Summary We sought to review our kidney transplant biopsy experience to assess the incidence, type, presenting symptoms, and timing of renal transplant biopsy complications, as well as determine any modifiable risk factors for postbiopsy complications. This is an observational analysis of patients at the University of Wisconsin between January 1, 2000, and December 31, 2009. Patients with an INR ≥1.5 or platelet counts less than 50 000 were not biopsied. An 18‐gauge needle was used for biopsy. Over the study period, 3738 biopsies were performed with 66 complications (1.8%). No deaths occurred. A total of 0.7% were mild complications, 0.7% were moderate complications, 0.21% were severe complications, and 0.19% were life‐threatening. Most complications occurred within the 4‐h postbiopsy period, although serious complications were often delayed: 67% of complications requiring surgical intervention presented greater than 4 h after biopsy. Biopsy within 1 week of transplant had a 311% increased risk of a complication. Postbiopsy reduction in hematocrit and hemoglobin at 4 h was associated with a complication. In conclusion, life‐threatening complications after renal allograft biopsy occurred in 0.19% of patients. Most complications occurred within 4 h postprocedure; however, many serious complications occurred with a time delay after initially uneventful monitoring. The only clinically significant laboratory predictor of a complication was a fall in the hematocrit or hemoglobin within 4 h. Patients biopsied within a week of transplant were at the highest risk for a complication and should therefore be most closely monitored.

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Coronary CT angiography gives us a good understanding of the variations and anomalies of the anatomy of the coronary arteries. This can be of immense help to the clinician planning interventional procedures.

Background: Accurate etiological diagnosis of seizures in children is important to begin an effective treatment. MRI is an excellent neuroimaging tool that is highly accurate. It helps in diagnosis, determining the treatment protocol and predicting the outcome. Dedicated studies in paediatric population using MRI brain have been even fewer till date in India. Current study aims to find the common etiology of pediatric seizures on MRI in a developing country like India.Methods: Hospital based retrospective study. 105 cases in age group between 0 months to 12 years. Seen between 2014 till date included in the study. All cases underwent MRI.Results: Most common imaging findings were inflammatory granuloma in 10 (9.5%). Other findings were- Hypoxic ischemic encephalopathy (HIE) in 5 (4.7%), cerebral atrophy in 2 (1.9%), focal dysmyelination in 3 (2.8%), calcifying granuloma in 3 (2.8%) and periventricular leucomalacia in 2 (1.9%). Uncommon findings were that of lissencephaly, dysgenesis of corpus callosum, mesial temporal sclerosis, AV malformation, periventricular hemorrhage, schizencephaly, abscess and infarction in one child each (0.9% each). 69 children had no abnormal findings in brain.Conclusions: The commonest etiology of seizures is inflammatory granuloma. Early recognition of potentially treatable diseases helps in timely treatment and arrest of progression of disease. It is highly recommended to use MRI as primary investigation for seizures. Every effort should be made to provide facility of MRI for management of seizures in all parts of India.

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summaryWe report a case of 19 year-old female patient diagnosed as systemic lupus erythematosus (SLE) presented with fever and diffuse cutaneous lesions. During the hospital stay she had acute pneumonia, pleural effusion and respiratory failure, which required intensive care unit (ICU) care and mechanical ventilator support. A fulminant course of the disease, decreased values of complement levels and positive antinuclear antibodies (ANA) in pleural fluid and repeated negative sputum for acid-fast bacillus, blood cultures enabled diagnosis of fulminant lupus pneumonitis. Fulminant lupus pneumonitis is a rare but potentially life threatening complication of SLE. Management requires involvement of multiple specialties and rigorous efforts in reviving the patient.