ABSTRACT C3 glomerulopathies are a rare group of glomerular diseases resulting from excessive activation of the alternative complement pathway. The pathogenesis involves genetic, acquired, or immunologic defects in regulators of the alternative complement pathway. Currently, these diseases have a chronic course with progression to end-stage renal disease in up to 50% of adult patients. We report a case of a young woman who presented with nephrotic syndrome and renal disfunction. During follow-up, the diagnosis of C3 glomerulopathy associated with complement factor I deficiency was established. After relapse of nephrotic proteinuria, immunosuppressive therapy with mycophenolate mofetil and glucocorticoid was added to supportive care. There is no disease-specific therapy for C3 glomerulopathies, and treatment is focused on reducing proteinuria and renal inflammation. Supportive treatment with ACE inhibitors or angiotensin receptor blockers is the first-line therapy. Immunosuppressive therapy with mycophenolate mofetil plus corticosteroids is associated with higher chances of clinical remission and lower risk of kidney failure. Complement targeting therapies, such as eculizumab, avacopan, danicopan, iptacopan, and pegcetacoplan, are being studied as potential new therapeutic options. This article highlights the need for more clinical trials to test new therapeutic agents, as well as to better understand the heterogeneity of the disease and its long-term outcomes.

ABSTRACT Accidental or intentional poisoning and drug overdose are a significant source of morbidity, mortality and health care expenditure worldwide. Extracorporeal removal treatments have been used to treat poisoning for decades and different modalities are available, including hemodialysis, hemofiltration, hemoperfusion, continuous renal replacement therapy and therapeutic plasma exchange. A comprehensive understanding of their purpose is key to choose the right modality for each clinical scenario. Lithium, salicylates, metformin and toxic alcohols are amongst the most common poisons treated with extracorporeal removal. Unfortunately, due to poison characteristics and specific modality limitations, extracorporeal treatments are useful to treat only a small number of poisons. Nevertheless, they have been increasingly used for supportive care in poisoning caused by substances not amenable for removal. Evidence regarding extracorporeal treatment in poisoning is modest. However, its use has been systematically reviewed in several poisons within the last decade by the Extracorporeal Treatment in Poisoning workgroup. The preferred treatment for extracorporeal removal of poisons is intermittent hemodialysis, according to the most recent guidelines and case reports available, as it effectively removes most of the common substances involved in poisoning and corrects electrolytes and acid base imbalances. This narrative review gives an overview of the available extracorporeal modalities used for poisoned patients, reflecting on their main indications and limitations as well as a practical view on the management of the most common poisons found in clinical practice.

Apresentação do projecto Tipo. PT: www.tipo.pt e Portuguese Small Press Yearbook, respectivamente um arquivo online e uma publicação anual sobre livros de artista e edição de autor em Portugal.

Introducing the project Tipo.PT: the online archive www.tipo.pt and the publication Portuguese Small Press Yearbook, on artists' Books and self-editing in Portugal.