This systematic and meta-analysis aims to evaluate humoral and cellular responses to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine among kidney transplant recipients (KTRs). We conducted a systematic literature search across databases to evaluate seroconversion and cellular response rates in KTRs receiving SARS-CoV-2 vaccines. We extracted studies that assessed seroconversion rates described as the presence of antibody de novo positivity in KTRs following SARS-CoV-2 vaccination published up to January 23rd, 2022. We also performed meta-regression based on immunosuppression therapy used. A total of 44 studies involving 5,892 KTRs were included in this meta-analysis. The overall seroconversion rate following complete dose of vaccines was 39.2% (95% confidence interval [CI], 33.3%–45.3%) and cellular response rate was 41.6% (95% CI, 30.0%–53.6%). Meta-regression revealed that low antibody response rate was significantly associated with the high prevalence of mycophenolate mofetil/mycophenolic acid (p=0.04), belatacept (p=0.02), and anti-CD25 induction therapy uses (p=0.04). Conversely, tacrolimus use was associated with higher antibody response (p=0.01). This meta-analysis suggests that postvaccination seroconversion and cellular response rates in KTRs are still low. And seroconversion rate was correlated with the type of immunosuppressive agent and induction therapy used. Additional doses of the SARS-CoV-2 vaccine for this population using a different type of vaccine are considered.

INTRODUCTION: Acute kidney injury (AKI) is one of the severe complications in dengue hemorrhagic fever, usually occurred in shock. We report an interesting case of AKI in a hemodynamically stable dengue hemorrhagic fever patient. CASE PRESENTATION: An 18-year-old male dengue fever patient referred to our institution in his day eight of illness due to three days of decreased urine output. He was hemodynamically stable with thrombocytopenia, increase in creatinine, positive for Anti dengue IgM, proteinuria, and hematuria. Ultrasound examination showed ascites. He was diagnosed with AKI stage III related to dengue hemorrhagic fever and underwent hemodialysis. A total of four series of hemodialysis and furosemide drip were performed during 12 days of admission and he was finally improved. CONCLUSION: Renal injury might occur in hemodynamically stable dengue hemorrhagic patients. It is a reversible condition; hence, appropriate treatment and close monitoring result in good outcomes
Severe Dengue ; Acute Kidney Injury ; Dengue ; Pyelonephritis ; Hemodynamics

INTRODUCTION: Rheumatoid arthritis (RA) is one of systemic chronic progressive inflammatory disorders based on immunological disharmonies. Poorly controlled systemic inflammation in RA often leads to renal diseases such as secondary amyloidosis. CASE PRESENTATION: A 30-year-old man complained of swelling and tenderness of multiple joints gradually worsened the past 7 years. His laboratory examination showed anemia, positive rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA). C-reactive protein (CRP) was 48.7 mg/L (Normal value is <5 mg/L), increase in serum creatinine and protein was +3 in urine. His estimated glomerular filtration rate (e-GFR) was 58.3 mL/min/1.73 m2 Radiologic examinations of joints revealed features that support the diagnosis of rheumatoid arthritis. Renal biopsy was done revealed amyloid deposit. He was diagnosed with rheumatoid arthritis and secondary renal amyloidosis. CONCLUSION: Early proper diagnosis of RA is important and immunosuppressive drugs might slow disease progression by controlling the inflammatory process We discussed the importance of early diagnosis and the use of better treatment in managing RA to prevent renal amyloidosis.
Amyloidosis ; Arthritis, Rheumatoid ; Early Diagnosis