fewer than three of the standard diagnostic criteria of AS. With such a population background, simultaneous next-generation sequencing of all three genes may be recommended as the most expedite approach to diagnose collagen IV-related glomerular basement membrane nephropathies.
- Much more than a foot dropPublication . Vilela de Oliveira, J; Tribuna, C; Alves, R; Rodrigues, M; Rocha, M; Gonçalves, F
- Strychnine Intoxication: A Case ReportPublication . Lage, A; Pinho, J; Alves, R; Capela, C; Lourenço, E; Lencastre, LStrychnine acts as an inhibitor of post-synaptic neuronal inhibition and intoxication leads to distinct clinical manifestations which may culminate in death. Since its commercialization is prohibited in most countries, cases of strychnine intoxication are now rare. We present a case of an elderly patient who voluntarily ingested a white powder thought to be strychnine. He developed myoclonus, startle response, and episodes of generalized muscle contractions accompanied by respiratory arrest in one occasion. Diazepam, valproic acid and supportive treatments were able to control manifestations, however the patient died after 2 days. Our aim is to alert clinicians that, despite its rarity, strychnine intoxication may still be seen in emergency departments, and clinical outcome can be influenced by rapid recognition and timely institution of adequate treatment.